Critical Care and Shock

A pre-printed medication chart in the ICU for patients admitted after coronary artery bypass graft surgery improves prescribing of secondary prevention at hospital discharge

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Objective: To determine whether the introduction of a pre-printed Intensive Care Unit (ICU) drug chart after coronary artery bypass graft surgery (CABG) surgery was associated with an improvement in the rates of prescription of secondary prevention medicines at hospital discharge.
Design: Retrospective cohort study.
Setting: Tertiary cardiothoracic referral hospital in Wellington, New Zealand.
Patient and participants: Seven hundred forty-six CABG surgery patients. Three hundred seventy-one from the year before and 357 from the year after the introduction of the pre-printed ICU cardiac drug chart.
Interventions: A pre-printed ICU medication chart including aspirin, metoprolol, and atorvastatin used on all patients admitted to the ICU following CABG surgery.
Measurements: The primary outcome variable was the proportion of patients prescribed appropriate secondary prevention at hospital discharge. Secondary outcome variables included the proportion of patients receiving each of: aspirin, a beta-blocker, or a statin individually.
Results: Prescribing of appropriate secondary prevention increased from 81.1% to 92.7% following the introduction of the chart, adjusted OR 2.63 (1.53 to 4.50), p<0.001. The association between year of prescription and overall prescribing was mainly due to an increase in the prescription of beta-blockers.
Conclusions: Introduction of a pre-printed ICU cardiac drug chart was associated with an increase in the rates of prescribing of secondary prevention on hospital discharge post-CABG surgery.