Appropriateness of Stat Medication Orders across Emergency Department, Intensive, and Non-intensive Care Units at Srinagarind Hospital, Khon Kaen University

Abstract

Background  and  objective: Stat  medication  orders  are  intended  for  emergency  situations  requiring  drug  administration within 30 minutes. However, inappropriate overuse has increasingly been observed. This study evaluated  the  patterns  and  appropriateness  of  stat  medication  orders  across  the  emergency  department,  intensive care units, and non-critical care wards. The findings are intended to inform the optimization of stat medication criteria and urgent medication management systems.

Methods: A retrospective descriptive study was conducted at Srinagarind Hospital from January to June 2024. The study specifically focused on stat order data recorded in the hospital information system, and evaluated appropriateness  based  on  the  statdrug  formulary  criteria  of  Srinagarind  Hospital  (not  based  on  individual  clinical indications)

Results: A total of 327,361 stat medication orders were identified: 15,235 orders (%4.65) from the emergency department, 138,069 orders (%42.18) from intensive care units, and 174,057 orders (%53.17) from non-critical care wards. Overall, 167,148 orders (%51.06) met the established criteria, with the highest proportion observed in intensive care units. A total of 160,213 orders (%48.94) were deemed inappropriate, most commonly in the emergency department. Non-critical care wards had the highest proportion of inappropriate medication items. Workload analysis revealed a marked disparity across shifts: the morning shift had the lowest burden at 45orders per pharmacist, whereas the afternoon and night shifts carried substantially higher workloads at322 and 272 orders per pharmacist, respectively.

Conclusions: Stat  medication  orders  were  extensively  utilized,  with  nearly  half  failing  to  meet  established  criteria,  this  may  impact  workload,  particularly  during  off-hours. Revision  of  stat  medication  criteria  and  implementation of clinical decision support systems are recommended to reduce inappropriate use.