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Gjone H, Burns G, Teasdale T, Hattingh HL. Exploring pharmacists' perspectives on preparing discharge medicine lists: A qualitative study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 9:100225. [PMID: 36817331 PMCID: PMC9932125 DOI: 10.1016/j.rcsop.2023.100225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 12/20/2022] [Accepted: 01/17/2023] [Indexed: 01/26/2023] Open
Abstract
Background Hospital pharmacists play an important role in the discharge process, including conducting medicine reconciliation, counselling patients or carers, and generating discharge medicine lists. These contribute to medicine handover at transition of care from hospital discharge. However, pharmacists face numerous barriers to providing comprehensive discharge services. Aim To gain a deeper understanding of the hospital pharmacists discharge processes. Method Qualitative study design was used to explore pharmacists' experiences and opinions regarding (1) the use of technology and software to prepare patient discharges, (2) involvement of pharmacy assistants in discharge processes, and (3) challenges and facilitators in preparing patient discharges. An independent researcher conducted semi-structured interviews with 15 pharmacists between 29 October and 22 December 2021 (mean interview 21 min). Interview transcriptions were analysed using thematic analysis. Results Interviews revealed four overarching themes: patient safety, staff involved in discharge processes, discharge handover procedures and electronic health software. Barriers to completing discharges included staff workloads, poor medical record software integration and lack of advanced discharge notice. Good communication between pharmacists and other clinicians, including the presence of a discharge nurse on the inpatient unit, made discharges more efficient, and most pharmacists favoured utilisation of pharmacy assistants in preparing discharge medicine lists. Conclusion Poor integration between medical software systems negatively impacts pharmacists' ability to complete discharge medicine lists. Pharmacists require advance notice of upcoming discharges to effectively prioritise high workloads, while increased utilisation of trained pharmacy assistants may facilitate discharge workflows.
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Affiliation(s)
- Helena Gjone
- School of Pharmacy and Medical Sciences, Griffith University, QLD 4222, Australia,Pharmacy Department, Royal Hobart Hospital, Tasmania, Australia
| | - Gemma Burns
- Pharmacy Department, Gold Coast Health, QLD 4215, Australia
| | - Trudy Teasdale
- Pharmacy Department, Gold Coast Health, QLD 4215, Australia
| | - H. Laetitia Hattingh
- School of Pharmacy and Medical Sciences, Griffith University, QLD 4222, Australia,Pharmacy Department, Gold Coast Health, QLD 4215, Australia,Corresponding author at: Pharmacy Department, Gold Coast Health, QLD, Australia 4215.
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Ntani SN, Tchue NF. Health Care Providers’ Attitude and Satisfaction Toward Patient-Oriented Services Provided by Pharmacy Technicians at Three Faith-Based Hospitals. J Pharm Technol 2022; 38:206-212. [DOI: 10.1177/87551225221097038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Pharmacists and pharmacy technicians often work together to provide optimal pharmacy services, however, some low-middle-income countries lack strong regulatory mechanisms and have an inadequate number of pharmacists, necessitating some hospitals to rely on pharmacy technicians providing direct patient care services. Objectives: This study sort to investigate health care providers’ attitudes and satisfaction toward patient-oriented pharmacy services offered by pharmacy technicians at 3 faith-based hospitals in Cameroon. Methods: A cross-sectional study was conducted from February to April 2021. Self-administered questionnaires were distributed to 159 health care providers (HCPs) in 3 institutions of the Cameroon Baptist Convention Health Services. The questionnaire was made up of 3 parts evaluating HCPs’ attitudes and satisfaction. Results: A total of 140 questionnaires were completed (88.1%) response rate. The majority of respondents were female (70%) and <35 years (60.7%). Almost all respondents showed a positive attitude toward pharmacy technicians’ role in patient education (90%) and provision of medication information (93.6%). However, only 46% agreed that pharmacy technicians should take medication histories. The majority of respondents were satisfied with overall pharmacy services (80.7%). Only 25% were satisfied with pharmacy technicians’ participation in ward rounds. Gender was associated with attitude of respondents ( P = 0.02). Factors associated with satisfaction of respondents included profession ( P = 0.047) and work experience ( P = 0.008). Conclusions: Our results revealed a positive attitude and overall satisfaction with technician-led patient-oriented pharmacy services. Additional training, clear job descriptions, and direct pharmacist supervision could ensure the quality and safety of these services.
