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International Journal of Clinical Pharmacy
Erschienen in: International Journal of Clinical Pharmacy 3/2014

01.06.2014 | Research Article

Evidence based development of bedside clinical drug rules for surgical patients

verfasst von: Maya A. Ramrattan, Eveline B. Boeker, Kim Ram, Desiree M. T. Burgers, Monica de Boer, Loraine Lie-A-Huen, Wilhelmina M. C. Mulder, Marja A. Boermeester

Erschienen in: International Journal of Clinical Pharmacy | Ausgabe 3/2014

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Abstract

Background Surgical adverse events constitute a considerable problem. More than half of in-hospital adverse events are related to a surgical procedure. Medication related events are frequent and partly preventable. Due to the complexity and multidisciplinary nature of the surgical process, patients are at risk for drug related problems. Consistent drug management throughout the process is needed. Objective The aim of this study was to develop an evidence—based bedside tool for drug management decisions during the pre- and postoperative phase of the surgical pathway. Setting Tool development study performed in an academic medical centre in the Netherlands involving an expert panel consisting of a surgeon, a clinical pharmacist and a pharmacologist, all experienced in quality improvement. Method Relevant medication related problems and critical pharmacotherapeutic decision steps in the surgical process were identified and prioritised by a team of experts. The final selection comprised undesirable effects or unintended outcomes related to surgery (e.g. pain, infection) and comorbidity related hazards (e.g. diabetes, cardiovascular diseases). To guide patient management, a list of bedside surgical drug rules was developed using international evidence-based guidelines. Main outcome measure 55 bedside drug rules on 6 drug categories, specifically important for surgical practice, were developed: pain, respiration, infection, diabetes, cardiovascular diseases and anticoagulation. Results A total of 29 evidence—based guidelines were used to develop the Bedside Surgical Drug Rules tool. This tool consist of practical tables covering management regarding (1) the most commonly used drug categories during surgery, (2) comorbidities that require dosing adjustments and, (3) contra-indicated drugs in the perioperative period. Conclusion An evidence-based approach provides a practical basis for the development of a bedside tool to alert and assist the care providers in their drug management decisions along the surgical pathway.
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Metadaten
Titel
Evidence based development of bedside clinical drug rules for surgical patients
verfasst von
Maya A. Ramrattan
Eveline B. Boeker
Kim Ram
Desiree M. T. Burgers
Monica de Boer
Loraine Lie-A-Huen
Wilhelmina M. C. Mulder
Marja A. Boermeester
Publikationsdatum
01.06.2014
Verlag
Springer Netherlands
Erschienen in
International Journal of Clinical Pharmacy / Ausgabe 3/2014
Print ISSN: 2210-7703
Elektronische ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-014-9941-x

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