1. PICU Pharmacist Interventions: what can they tell us?
Birmingham Children's Hospital
PICU Pharmacist Interventions: what can they tell us?

2. Birmingham Children’s Hospital PICU
Currently 21 bed & 
1462 patients
8050 pt bed days
Average of 21.4 prescriptions per patient per day
Over 33,000 per year

3. Pharmacist Intervention Form

4. Formulation/ administration Pharmacokinetic issue
The data analysis
287 interventions
102 drugs
591 “types”
Code 21 subdivided
Prematurity
Interaction
Compatibility
Formulation/ administration
Liver impairment
Pharmacokinetic issue
Adverse Drug Reaction
Transcription issue

5. Outcome of Interventions

6. Insulin prescribed and running on patient, 10 times the intended dose.
Example of one of the interventions
Insulin prescribed and running on patient, 10 times the intended dose.

7. National Reporting & Learning System Severity Rating Scale
How would you score it?
No harm
Low harm
Moderate harm
Severe harm
Death

9. Example:
Insulin x 10 fold error.

10. PICU Intervention Index Results

11. Patient harm intervention by day of week
MERP A-D/ no harm MERP E-G/ harm

12. Pharmacist Skills & Knowledge

13. Intervention by drug class

14. What has changed? Attendance on morning and afternoon round
Afternoon admission reviewed timely
Timely supply new therapy
Microbiology MDT review
Pharmacist interventions documented as medication incidents, MDT review
Directed teaching e.g. TPN rates, PK issues
“Drug of the week”/ BNFc adaption