BAR CODE DOCUMENTATION OF PHARMACOTHERAPY SERVICES IN INTENSIVE-CARE UNITS

Bar code technology has been used for 5 years to improve the efficienc y of identifying and documenting clinical pharmacy services at our ins titution. Data for an entire year (1993) were analyzed to quantify the nature and magnitude of pharmacy services provided for critically ill patients in intensive care units (ICU). Patients in the medical (MICU ), respiratory (RICU), intermediate (IMU), and surgical (SICU) units ( 3234/3743 patients, 86%) were reviewed. Clinical interventions and exp ected outcomes were documented by pharmacists using an automated bar c ode system. There were 11,628 pharmacotherapy interventions, 3.6/patie nt; 12/pharmacist work day. Of patients whose drug therapy was reviewe d at least once, 50% (1610/3234) received at least one intervention. T he mean number of interventions/patient was 7.2 in the MICU, 6.1 in RI CU, 3.4 in IMU, and 2.4 in the SICU, corresponding to APACHE III score s of 71.2, 66.2, 42.8, and 43.3, respectively. The majority of interve ntions were to modify dosages of antimicrobial agents, and were perfor med to achieve optimum efficacy (42%) and to minimize toxicity (46.2%) . These data support the necessity for pharmacists to provide individu alized care to critically ill patients.