Today in the chart

Intensive care units house some of the sickest patients needing some of the most specialized medications. Still, many of them only have one specialist in ICU conditions on their pharmacist team.

As a result, patients often experience extended wait times for expert care from a pharmacist — because those with general backgrounds can’t tend to critical-care situations, such as determining whether a delirious patient needs to switch medications.

A new study published in the Journal of Clinical Outcomes Management explores the cost-benefit of implementing a training program in common ICU conditions for pharmacists, and the results were extremely positive, researchers say.

The research, led by Liza Barbarello Andrews, a clinical associate professor at Rutgers University’s Ernest Mario School of Pharmacy, followed the success of a new model Andrews put into action at Robert Wood Johnson University Hospital Hamilton, where she is the sole critical care pharmacy specialist.

The model is believed to be the first of its kind. It includes a six-month training program with classroom and clinical work that addresses complications patients face while attached to mechanical ventilators, infectious disease risk, and blood flow management for non-mobile patients.

Thanks to this new level of education, informal input and survey data showed the pharmacists working under Andrews became comfortable providing all patient interventions that previously fell under only her purview. Moreover, they reported higher degrees of professional satisfaction, and other clinicians in the ICU also felt a positive impact. Nurses and physicians observed improvements in pharmacy care, most notably a consistently high level of care even when the specialist was not on duty.

“Before we tried this model, the non-specialty pharmacists in the ICU were often uncomfortable with clinical issues, which sometimes meant going to the bedside to assess the situation,” Andrews said, “As a result, relatively minor issues were frequently escalated with a call to the specialist, who was not always readily available. Our new model effectively empowers all our pharmacists to act as specialists.”

Perhaps the most exciting part of the study? Implementing the new model didn’t cost much and would be feasible for hospitals with limited financial resources.