Retrospective study evaluates pharmacist impact on medication errors in emergency situations, suggesting improvement in outcomes.
Introduction: In emergent situations, such as rapid responses and cardiopulmonary arrests, the fast-paced environment increases the risk of medication errors, including those related to medication preparation and administration. A medication expert, like a clinical pharmacist, present in these situations, could potentially help with preventing these medication errors. This project aimed to evaluate the implementation and impact of a pharmacy presence in rapid responses and cardiopulmonary arrests at a tertiary academic medical center. Methods: This was a single-center retrospective descriptive study at a tertiary academic medical center between March 2023 and June 2025. Electronic medical record system was queried to retrieve clinical pharmacists’ interventions in rapid responses and cardiopulmonary arrests. Results: In this time period, there was a total of 221 responses with 148 (67.0%) to rapid responses and 73 (33.0%) to cardiopulmonary arrests. Majority of responses were to medicine floors at 124 (56.1%), followed by the intensive care unit at 54 (24.4%), stepdown unit at 36 (16.3%), and inpatient rehab at 7 (3.2%). Interventions documented were as followed: 65 (42.5%) for medication procurement, 34 (22.2%) for dosing recommendations, 27 (17.6%) for medication preparation, 9 (5.9%) for medication initiation, 7 (4.6%) for drug information provided, 6 (3.9%) for medication discontinuation, and 5 (3.3%) for alteplase dosing and administration. Conclusions: This study demonstrated the impact a clinical pharmacist can make in emergent situations including assisting with medication preparation, in dosing recommendations, and assisting ancillary staff. Further research can potentially look at more specific outcomes pre-and post-pharmacist presence, such as time to medication administration and reduction of medication errors.
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Otiker et al. (2026) studied this question.
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