Comprehensive Clinical Pharmacy Services Enhance Care of COVID-19 Patients

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ACCP Member Christine Groth, Pharm.D., BCCCP, reports how the University of Rochester Medical Center (URMC) clinical pharmacy staff have collaborated to develop a variety of useful clinical tools for care of COVID-19 patients, including an intensive care unit (ICU) admission order set, an order panel with advanced ICU therapies, a guideline to decrease use of critical medications experiencing shortages, an IV to PO protocol, a supportive care guideline with medication use criteria (e.g., for inhaled epoprostenol, paralytics, DVT prophylaxis), a process to increase safety via infusion pump use outside patient rooms, a care guideline with a protocol to change administration times to bundled care times, recommendations for infusions over boluses (for opioids, sedatives, and steroids), and guidance on aggressive subcutaneous insulin regimens to decrease the need for insulin infusions/hourly glucose checks. URMC pharmacy staff meet with providers daily to give updates on drug shortages/medication use, review patients remotely, provide therapeutic recommendations, and document interventions in the medical record. Clinical pharmacists will also see COVID-19 patients in URMC’s post-ICU home-based rehabilitation telemedicine program to provide medication reconciliation, education, and other follow-up.