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Iheanacho CO, Adeyeri O, Eze UI. Evolving role of pharmacy technicians in pharmaceutical care services: Involvement in counselling and medication reviews. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 5:100113. [PMID: 35478530 PMCID: PMC9029913 DOI: 10.1016/j.rcsop.2022.100113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/01/2022] [Accepted: 02/01/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Chinonyerem O. Iheanacho
- Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Cross River State, Nigeria
- Corresponding author at: Department of Clinical Pharmacy and Public Health, University of Calabar, Cross River State PMB 1115, Nigeria.
| | - Oluwakemi Adeyeri
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
| | - Uchenna I.H. Eze
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Ogun State, Nigeria
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Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study. Int J Clin Pharm 2022; 44:1028-1036. [PMID: 35761018 PMCID: PMC9243950 DOI: 10.1007/s11096-022-01436-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 05/23/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND : Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from hospital. Hospital pharmacists play an important role in preparing these lists although this process is time consuming. AIM : To measure the time required by hospital pharmacists to complete the various tasks involved in discharge medicine handover. METHOD : Time-and-motion study design was used to (1) determine the time involved for pharmacists to produce discharge medicine lists, (2) explore how pharmacists utilise various software programs to prepare lists, and (3) compare the time involved in discharge medicine handover processes considering confounding factors. An independent observer shadowed 16 pharmacists between 22 February and 12 March 2021 and recorded tasks involved in 50 discharge medicine handovers. Relevant information about each discharge was also collected. RESULTS : Pharmacists observed represented a range of practice experiences and inpatient units. Mean time to complete discharges was 26.2 min (SD 13.6), with over half of this time used to check documentation and prepare discharge medicine lists. A mean of 4.0 min was spent on manually retyping and reconciling medicine lists in different software systems. Medical inpatient unit discharges took 4.6 min longer to prepare compared to surgical ones. None of the 50 discharges involved support from pharmacy assistants; all 50 discharges had changed or ceased medicines. CONCLUSION : There is a need to streamline current discharge processes through optimisation of electronic health software systems and better delegation of technical tasks to trained pharmacy assistants.
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Eze UIH, Adeyeri OH, Iheanacho CO. Participation of pharmacy technicians in clinical and patient-centered care practices: A state-wide survey in Nigeria. J Am Pharm Assoc (2003) 2021; 62:845-852. [PMID: 34876327 DOI: 10.1016/j.japh.2021.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 10/15/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Identifying the involvement of pharmacy technicians (PTs) in nonclinical and clinical duties will provide insight for improved pharmaceutical services. OBJECTIVES This study assessed the involvement of PTs in nonclinical tasks, patient-centered services, and more specialized patient care services and the difference in practice between hospital and community PTs. METHODS A cross-sectional survey was conducted using a 5-point Likert scale, and an analysis of data was performed using IBM SPSS version 21.0 (IBM). Descriptive statistics was done, and P ≤ 0.05 was considered statistically significant. The study was conducted in community and hospital pharmacies in Ogun State, Nigeria, among 100 PTs. Outcome measures were the involvement of PTs in clinical roles and other pharmaceutical care practices. RESULTS A total of 73 (73.0%) participated in the study, 45 (61.6%) and 28 (38.4%) practiced in hospital and community pharmacies, respectively. From the 11 listed nonclinical activities, only stocking of medications 61 (83.6%) and processing clients' or patient's charges 48 (65.8%) were often or very often performed. More than half of the participants often performed each of all 7 listed patient-centered activities, particularly empathy and confidentiality 62 (84.9%), providing information and referrals to patients or clients 56 (76.7%), and identifying patients or clients for counseling 51 (69.9%), respectively. No statistically significant difference was observed between the practice areas (P > 0.05). Only 2 of the 11 listed specialized clinical activities were performed by more than half of the respondents: screening prescriptions for completeness and authenticity 43 (58.9%) and alerting the pharmacist of drug therapy problems 46 (63.0%). Differences in the practice of specialized tasks was statistically significant for consultations (P = 0.002) and resolution of clinical conflict (P = 0.040) between the practice areas. CONCLUSION Study participants were less frequently involved in nonclinical activities but often involved in clinical activities. They also participated in specialized clinical tasks at lesser frequencies. Differences were observed between the practice areas in performance of nonclinical and specialized activities. Strategies to fill in the observed gaps should be explored for improved practice.
