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PSNet: Patient Safety Network
Journal Article

Pharmacist participation on physician rounds and adverse drug events in the intensive care unit.

Leape LL, Cullen DJ, Clapp MD, et al. JAMA. 1999;282:267-70.

The authors report a controlled, before-and-after comparative trial of having an experienced pharmacist participate in the daily rounds of physicians and nurses in an academic intensive care unit. The authors assessed the baseline rate of all adverse drug events (ADEs) and preventable ADEs by chart review and compared rates in the intervention and control units before and after the intervention. The authors found an almost threefold reduction in ADEs per 1000 patient-days with the intervention. Physicians and nurses were highly accepting of the pharmacist’s participation, with physicians accepting 99% of the pharmacist’s suggestions. The authors estimate a total cost savings of $270,000 per year in the 17-bed intervention unit. They assert that no additional resources were consumed because the pharmacist’s time spent on rounds was compensated for by relief from correcting physicians’ orders after they were placed.