The clinical pharmacist’s contributions within the multidisciplinary patient care team of an intern nephrology ward

Objective To describe and evaluate newly implemented clinical pharmacy services and ward round participation on a specialized nephrology ward in a large tertiary care hospital. Method All issues addressed by the clinical pharmacist were systematically collected, and the contributions were classified by type. Where applicable, physicians’ acceptance rates were recorded. The drugs most commonly affected by the clinical pharmacist’s contributions are described. Results A total of 158 clinical pharmacist’s contributions were recorded. Approximately 90% (n = 104) of applicable suggestions (117 out of 158; 74%) were accepted by the treating physicians. Most issues were discussed with physicians (85%); the remaining issues were discussed with nurses and medical students. Antimicrobials, drugs affecting the alimentary system and metabolism, and cardiovascular drugs were among the most commonly affected drugs. Issues concerning dosage and drug-therapy selection were common. The clinical pharmacist was also involved in developing dosing guidelines and performing literature searches. Conclusion The observed effects of a newly implemented clinical pharmacy service on an internal nephrology ward are encouraging; acceptance rates of suggestions and the multidisciplinary appreciation of clinical pharmacy services are high.