Development of a palmtop relational database for providing pharmaceutical care in a tertiary care intensive care unit

Context

Pharmacy is an information intensive profession where increasing responsibilities and demands on time necessitate the effective use of technology.  Personal digital assistants (PDAs) are handheld devices that provide computing and communications abilities.  The purpose of this project was to improve data and information processing in clinical practice by integrating PDAs into the patient care process.

Objectives

To design an electronic template on a PDA for providing pharmaceutical care in the Intensive Care Unit (ICU).  To assess the feasibility of a PDA as a pharmaceutical care monitoring tool.  To automatically generate drug cost savings reports using standard office spreadsheet software.

Setting

A 12-bed Canadian tertiary care intensive care unit.

Design

The current means of providing pharmaceutical care was characterized, software and hardware for replicating paper forms were selected, pertinent data fields were chosen, and a database was developed.  ICU patient data and pharmacists’ recommendations were manually recorded on the PDA.  The feasibility of integrating PDAs into an ICU practice was assessed by subjective user evaluation.

Main Outcome Measures

The outcome measures were the production of an electronic patient monitoring template, a subjective user feasibility assessment and generation of pharmacist initiated drug cost savings reports.

Results

Providing pharmaceutical care in the ICU currently follows the pharmacist’s work-up of drug therapy with paper-based documentation.  Hardware and software selected include a Palm IIIe (Palm Inc.), HanDBase v2.01g, HanDJet 2.4, Microsoft Access 97, and Microsoft Excel 97.  The patient monitoring template design consisted of three sets of linked databases. Using data collected on the PDA, cost savings reports were generated.  The PDA relational database was determined to be a useful pharmaceutical care monitoring tool in the ICU.

Conclusions

We developed a feasible electronic patient monitoring template for providing pharmaceutical care in the ICU and generated cost savings reports from collected data.

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