신생아중환자의 안전한 약물사용을 위한 약료서비스
Pharmaceutical Care for Medication Safety in Critically Ill Neonates
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초록
Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.
Abstract
Objective: This study aimed to investigate pharmaceutical care for critically ill neonates and suggest targeted strategies compatible with the Korean health-system pharmacy. Methods: Articles that reported pharmacy practices for critically ill neonates were reviewed. Pharmaceutical care practices and roles of neonatal pharmacists were identified, and criteria were developed for neonates in need of specialized care by clinical pharmacists. Results: Neonatal pharmacists play many roles in the overall medication management pathway. For clinical decision support, multidisciplinary ward rounds, clinical pharmacokinetic services, and consultation for pharmacotherapy and nutrition support were conducted. Prevention and resolution of drug-related problems through review of medication charts contributed to medication safety. Pharmaceutical optimization of intravenous medication played an important role in safe and effective therapy. Information on the use of off-label medicine, recommended dosage and dosing schedules, and stability of intravenous medicine was provided to other health professionals. Most clinical practices for neonates in Korea included therapeutic drug monitoring and nutrition support services. Reduction in medication errors and adverse drug reactions, shortening the duration of weaning medicines, decreasing the use and cost of antimicrobials, and improvement in nutrition status were reported as the outcomes of pharmacist-led interventions. The essential criteria of pharmaceutical care, including for patients with potential high-risk factors for drug-related problems, was developed. Conclusion: Pharmaceutical care for critically ill neonates varies widely. Development and provision of standardized pharmaceutical care for Korean neonates and a stepwise strategy for the expansion of clinical pharmacy services are required.
참고문헌 (46)
- Ohlinger J, "Development of potentially better practices for the neonatal intensive care unit as a culture of collaboration: communication, accountability, respect, and empowerment", Pediatrics, 111, pp.e471~e481 (2003)
- Kaushal R, "Medication errors and adverse drug events in pediatric inpatients", JAMA, 285(16), pp.2114~2120 (2001)
- Dabliz R, "Medication safety in neonates", Am J Perinatol, 29(1), pp.49~56 (2012)
- Jain S, "Medication errors in neonates admitted in intensive care unit and emergency department", Indian J Med Sci, 63(4), pp.145~151 (2009)
- Chappell K, "Potential tenfold drug overdoses on a neonatal unit", Arch Dis Child Fetal Neonatal Ed, 89(6), pp.F483~4 (2004)
- Chedoe I, "Incidence and nature of medication errors in neonatal intensive care with strategies to improve safety : a review of the current literature", Drug Saf, 30(6), pp.503~513 (2007)
- Gray JE, "Medication errors in the neonatal intensive care unit : special patients, unique issues", Arch Dis Child Fetal Neonatal Ed, 89(6), pp.F472~F473 (2004)
- Campino A, "Educational strategy to reduce medication errors in a neonatal intensive care unit", Acta Paediatr, 98(5), pp.782~785 (2009)
- Cordero L, "Impact of computerized physician order entry on clinical practice in a newborn intensive care unit", J Perinatol, 24(2), pp.88~93 (2004)
- Johnson FL, "Neonatal medication surveillance by the pharmacist", Am J Hosp Pharm, 34(6), pp.609~612 (1977)
- Johnson CJ, "Development of a pharmaceutical care system in a neonatal intensive care satellite pharmacy", Am J Hosp Pharm, 50(6), pp.1158~1163 (1993)
- Dice JE, "Standardized versus pharmacist-monitored individualized parenteral nutrition in lowbirth-weight infants", Am J Hosp Pharm, 38(10), pp.1487~1489 (1981)
- Bryant BG, "Clinical pharmacist emerging member of the NICU team", Neonatal Netw, 3(6), pp.40~44 (1985)
- Lobas NH, "Expanding staff pharmacists'responsibilities to maintain pharmacy services in a neonatal intensive-care unit", Am J Hosp Pharm, 48(8), pp.1708~1711 (1991)
- Mills B, "Pharmacist-led Tdap vaccination of close contacts of neonates in a women’s hospital", Vaccine, 32(4), pp.521~525 (2014)
