Improving adverse drug event detection in critically ill patients through screening intensive care unit transfer summaries

Authors

  • Ananth M. Anthes,

    1. Surgical Intensive Care Unit, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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    • At the time of this study, Dr. Anthes was a Critical Care PGY2 Resident at the University of Pittsburgh Medical Center.
  • Lisa M. Harinstein,

    1. Surgical Intensive Care Unit, Cleveland Clinic, Cleveland, OH, USA
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    • At the time of this study, Dr. Harinstein was a Critical Care PGY2 Resident at the University of Pittsburgh Medical Center.
  • Pamela L. Smithburger,

    1. Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
    2. Medical Intensive Care Unit, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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  • Amy L. Seybert,

    1. Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA
    2. Critical Care and Cardiology Pharmacy Specialty Residencies, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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  • Sandra L. Kane-Gill

    Corresponding author
    1. Pharmacy and Therapeutics, Clinical Translational Science Institute and Critical Care Medicine, Schools for Pharmacy and Medicine, University of Pittsburgh, Pittsburgh, PA, USA
    • Department of Pharmacy, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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  • This research was presented in poster form during the 2011 Society for Critical Care Medicine Annual Congress and the 2011 American College of Clinical Pharmacy fall annual meeting.

Correspondence to: S. L. Kane-Gill, PharmD, MSc, FCCM, FCCP, School of Pharmacy, University of Pittsburgh, 918 Salk Hall, 3501 Terrace St., Pittsburgh, PA 15261, USA. E-mail: SLK54@pitt.edu

ABSTRACT

Purpose

This study aimed to determine the frequency and type of adverse drug events (ADEs) identified in intensive care unit (ICU) transfer summaries and in the hospital discharge summaries to demonstrate the effectiveness of ICU transfer summary surveillance in the identification of ADEs.

Methods

A retrospective electronic medical record review was conducted for medical ICU patients admitted between January 2009 and April 2009 to a large, academic medical center. The Harvard Practice Scale and the modified Leonard Assessment Scale were used to evaluate the presence of an ADE from the ICU transfer and hospital discharge summaries.

Results

Two hundred and fifty-four patients were identified for inclusion with a median medical ICU length of stay of 4.5 days and hospital length of stay of 13 days. The ICU transfer summary review revealed 173 ADEs among 124 unique patients with a rate of 33.9 ADEs per 1000 hospital patient days. Sixty-nine ADEs among 63 unique patients were identified through the hospital discharge summary with a rate of 13.5 ADEs per 1000 hospital patient days. Only 23.1% of ADEs discussed in the ICU transfer summary were also discussed in the hospital discharge summary.

Conclusions

The use of ICU transfer summaries is an effective tool to increase ADE detection. The use of an ICU transfer summary should be considered as an adjunct method to an existing ADE surveillance system for heightened pharmacovigilance. Copyright © 2013 John Wiley & Sons, Ltd.

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