Characteristics of Critical Care Pharmacy Services in Saudi Arabia

Figures & data

Table 1 Practice Site Information

Practice Site Characteristics	(N=23)
Location	No.	(%)
Central Region	11	47.8
Eastern Region	7	30.4
Western Region	5	21.7
Number of hospital beds
200 beds or less	1	4.4
200–400 beds	3	13
400–600 beds	8	34.8
600–1000 beds	3	13
More than 1000 beds	8	34.8
Hospital Ownership
Private Hospital	1	4.3
Military Hospital	6	26.1
Ministry of Health Hospital	8	34.7
Academic Medical Center	7	30.4
Others	1	4.3
ICU Bed Capacity
10–30	10	43.4
30–100	9	39.1
More than 100	4	17.3
ICU Physician model provided at each practice site
A Closed ICU: Only the ICU attending can be the physician of record for ICU patients	17	73.9
Open ICU: Attending may be any staff physician with hospital admitting privilege, maybe the physician of record for ICU patients.	2	8.7
Combination of both	4	17.4
Type of Pharmacy Practice model implemented at each practice site
Service-based (Assigns the pharmacist to a medical service such as ICU, PICU, CCU)	15	65.2
Unit-based (Pharmacist will cover a geographic area (ie, a nursing unit such as ward 4, ward A)	4	17.4
Pharmacy Mixed (Service- and Unit-based pharmacist)	3	13
Others	1	4.4

Table 2 Types of Medication Use Systems Available to Pharmacists Caring for Critically Ill Patients

	Types of Medication Use Systems	N=23%
1.	Creates and maintains inpatient drug profiles (F)	69.5
2.	Document clinical pharmacy patient care interventions (F)	91.3
3.	Alerts users to drug allergies (F)	65.2
4.	Alerts users to drug-drug interactions (F)	65.2
5.	Interfaces with laboratory data (F)	56.5
6.	Generates a computerized drug administration record (D)	47.8
7.	Provide intravenous admixture information (D)	43.4
8.	Alerts users to drug-food/nutrient interactions (F)	47.8
9.	Alerts users to maximum dosage limits (F)	43.4
10.	Alerts users to drug-disease state interactions (D)	30.4
11.	Interfaces with outpatient drug profiles (D)	43.4
12.	Interfaces with a bedside clinical information system (O)	34.7
13.	Provides direct provider order entry (O)	43.4

Abbreviations: D, desirable; O, Optimal; F, fundamental (according to the categorization of overall critical care services (level I, level II, and level III ICUs).

Table 3 Types of Clinical Activities Performed by Critical Care Pharmacists

Responsibilities		N=23%
1	The pharmacist’s time is dedicated to critical care patients, with few commitments outside the ICU area (F)	86.9
2	The pharmacist prospectively evaluates all drug therapy for appropriate indications, dosage, drug interactions, and drug allergies; monitors the patient’s pharmacotherapeutic regimen for effectiveness and ADEs; and intervenes as needed (F)	95.6
3	The pharmacist identifies ADEs and, assists in their management and prevention, and develops process improvements to reduce drug errors and preventable ADEs (F)	86.9
4	The pharmacist uses the medical record as one means to communicate with other health care professionals and to document specific pharmacotherapeutic recommendations (F)	73.9
5	The pharmacist provides pharmacokinetic monitoring when a targeted drug is prescribed (F)	86.9
6	The pharmacist provides drug information and intravenous compatibility information to the ICU team and uses the regional poison information center when indicated (F)	91.3
7	In conjunction with the clinical dietitian, the pharmacist evaluates all orders for parenteral nutrition and recommends modifications as indicated to optimize the nutritional regimen (F)	56.5
8	The pharmacist documents clinical activities that include but are not limited to, disease state management, general pharmacotherapeutic monitoring, pharmacokinetic monitoring, ADEs, education, and other patient care activities (F)	82.6
9	The pharmacist acts as a liaison between the pharmacy, nursing, and medical staff to educate health professionals regarding current drug-related procedures, policies, guidelines, and pathways (F)	91.3
10	The pharmacist implements and maintains departmental policies and procedures related to the safe and effective use of drugs in the ICU (F)	91.3
11	The pharmacist regularly makes rounds as a member of the multidisciplinary critical care to provide pharmacotherapeutic management for all ICU patients (D)	95.6

Abbreviations: D, Desirable; F, Fundamental (according to the categorization of overall critical care services (level I, level II, and level III ICUs).