STORIMAP
Introduction
Clinical pharmacy services encompass a wide range of activities, including medication counselling, medication reconciliation, bedside dispensing and therapeutic drug monitoring.
- In the context of limited manpower and a high volume of admissions in busy medical wards, prioritizing patient care for optimal pharmacotherapy is crucial.
- Many paediatric patients and healthy adults admitted for acute conditions with short hospital stays may not significantly benefit from a comprehensive pharmacotherapy review.
- By focusing on patients with the greatest need, clinical pharmacists can more efficiently detect drug-related problems, enhancing patient safety and treatment outcomes.
Criteria
Several pharmaceutical assessment tools have been designed and validated to assist pharmacists in identifying patients with higher complexity requiring intensive pharmaceutical care.
- These include the PAST tool from a UK hospital, the Assessment of Risk Tool (ART) from a New Zealand hospital and the DART (Drug-Associated Risk Tool) tool.
- This involved incorporating a scoring system for each criterion to determine the overall patient acuity level (PAL).
- Three Delphi rounds were conducted to finalize the tool, which was subsequently rearranged into the mnemonic "STORIMAP".
- Specific drugs requiring close monitoring
- Therapeutic drug monitoring
- Organ dysfunction
- Specialty care referral
- Intensive/critical care transition
- Medication-related issues
- High alert medications
- Patient-related issues
Summary
STORIMAP has the potential to be a valuable tool for quickly prioritizing patient care after completing the medication history taking and reconciliation (CP1 form), thereby establishing acuity-based pharmaceutical care.
- In daily practice, a rapid assessment of patient care can be achieved by reviewing the chief complain, history of presenting illness, the patient's medication chart, renal and liver function tests and other relevant laboratory investigations.
- Any critical issues identified during this initial assessment warrant a more in-depth evaluation.
- This may include a quick clerking for PAST Scores of 2-6 (comprising completion of CP2 form Parts A, C and D, excluding laboratory investigations) and a full clerking for PAST Scores of 7 and above.
This approach aligns with the principle of resource allocation, recognizing that patients with minimal health issues may not require the extensive attention associated with comprehensive case clerking.
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