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Watterson TL, Moon J, Stone JA, Gilson AM, Berbakov ME, Hoffins EL, Chladek JS, Lehnbom EC, Resendiz SM, Mai S, Walker KD, Gollhardt JD, Chui MA. Linking Inner Context and Innovation Factors: Examining a pharmacy-based intervention through the eyes of pharmacy staff. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 15:100486. [PMID: 39205955 PMCID: PMC11350256 DOI: 10.1016/j.rcsop.2024.100486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/30/2024] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
INTRODUCTION Community pharmacies, as unique and accessible healthcare venues, are ideal locations to implement interventions aiming to improve patient care. However, these interventions may increase workload or disrupt workflow for community pharmacists, technicians, and other staff members, threatening long-term sustainment. There are growing calls from the field of implementation science to design for intervention sustainment and maintenance by maximizing innovation fit. Senior Safe™, an intervention to facilitate safer over-the-counter (OTC) product selection by older adults, serves as a case study to examine the congruence between Innovation Factors and community pharmacy Inner Context constructs and their implications for workload and sustainment. METHODS Using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework, this qualitative study identified factors surrounding Senior Safe implementation. Semi-structured interviews were conducted with staff from pharmacies where Senior Safe was implemented. Two coders independently analyzed interview transcripts using deductive analysis based on EPIS constructs. Thematic analysis was used to generate three themes that encapsulated innovation fit. RESULTS Nineteen pharmacy staff members participated, with the majority reporting no significant change in their workload or workflow due to Senior Safe. Interview feedback supported a pre-existing culture of the healthcare system to engage patients, of leadership commitment to patient safety initiatives, and of an amplified role of pharmacy technicians. DISCUSSION AND CONCLUSION Pharmacy staff interviews revealed congruence between Innovation Factors and Inner Context that likely yielded intervention workload neutrality. This study highlighted the importance for researchers to consider maintenance and sustainability when designing and implementing an intervention and the critical influence of culture and leadership support during this process.
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Affiliation(s)
- Taylor L. Watterson
- Pharmacy Systems Outcomes and Policy, College of Pharmacy, University of Illinois Chicago, USA
| | - Jukrin Moon
- Department of Industrial and Systems Engineering, University of Iowa, USA
| | - Jamie A. Stone
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
- Sonderegger Research Center for Improved Medication Outcomes, University of Wisconsin-Madison, USA
| | - Aaron M. Gilson
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
- Sonderegger Research Center for Improved Medication Outcomes, University of Wisconsin-Madison, USA
| | - Maria E. Berbakov
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
- Sonderegger Research Center for Improved Medication Outcomes, University of Wisconsin-Madison, USA
| | - Emily L. Hoffins
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
| | - Jason S. Chladek
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
| | - Elin C. Lehnbom
- Social Pharmacy Group, Department of Pharmacy, Faculty of Pharmacy, Uppsala University, Uppsala, Sweden
| | - Stephanie M. Resendiz
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
| | - Shiying Mai
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
| | | | | | - Michelle A. Chui
- Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, USA
- Sonderegger Research Center for Improved Medication Outcomes, University of Wisconsin-Madison, USA
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Watterson TL, Chui MA. Subjective Perceptions of Occupational Fatigue in Community Pharmacists. PHARMACY 2023; 11:84. [PMID: 37218966 PMCID: PMC10204370 DOI: 10.3390/pharmacy11030084] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
INTRODUCTION Community retail pharmacists are experiencing unsafe levels of stress and excessive demands within the workplace. One aspect of workload stress that has been overlooked among pharmacists is occupational fatigue. Occupational fatigue is a characteristic of excessive workload including increased work demands and reduced capacity and resources to complete the work. The goal of this study is to describe the subjective perceptions of occupational fatigue in community pharmacists by using (Aim 1) a previously developed Pharmacist Fatigue Instrument and (Aim 2) semi-structured interviews. METHODS Wisconsin community pharmacists were eligible to participate in the study and recruited via a practice-based research network. Participants were asked to complete a demographic questionnaire, a Pharmacist Fatigue Instrument, and semi-structured interview. Survey data were analyzed using descriptive statistics. Interview transcripts were analyzed using qualitative deductive content analysis. RESULTS Totally, 39 pharmacists participated in the study. From the Pharmacist Fatigue Instrument, 50% of the participants stated they had times where they were not able to go above and beyond standard patient care on more than half of the days they worked. A total of 30% of the participants reported that they found it necessary to take short-cuts when providing patient care on more than half of the days they worked. Pharmacist interviews were separated into overarching themes including mental fatigue, physical fatigue, active fatigue, and passive fatigue. CONCLUSIONS The findings highlighted the pharmacists' feelings of despair and mental fatigue, fatigue's connectedness to interpersonal relationships, and the complex nature of pharmacy work systems. Interventions aimed at improving occupational fatigue in community pharmacies should consider key themes of fatigue that pharmacists are experiencing.
