The invisible white coat: awareness of pharmacists in a neonatal intensive care unit.

Hospital pharmacists play an important role in improving patient outcomes and have a positive impact on patient safety and survival.1 In one study,1 the following 7 pharmacy services had a statistically significant association with reduced mortality rates: pharmacist participation in medical rounds, pharmacist-provided admission drug histories, drug-use evaluation, in-service education, management of adverse drug reactions, management of drug protocols, and participation on the cardiopulmonary resuscitation team. Pharmacists provide patient-centred care to ensure safe and effective drug therapy. Despite the known benefits in terms of patient outcomes and safety, many patients and their families are unaware that a pharmacist is part of their health care team and are similarly unaware of the services that pharmacists provide. According to the Hospital Pharmacy in Canada 2009/2010 Report,2 of 222 Canadian hospitals, about half (n = 112) reported conducting client satisfaction surveys, and only 27 (24%) of these stated that the survey included a question about speaking to a pharmacist while in hospital. Among hospitals that asked patients and families about speaking with a pharmacist, less than half of the patients remembered speaking with a pharmacist while in the hospital.2 A telephone survey conducted by Alberta Health Services found that 21% of patients remembered speaking to a pharmacist.3 One of the objectives for pharmacy practice in hospitals and related health care settings to be achieved by 2015, as part of the Canadian Society of Hospital Pharmacists’ CSHP 2015 initiative, is that “50% of recently hospitalized patients or their caregivers (family members for example) will recall speaking with a pharmacist while in the hospital”.4 Although the target of 50% is arbitrary, this objective is part of the overarching goal to “increase the extent to which pharmacists in hospitals and related healthcare settings help individual hospital inpatients achieve the best use of medications”.4 The neonatal intensive care unit (NICU) setting provides unique opportunities and challenges for meeting this CSHP 2015 objective. Babies and their families “live” in the NICU for periods of weeks to months. The babies are critically ill, and their health status may change or fluctuate dramatically and quickly. Little information is available regarding the safe and effective use of medications in this patient population. Pharmacists working in NICUs use specialized knowledge and skill sets to ensure effective and safe pharmacotherapy as the babies grow and develop and their health status changes. Families face immense stresses, sometimes with multiple babies (e.g., twins or triplets) receiving treatment, and during their stay meet a multitude of health care providers, all of whom give them information emphasizing different aspects of their baby’s (or babies’) care. The goal of this study was to improve families’ access to and awareness of their babies’ pharmacists. The primary objectives were to increase families’ awareness of the NICU pharmacist and to describe topics that families want to discuss with the NICU pharmacist.