Pharmacist intervention to enhance postoperative fluid prescribing practice in an Iraqi hospital through implementation of NICE guideline
| Autor: | Sarah K. Abbood, Ali Azeez Al-Jumaili, Hayder Chasib Assad |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Pharmacist lcsh:RS1-441 Pharmaceutical Science Nice Pharmacy Pharmacy Service Pharmacists mesh:Professional Practice 030226 pharmacology & pharmacy lcsh:Pharmacy and materia medica 03 medical and health sciences Electrolytes Hospital 0302 clinical medicine mesh:Fluid Therapy mesh:Guideline Adherence medicine mesh:Electrolytes Prospective Studies mesh:Pharmacists mesh:Iraq Prospective cohort study health care economics and organizations computer.programming_language Original Research mesh:Body Weight business.industry Incidence (epidemiology) lcsh:RM1-950 Body Weight Professional Practice Guideline medicine.disease mesh:Hospital lcsh:Therapeutics. Pharmacology Emergency medicine Iraq Fluid Therapy Hypernatremia Guideline Adherence medicine.symptom Hyponatremia business Weight gain computer mesh:Pharmacy Service mesh:Prospective Studies Pharmacy Service Hospital |
| Zdroj: | Pharmacy Practice Pharmacy Practice (Granada) v.17 n.3 2019 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname Pharmacy Practice (Granada), Volume: 17, Issue: 3, Article number: 1552, Published: 25 NOV 2019 Pharmacy Practice, Vol 17, Iss 3, p 1552 (2019) |
| ISSN: | 1885-642X |
| Popis: | Objective: The objectives of this study were to evaluate the current practice of postoperative fluid prescribing and assess the effectiveness of pharmacist-led intervention in the implementation of the National Institute of Health and Care Excellence (NICE) fluid therapy guideline in an Iraqi hospital. Methods: The prospective interventional study was conducted at AL-Hilla Teaching Hospital, Babylon, Iraq between November 2017 and July 2018. The study included two phases: The pre-intervention phase with 84 patients and the post-intervention phase with 112 patients. A pharmacist provided training and educational sessions for the hospital physicians and pharmacists about the NICE guideline of fluid therapy. The researcher calculated the amount of given post-operative fluids and compared to the NICE guideline and also measured the patients’ body weight, serum Na, K and creatinine pre-and post-operatively. Results: The pre-intervention phase showed no correlation between the amounts of prescribed fluids and body weight which caused increases in patients’ body weight. In pre-intervention phase, 6% of patients experienced hyponatremia, 19% had hypernatremia and 7.1% had hypokalemia. In the post-intervention phase, abnormal level of electrolytes and patient weight gain decreased significantly. Additionally, the intervention led to a strong correlation between body weight and amount of prescribed fluids in addition to lowering the incidence of electrolyte disturbances. Conclusions: A high proportion of patients in the pre-intervention phase experienced fluid overload, weight gain and electrolyte disturbances when fluid therapy was not prescribed in accordance with the NICE guidelines. The pharmacist-led intervention increased the surgeon awareness of the proper use of the NICE guideline which decreased the incidence of fluid-related complications and the inconsistency of fluid prescribing. Pharmacists can play a critical role to enhance post-operative fluid prescribing and minimize fluid-induced complications. |
| Databáze: | OpenAIRE |
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