Effect of a pharmacist-based toxicology consult service on appropriate use of intravenous N-acetylcysteine for acetaminophen toxicity: A retrospective cohort study.
Jonathan A Summerlin, Kellie M Wang, Andre J McMahon, Jeremy A Lund
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引用次数: 0
Abstract
Background: Incorporating clinical pharmacists on the medical team has been associated with fewer medication errors and increased error interception. Due to the logistical complexities of the intravenous (IV) N-acetylcysteine (NAC) regimen for acetaminophen toxicity, many opportunities for medication errors exist. A pharmacist-based toxicology consultation service was implemented at our institution, allowing pharmacists to formally aid in the management of toxicology patients throughout their hospital admission, including those with acetaminophen toxicity. The purpose of this study was to evaluate the effect of a house-wide pharmacist-based toxicology consult service on errors associated with IV NAC treatment for patients admitted with acetaminophen toxicity.
Methods: A retrospective, pre-post cohort study was conducted on patients who received IV NAC for acetaminophen toxicity. The intervention evaluated was the implementation of a pharmacist-based toxicology consult service, known as the pharmacy toxicology team. The primary end point was the incidence of an error associated with IV NAC. An error was defined as the composite of inappropriate dose, administration rate, initiation, continuation, or discontinuation.
Results: Eighty-four patients were included; 30 patients in the pregroup, and 54 patients in the postgroup. Fewer patients experienced an error in the postgroup compared to the pregroup (30% vs 63%, P = 0.003).
Conclusion: The implementation of this unique pharmacist-based toxicology consult service was associated with fewer patients experiencing an error related to IV NAC therapy for acetaminophen toxicity. Application of this data may aid in the justification for development of clinical pharmacist-based toxicology consult services at other institutions.
期刊介绍：
IJCIIS encourages research, education and dissemination of knowledge in the field of Critical Illness and Injury Science across the world thus promoting translational research by striking a synergy between basic science, clinical medicine and public health. The Journal intends to bring together scientists and academicians in the emergency intensive care and promote translational synergy between Laboratory Science, Clinical Medicine and Public Health. The Journal invites Original Articles, Clinical Investigations, Epidemiological Analysis, Data Protocols, Case Reports, Clinical Photographs, review articles and special commentaries. Students, Residents, Academicians, Public Health experts and scientists are all encouraged to be a part of this initiative by contributing, reviewing and promoting scientific works and science.
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