Pharmacy practice resident interventions in the emergency department and associated barriers to further expansion of pharmacy services

The American Society of Health-System Pharmacists released a statement in 2008 promoting the extension of pharmacy services to every hospital emergency department (ED).  Several recently published articles have demonstrated that pharmacists are an asset in the ED in a variety of ways: optimizing medication usage, patient education and adherence, and reducing medication errors. Pharmacist roles are dependent upon the needs of individual hospitals and ED staff.

At Creighton University Medical Center (CUMC), pharmacy practice residents are given the option to complete elective rotations in the ED. Currently there is no dedicated pharmacist presence in CUMC's ED, therefore the residents serve in this function during their one-month rotations. To date, no articles have been published examining the effect of pharmacy practice residents rotating in an ED with no dedicated pharmacist presence.

Objectives: The primary objective of this observational study is to identify the types of interventions made by a pharmacy practice resident and any barriers experienced during the rotation. Benefits of the residents' presence and perceived barriers from the perspective of non-pharmacy ED practitioners will be assessed after all residents have completed their rotations.

Methods: Interventions and barriers were documented from September 1, 2011, through November 30, 2011. All patients presenting to the ED during the hours a pharmacy resident was present were eligible for inclusion. An electronic survey will be utilized to assess the views of the ED practitioners.

Results: A total of 208 interventions were made, 95% percent of which were accepted by the ED practitioners. The most common interventions were provision of drug information, procurement of patient information including medical histories, and dose adjustments. Barriers encountered by residents included lack of dedicated workspace and ED practitioners' unfamiliarity with working with pharmacists. Results of the ED practitioner survey are under investigation. 

Conclusion: Final data analysis and conclusions are underway.