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Cheah R, Rajkhowa A, James R, Wangeman K, Koning S, Thursky K, Buising K. Case for antimicrobial stewardship pharmacy technicians in Australian hospitals. AUST HEALTH REV 2021; 44:941-943. [PMID: 33213691 DOI: 10.1071/ah19236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/10/2020] [Indexed: 11/23/2022]
Abstract
The pharmacist's role in hospital antimicrobial stewardship (AMS) programs is known to improve patient safety and the quality of care. Despite this, many Australian hospitals struggle to provide adequate pharmacy AMS program resourcing and need to explore newer models of care. The Pharmacy Board of Australia's Guidelines for Dispensing Medicines permit suitably qualified, competent and experienced pharmacy technicians to assist pharmacists in 'tasks in a pharmacy department'. The pharmacy technician workforce is expanding, and there is growing interest in career advancement and expansion of the pharmacy technician role. We propose that the pharmacy technician, a well-integrated member of many Australian hospital pharmacy departments, can play an important role in hospital AMS programs. To bolster AMS initiatives in Australian hospitals, this paper explores the existing evidence for pharmacy technicians in AMS programs and describes how this role may be better supported in Australia.
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Affiliation(s)
- Ron Cheah
- National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Vic. 3000, Australia. ; ; ; and Monash Health, Pharmacy Department, Clayton, Vic. 3168, Australia; and Corresponding author.
| | - Arjun Rajkhowa
- National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Vic. 3000, Australia. ; ; ; and University of Melbourne, Department of Medicine, Melbourne, Vic. 3010, Australia.
| | - Rodney James
- National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Vic. 3000, Australia. ; ;
| | - Kym Wangeman
- Eastern Health, Pharmacy Department, Box Hill, Vic. 3128, Australia. ;
| | - Sonia Koning
- Eastern Health, Pharmacy Department, Box Hill, Vic. 3128, Australia. ; ; and Monash University, Faculty of Pharmacy and Pharmaceutical Sciences, Parkville, Vic. 3052, Australia
| | - Karin Thursky
- National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Vic. 3000, Australia. ; ; ; and University of Melbourne, Department of Medicine, Melbourne, Vic. 3010, Australia. ; and Royal Melbourne Hospital, Victorian Infectious Diseases Service, Melbourne, Vic. 3050, Australia; and Peter MacCallum Cancer Centre, Department of Infectious Diseases, Melbourne, Vic. 3000, Australia
| | - Kirsty Buising
- National Centre for Antimicrobial Stewardship, Doherty Institute, Melbourne, Vic. 3000, Australia. ; ; ; and University of Melbourne, Department of Medicine, Melbourne, Vic. 3010, Australia. ; and Royal Melbourne Hospital, Victorian Infectious Diseases Service, Melbourne, Vic. 3050, Australia
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Vest TA, Gazda NP, Schenkat DH, Eckel SF. Practice-enhancing publications about the medication-use process in 2019. Am J Health Syst Pharm 2021; 78:141-153. [PMID: 33119100 DOI: 10.1093/ajhp/zxaa355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE This article identifies, prioritizes, and summarizes published literature on the medication-use process (MUP) from calendar year 2019 that can impact health-system pharmacy daily practice. The MUP is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The MUP is defined in this article as having the following components: prescribing/transcribing, dispensing, administration, and monitoring. Articles that evaluated one of the steps were gauged for their usefulness in promoting daily practice change. SUMMARY A PubMed search was conducted in January 2020 for calendar year 2019 using targeted Medical Subject Headings keywords; in addition, searches of the table of contents of selected pharmacy journals were conducted. A total of 4,317 articles were identified. A thorough review identified 66 potentially practice-enhancing articles: 17 for prescribing/transcribing, 17 for dispensing, 7 for administration, and 25 for monitoring. Ranking of the articles for importance by peers led to the selection of key articles from each category. The highest-ranked articles are briefly summarized, with a mention of why each article is important within health-system pharmacy. The other articles are listed for further review and evaluation. CONCLUSION It is important to routinely review the published literature and to incorporate significant findings into daily practice; this article assists in identifying and summarizing the most impactful recently published literature in this area. Health-system pharmacists have an active role in improving the MUP in their institution, and awareness of the significant published studies can assist in changing practice at the institutional level.