- Simpson JH, "Reducing medication errors in the neonatal intensive care unit", Arch Dis Child Fetal Neonatal Ed, 89(6), pp.F480~F482 (2004)
- Schellack N, "An overview of the time needed to render critical ward services in a neonatal intensive care unit : documenting the activities of a clinical pharmacist : original research", S Afr Pharm J, 78(7), pp.1~3 (2011)
- Mulholland PJ, "Pharmacists as non-medical prescribers: what role can they play? The experience in a neonatal intensive care unit", Eur J Hosp Pharm, 21, pp.335~338 (2014)
- de Jager Z, "What role does the clinical pharmacist play in the neonatal intensive care unit?", S Afr Pharm J, 81(7), pp.22~23 (2014)
- Ragab MH, "Neonatal parenteral nutrition : Review of the pharmacist role as a prescriber", Saudi Pharm J, 24(4), pp.429~440 (2016)
- Dunkley MK, "Neonatal intensive care – an Australian survey of the pharmacist’s role", Aust J Hosp Pharm, 21, pp.104~108 (1991)
- Krzyzaniak N, "A global perspective of the roles of the pharmacist in the NICU", Int J Pharm Pract, 25(2), pp.107~120 (2017)
- Kim SL, "Growth curves and factors associated with growth of premature infants during initial hospitalization", J Kor Soc Health-Syst Pharm, 19(3), pp.243~248 (2002)
- 양혜란, "신생아중환자실에 입원한 미숙아에서영양지원팀 활동의 임상적 의의", Pediatric Gastroenterology, Hepatology & Nutrition, 12(1), pp.39~45 (2009), 대한소아소화기영양학회
- An SH, "Outcomes of a new dosage regimen of amikacin based on pharmacokinetic parameters of Korean neonates", Am J Health Syst Pharm, 71(2), pp.122~127 (2014)
- 박태영, "담당약사의 처방중재활동에 대한 약물유해반응 예방의 비교 분석", 병원약사회지, 31(1), pp.638~643 (2014), 한국병원약사회[DOI]
- Jung JW, "Preliminary study for economic evaluation of clinical pharmacist intervention", J Kor Soc Health-Syst Pharm, 28(4), pp.327~336 (2011)
- 김윤희, "신생아중환자실 전담약사의 임상적 중재에 의한 회피비용 및 절감비용 분석", 병원약사회지, 35(3), pp.281~291 (2018), 한국병원약사회[DOI]
- 오윤경, "신생아 중환자실 영양요법치료에서 약사의 역할과 영향", 한국임상약학회지, 23(2), pp.167~174 (2013), 한국임상약학회
- 도현정, "신생아에서의 Vancomycin 용량 가이드라인 적절성 평가", 병원약사회지, 33(2), pp.130~140 (2016), 한국병원약사회[DOI]
- 최동욱, "신생아중환자의 phenobarbital 용량과 치료약물농도모니터링", 약 학 회 지, 62(1), pp.49~53 (2018), 대한약학회[DOI]
- Kim SL, "Impact of clinical decision support system and clinical pharmacist in pediatrics", J Kor Soc Health-Syst Pharm, 23(2), pp.95~103 (2006)
- Taketomo CK, "Pediatric & Neonatal Dosage Handbook", pp.787~790 (2012), Lexi-Comp
- An SH, "Prevention of medication errors by clinical pharmacist and the computerized decision support system (CDSS) in neonatal intensive care unit", Pharmacotherapy, 29(3), pp.128e~ (2009)
- Pandolfini C, "A literature review on off-label drug use in children", Eur J Pediatr, 164(9), pp.522~528 (2005)
- 배혜정, "단일기관 신생아중환자실에서의 허가외 약물 사용 현황", 병원약사회지, 36(3), pp.325~334 (2019), 한국병원약사회[DOI]
- Al-Turkait A, "Review of drug utilization studies in neonatal units : a global perspective", Int J Environ Res Public Health, 17(16), pp.E5669~ (2020)
- Krzyżaniak N, "Review of drug utilization patterns in NICUs worldwide", J Clin Pharm Ther, 41(6), pp.612~620 (2016)
- Johnson MR, "Development and implementation of a pharmacist-managed, neonatal and pediatric, opioid-weaning protocol", J Pediatr Pharmacol Ther, 19(3), pp.165~173 (2014)
- Willis ZI, "Reducing antimicrobial use in an academic pediatric institution : Evaluation of the effectiveness of a prospective audit with real-time feedback", J Pediatric Infect Dis Soc, 6(4), pp.339~345 (2017)
- Hamdy RF, "Vancomycin use in a level IV NICU", Pediatrics, 146(2), pp.e20192963~ (2020)
- Krzyżaniak N, "The role of the clinical pharmacist in the NICU : a cross-sectional survey of Australian and Polish pharmacy practice", Eur J Hosp Pharm, 25(e1), pp.e7~e16 (2018)
- 안숙희, "신생아중환자의 약동학적 다양성에 영향을 미치는 요인", 한국임상약학회지, 27(2), pp.63~68 (2017), 한국임상약학회[DOI]
- Leopoldino RD, "Drug related problems in the neonatal intensive care unit: incidence, characterization and clinical relevance", BMC Pediatr, 19(1), pp.134~ (2019)
- Nascimento ARFD, "Drug-related problems in cardiac neonates under intensive care", Rev Paul Pediatr, 38, pp.e2018134~ (2020)
- Loureiro CV, "Medication follow-up in newborns with extremely low birthweight", Pharm Pract(Granada), 17, pp.1584~ (2019)