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A Pharmacist-Led Practice to Improve Perioperative Glycemic Control in Elective Surgery

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posted on 2023-02-17, 19:36 authored by Nathaniel P. Morin

  

The South Health Campus (SHC) is a tertiary care hospital located in Calgary, Alberta, Canada. It has ~275 inpatient beds and multiple outpatient clinics serving Calgary and Southern Alberta. SHC has team-based pharmacy services coverage, through which the same pharmacist team will cover an inpatient unit and that unit’s corresponding outpatient clinic. For example, the inpatient cardiology pharmacist team also works in the hospital’s outpatient cardiology clinic and the inpatient neurology pharmacist team also works in the neurology outpatient clinic.

Surgical pharmacist team members split their time between the inpatient surgical unit and the outpatient pre-admission clinic (PAC). In the PAC, people with planned surgery are seen by a team of internists, anesthesiologists, nurses, and pharmacists if they have complex medical conditions (e.g., coronary artery disease, inflammatory bowel disease on biologic drug therapy, active cancer, or an indication for anticoagulation therapy). This pre-surgery process is to ensure that patients are medically optimized before surgery and to provide recommendations for perioperative care to the surgeons.

In the PAC, patients with diabetes are given standardized recommendations based on internal guidelines for which oral antidiabetic medications they should take or hold on the morning of surgery and, if applicable, how to adjust their long-acting insulin the day of or night before surgery.

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