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Affiliation(s)
- Tyler A Vest
- Duke University Hospital, Durham, NC.,University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC
| | | | | | - Stephen F Eckel
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC.,University of North Carolina Medical Center, Chapel Hill, NC
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Banks VL, Barras M, Snoswell CL. Economic benefits of pharmacy technicians practicing at advanced scope: A systematic review. Res Social Adm Pharm 2020; 16:1344-1353. [DOI: 10.1016/j.sapharm.2020.01.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
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Raleigh RA, Teasdale TL, Mahoney JL, Wenke RJ, Galbraith KJ. The impact of a Calderdale Framework designed advanced pharmacy assistant role on inpatient pharmacy services. Int J Clin Pharm 2020; 42:184-192. [PMID: 31898167 DOI: 10.1007/s11096-019-00956-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 12/14/2019] [Indexed: 11/25/2022]
Abstract
Background Pharmacists in Australian hospitals do not see all inpatients. Effectively utilising pharmacy assistants in non-traditional roles may provide an opportunity to increase the number of patients seen by pharmacists. Objective To implement a Calderdale Framework designed advanced pharmacy assistant role on an inpatient unit and evaluate the impact of the role on the provision of clinical pharmacy services provided by the pharmacist in an Australian University hospital. Setting The study was conducted in a single 24-bed medical IPU at a tertiary hospital in Queensland, Australia. Method A quasi-experimental two-cohort comparison design, completed over three phases from 30/5/2016 to 30/9/2016 was employed. To evaluate the impact of the advanced pharmacy assistant on an inpatient unit an 8-week period of usual care was compared to the same time period on the same unit where the pharmacist provided usual care with the support of an advanced assistant. Pharmacist and assistant satisfaction was also surveyed. A training and lead-in phase was completed to ensure the advanced pharmay assistant was competent in completing the delegated tasks. Main outcome measure The primary outcome was percentage change of medication management plans documented by the pharmacist with an advanced assistant comparative to the pharmacist without. Results The number of documented medication management plans significantly increased by 9.5% (p = 0.019; CI 1.86-17.14). Plans documented within 24 h and time to documentation remained unchanged. Completeness increased in community pharmacy documentation. The percentage of completed discharge medication records rose by 15.6%, (p < 0.001; CI 7.78-23.16). Interventions documented increased by 55 and the percentage of patients with clinical reviews documented increased by 35%. There were fewer missed doses recorded and pharmacists spent more time on clinically based tasks. Pharmacist and assistant satisfaction also improved. Conclusion The use of the Calderdale Framework enabled structured pharmacy assistant role redesign that impacted significantly on the provision of clinical pharmacy services on an inpatient unit.
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Affiliation(s)
- Rachael A Raleigh
- Pharmacy Department, Gold Coast Hospital and Health Service, A Block Lower Ground, 1 Hospital Boulevard, Southport, QLD, 4215, Australia.
- Experiential Development and Graduate Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC, Australia.
| | - Trudy L Teasdale
- Pharmacy Department, Gold Coast Hospital and Health Service, A Block Lower Ground, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Jill L Mahoney
- Allied Health Clinical Governance Education and Research, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Rachel J Wenke
- Allied Health Clinical Governance Education and Research, Gold Coast Hospital and Health Service, 1 Hospital Boulevard, Southport, QLD, 4215, Australia
| | - Kirsten J Galbraith
- Experiential Development and Graduate Education, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, VIC, Australia
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