Support Technicians

The ICU CPST performs various data-collection duties consistent with those described previously in the literature, including obtaining, organizing, and distributing patient profiles, related material, and support documentation for the clinical pharmacy specialist. While a patient is under the care of one of the ICU teams, the CPST monitors day-to-day progress by tracking targeted patient-specific parameters and transferring the information to the monitoring form used by the clinical pharmacy specialist. This allows the clinical pharmacy specialists to focus on interpreting the data, rather than collecting it. Data collected for each ICU patient includes the following: demographic characteristics on admission, reason for admission, visit history, medication- related allergies, and list of medications before admission, as documented in PharmaNet (a provincial database containing data about prescriptions dispensed in BC community pharmacies). The CPST ensures that a hard copy of the PharmNet documentation is included with the patient monitoring form and is inserted into the patient’s medical record. The CPST also monitors information about intravascular devices, such as time of placement, location, and type of access (e.g., central or arterial lines), and availability of a urine catheter or nasogastric or orogastric tubes. In addition, medication information for each patient, such as drug, dose, route, frequency, and start and stop dates, is collected daily by the CPST and transferred to the standard monitoring form. This activity is critical because of the unit’s current lack of a computer-generated medication administration record. Various predefined laboratory and microbiological parameters, such as electrolytes, hematology and liver profile, coagulation parameters, and culture and sensitivity results, are also updated by the CPST on the patient monitoring form. These data are collected at the start of the day, after patient care rounds, and on an as-needed basis.

Any new abnormalities in laboratory parameters, especially those reported at a predefined critical value requiring action, or results of new microbiological cultures arising from regular checks throughout the day are brought to the attention of a clinical pharmacy specialist immediately and highlighted on the patient monitoring form. This allows the pharmacist to make drug-related decisions based on the most up-to-date information. cialis professional

Therapeutic Drug Monitoring

The CPST is trained to assist in providing therapeutic drug monitoring services for medications such as vancomycin, aminoglycosides, phenytoin, digoxin, and any other medication for which monitoring is requested by the clinical pharmacy specialist. Patient-specific information about these drugs is collected by the CPST and transcribed to a standardized therapeutic drug monitoring form (see Online Appendix 2, at www.cjhp-online.ca/index.php/cjhp/issue/view/72/showToc). Therapeutic drug monitoring for a particular drug is performed daily for as long as the patient is receiving the medication. Other information collected includes trends from blood work, vital signs, medication administration times, serum drug concentrations, any documented seizure activity (for patients receiving an anticonvulsant), and any sources of cooling (such as antipyretics for patients who are taking antibiotics). This activity requires the CPST to review each patient’s medical record and daily flow sheet and to interact with other health care professionals. The clinical pharmacy specialists are notified immediately when a serum drug concentration becomes avail­able and in any instance of predefined critical values or missing doses, and the information is highlighted in the therapeutic drug monitoring form. The clinical pharmacy specialist benefits from this support activity because all pertinent information is up to date and readily available when a decision is needed regarding a patient’s drug therapy. In addition, most information required for a detailed clinical pharmacy note can be obtained from the therapeutic drug monitoring and patient monitoring forms. canadian pharmacy support net