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Impact of a pediatric clinical pharmacist in the pediatric intensive care unit

Krupicka, Marianne I. PharmD; Bratton, Susan L. MD, MPH; Sonnenthal, Karen MS, FNP; Goldstein, Brahm MD, FAAP, FCCM

PEDIATRIC CRITICAL CARE
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Objective  To study the impact of a clinical pharmacist in a pediatric intensive care unit. The goals of the study were to determine the type and quantity of patient care interventions recommended by a clinical pharmacist and to specifically examine cost savings (or loss) that resulted from clinical pharmacist recommendations.

Design  A prospective case series.

Setting  Ten-bed pediatric intensive care unit in a university-affiliated children’s hospital.

Patients  All patients admitted to the pediatric intensive care unit during the study period.

Interventions  None.

Measurements and Main Results  During the 24-wk study period, the pediatric clinical pharmacist documented all interventions that occurred during her shift. She rounded with the pediatric intensive care unit team approximately two times a week and reviewed medication lists daily. Drug acquisition costs were used to calculate drug cost savings. Demographic information was collected on all the patients in the pediatric intensive care unit during the study period.

There were 35 recommendations per 100 patient days. The most common interventions were dosage changes (28%), drug information (26%), and miscellaneous information (22%). The average time spent per day by the clinical pharmacist in the pediatric intensive care unit was 0.73 hrs or 0.02 full-time equivalent. The total cost direct savings for the study period was $1,977. Extrapolated to direct cost savings per year, the total amount saved was $9,135/year or 0.15 full-time equivalent. Indirect savings from educational activities, avoidance of medication errors, and optimization of medical therapies represent an additional nonquantifiable amount.

Conclusion  We conclude that a clinical pharmacist is an important and cost-effective member of the pediatric intensive care unit team.

From the Department of Pharmacy (MIK) and the Division of Pediatric Critical Care (SLB, KS, BG), Department of Pediatrics, Doernbecher Children’s Hospital & Oregon Health Sciences University, Portland, OR.

Supported, in part, by a grant from the American Society of Health-System Pharmacists (AHSP) Research and Education Foundation, Bethesda, MD.

© 2002 by the Society of Critical Care Medicine and Lippincott Williams & Wilkins