Describing and measuring the pharmacists’ involvement in dosing and monitoring vancomycin at Tucson Medical Center, a community teaching hospital

Abstract

Specific Aims: To measure the amount of time spent by pharmacists on vancomycin dosing and

monitoring at Tucson Medical Center (TMC).

Methods: This is a descriptive study that used data obtained through a questionnaire and data collection sheets from pharmacists at TMC from September 18 through October 13, 2017. Pharmacists were eligible to participate in the study if they were working in an inpatient pharmacy setting at this community hospital for at least 24 hours a week and more than 6 months. Data were analyzed by using student t-test to compare between groups. Main Results: Through a questionnaire, pharmacists reported spending an average of 13.5 minutes (SD 6.9) and 9.5 minutes (SD 4.3) for new and continuous vancomycin therapeutic drug monitoring per encounter, respectively. Data collection over a period of 29 days revealed that pharmacists spent a total of 112.33 hours and an average of 3.85 hours per day on vancomycin TDM. In general, pharmacists spent an average of 10.27 minutes (SD 6.76) per encounter and 30.42 minutes (SD 27.53) per patient. The mean time for new (n=163) versus continuous (n=493) vancomycin TDM was 11.7 minutes (SD 5.6) and 9.8 minutes (SD 7.0), respectively, with statistically significant P values of 0.001. The mean time spent per encounter was statistically significant between groups that used a vancomycin calculator (n=323) [13 minutes (SD 7.9)] versus those that did not use a calculator (n=333) [7.6 minutes (SD 3.9); P = 0.001]. Conclusions: The average time spent per patient by the pharmacist for vancomycin therapeutic drug monitoring (TDM) was about half an hour, which supported the prediction for the time spent on vancomycin by pharmacists prior to our study. More time was spent on new-start vancomycin TDM than existing vancomycin drug monitoring. In addition, more time was spent on vancomycin TDM with the use of a calculator.