ABSTRACT
<b>Objective: </b>In the intensive care unit (ICU), drugs are administered in sequence as the conditions of the patient change rapidly, and there are often cases where many injections are administered simultaneously. For this reason, it is important to quickly select the appropriate administration route. In this study, we prepared a quick reference table for incompatibilities of frequently used and highly important injections in the ICU (referred to as the “quick reference table”) that will enable selection of the appropriate administration route, and we investigated the status of use and usefulness of this quick reference table.<br><b>Methods: </b>The drugs included in the quick reference table were extracted from prescription records from May to October 2009, and these were finalized by discussions with the nurses in the ICU. Three reference materials were used: <i>Manual on the Supervision of Injection Preparation </i>(3rd Edition), <i>Data Search on Injection Incompatibilities 2009</i>, and <i>MICROMEDEX</i>®. The survey was conducted with all 12 nurses in the ICU after 4 months of distributing the quick reference table.<br><b>Results: </b>The quick reference table included 57 pharmaceutical items, and compatibility was classified into 10 categories. The quick reference table was prepared as one A3 page for convenience. The retrieval rate of the survey was 100%. The average number of years of practical experience as a nurse was 12.2 years, and 11 out of 12 nurses used the quick reference table. Of the 11 nurses who used the table, 6 answered that it was “very useful,” while 4 answered that it was “useful.” All 11 nurses who used the quick reference table answered that they “consulted the pharmacists less frequently.”<br><b>Conclusion: </b>Satisfactory evaluations were obtained with regard to the details included in the quick reference table, and the table was estimated to be highly useful and important even for ICU nurses with many years of experience. Furthermore, it was suggested that the quick reference table was also useful in reducing the workloads of the pharmacists.
ABSTRACT
<b>Objective</b>: At Kitasato Institute Hospital, Kitasato University (henceforth, the hospital), the first edition of an antimicrobial use guidebook (henceforth, the guidebook) was produced in 2000. This time, the Pharmaceutical Department’s members on the hospital’s Infection Control Committee (ICC) took the lead and revised the guidebook so that it better conforms to clinical conditions and assessed the guidebook they created.<br><b>Methods</b>: A Working Group (WG) consisting of two ICC Pharmaceutical Department members and two members of the Medical Products Information Office staff examined the items to be listed in the guidebook. These items were approved by the ICC and then assigned to physicians and pharmacists to be written up. A questionnaire survey was conducted on the physicians and pharmacists in the hospital as to their assessment of the content and the conditions of use of the guidebook created.<br><b>Results</b>: In the revised edition, “Antimicrobials PK/PD,” “TDM,” “Empiric Therapy for Infections in Each Department,” etc. have been added, the physicians wrote “Empiric Therapy for Infections in Each Department” and everything else was written by the WG. The return rate of the questionnaire was 65.7% (<i>N</i>=99), and the guidebook utilization rate was 75.4%. Frequently viewed items were “List of Antimicrobials Used In-Hospital,” “How to Administer Medication during Decreased Renal Function,” “Empiric Therapy for Infections in Each Department,” etc. by the internal medicine physicians, “List of Antimicrobials Used In-Hospital” and “How to Administer Medication during Decreased Renal Function,” etc. by the surgeons, and “Classification of Antimicrobials,” “List of Antimicrobials Used In-Hospital,” “When Renal Function is Decreased,” “TDM,” and “Empiric Therapy for Infections in Each Department,” etc. by the residents. Furthermore, there were no items deemed “not necessary for inclusion” for a clear reason. As to be expected in this guidebook, 72.3% of all respondents mentioned it was “a source of information on basic antimicrobial use” and next, “a source of information for treating infections outside one’s area of specialty.”<br><b>Conclusion</b>: The items listed in the guidebook are thought to be appropriate, and its usage conditions are also good. As they are specialists on antimicrobials, the pharmacists playing a central role while cooperating with the physicians on the ICC led to the creation of a highly useful guidebook.