Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent
or reduced the medication error.
Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's
file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and
recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis
of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers,
a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of
Medication Error Reporting and Prevention error classification system.
Results: Four of intervention that have the greatest incidence which represent the majority of the cases, and they
were related to: dosage 500 (38.7%), route of administration 300 (23.2%), frequency 100 (7.7%), and
incompatibility 120 (9.3%). The severity of medication errors that was judged as potentially life threatening (67;
5.1%), serious (135; 10.4%), significant (634; 49.1%), and insignificant (454; 35.1%). The acceptance to the
presence and intervention of pharmacist was as follow: senior physicians 75%, permanent physicians 20%, resident
physicians 77%, and nurses 30%.
Recommendation: Hospitals should contemplate assigning well-trained knowledgeable, efficient and skilled ED
clinical pharmacists to prospectively review medication orders whenever clinically possible. It is also recommended
that each hospital performs acquainted analysis of medication errors occurring in its ED, in order to determine
their origin and then establish the necessary ED-based clinical pharmacy services. The sets of actions needed to
provide such services, as well as the skills, which their ED pharmacists must possess or acquire in order to be
capable of producing desired outcomes
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(6)
(5)
Despite the multiplicity of institutions contributing to the decision-making process in the United States of America, they interact to crystallize positions regarding international and strategic situations. The formulation of the national security policy depends on a number of institutions that complement each other in order to achieve an advanced security situation. Thus, the decision reflects the process of interaction of the existing regulatory institutions. This is because the essence of the national security and achieving its requirements also stems from the existence of a coherent system of shared beliefs and principles in the American society. Besides, these elements are the bases for achieving
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