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Affiliation(s)
- Taylor L. Watterson
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 750 Highland Avenue, Madison, WI 53705, USA
| | - Michelle A. Chui
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, 777 Highland Avenue, Madison, WI 53705, USA
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Self-promotion and online shaming during COVID-19: A toxic combination. INTERNATIONAL JOURNAL OF INFORMATION MANAGEMENT DATA INSIGHTS 2022; 2. [PMCID: PMC9444892 DOI: 10.1016/j.jjimei.2022.100117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
A public shaming frenzy has spread through social media (SM) following the instigation of lockdown policies as a way to counter the spread of COVID-19. On SM, individuals shun the idea of self-promotion and shame others who do not follow the COVID-19 guidelines. When it comes to the crime of not taking a pandemic seriously, perhaps the ultimate penalty is online shaming. The study proposes the black swan theory from the human-computer interaction lens and examines the toxic combination of online shaming and self-promotion in SM to discern whether pointing the finger of blame is a productive way of changing rule-breaking behaviour. A quantitative methodology is applied to survey data, acquired from 375 respondents. The findings reveal that the adverse effect of online shaming results in self-destructive behaviour. Change in behaviour of individuals shamed online is higher for females over males and is higher for adults over middle-aged and older-aged.
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Stone RH, Gross S, Reardon B, Young HN. Emergency Contraception Access and Counseling in Metropolitan and Nonmetropolitan Pharmacies in Georgia. J Pharm Pract 2021; 36:523-531. [PMID: 34881653 DOI: 10.1177/08971900211052821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Emergency contraception (EC) efficacy is dependent on timing of administration. Adequate pharmacy stock information and accurate patient counseling are important to ensure timely access. Objective: This study evaluates pharmacist reported availability and counseling for levonorgestrel (LNG) and ulipristal acetate (UPA), and identifies differences between caller type and pharmacies in metropolitan vs nonmetropolitan areas of Georgia. Methods: This prospective, randomized, telephone-based study included 25% of Georgia community pharmacies, stratified by geographic location. Calls were made by investigators, first posing as a mystery shopper inquiring about EC stock and efficacy, then 3-6 weeks later as a researcher inquiring about EC stock. Analysis utilized descriptive statistics, chi Square, and logistic regression. Results: Of 600 pharmacies, the mystery shopper caller reached 86%: 74% of pharmacists initially discussed LNG, 57.1% had it stocked, more often in metropolitan areas (OR 1.7, 95% CI 1.08-2.6). Ulipristal acetate was discussed by 1.9% and reported in-stock < 1%. Of those who discussed window of efficacy, 79% indicated LNG would either not work 4 days after intercourse or they were unsure. The research caller successfully completed a second call for 64% of pharmacies: 57% stocked LNG, 3% stocked UPA, and UPA was more likely to be stocked in metropolitan pharmacies. Conclusion: In Georgia, UPA availability is poor, and nonmetropolitan pharmacies were less likely to stock LNG and UPA. A minority of pharmacists correctly indicated that LNG may work up to 120 hours after intercourse. Strategies are needed to overcome barriers to EC availability in community pharmacies and support pharmacists' EC counseling.
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Affiliation(s)
- Rebecca H Stone
- Department of Clinical and Administrative Pharmacy, 1355University of Georgia College of Pharmacy, Athens, GA, USA
| | - Savannah Gross
- 15506University of Georgia College of Pharmacy, Athens, GA, USA
| | - Brielle Reardon
- Department of Pharmacy, 1466Johns Hopkins Hospital, Baltimore, MD, USA
| | - Henry N Young
- Department of Clinical and Administrative Pharmacy, 1355University of Georgia College of Pharmacy, Athens, GA, USA
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Use of the Professional Fulfillment Index in Pharmacists: A Confirmatory Factor Analysis. PHARMACY 2021; 9:pharmacy9040158. [PMID: 34698269 PMCID: PMC8544746 DOI: 10.3390/pharmacy9040158] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022] Open
Abstract
Most research on pharmacist professional wellbeing has focused on measuring burnout. However, using valid and reliable instruments to assess professional fulfillment in pharmacists can expand understanding of pharmacists' professional wellbeing. This study aimed to (1) establish the validity of the Professional Fulfillment Index (PFI) for a sample of pharmacists licensed in the United States (US) using confirmatory factor analysis (CFA), and (2) compare the professional wellbeing of pharmacists across demographics and work settings. Data for this study were obtained from the 2019 National Pharmacy Workforce Survey (NPWS). The survey assessed pharmacist professional wellbeing using the PFI. The model fit of the PFI was assessed using CFA. Multiple linear regression was used to compare pharmacist wellbeing across demographics and work settings. The CFA affirmed that the PFI possesses a satisfactory model fit for use in pharmacists. Regression analysis showed higher burnout (work exhaustion and interpersonal disengagement) was associated with decreasing age, being female, working more hours, and working in a community pharmacy. Higher professional fulfillment was associated with men, and working in non-community pharmacy work settings. The PFI is a psychometrically reliable and valid instrument for assessing the professional wellbeing of pharmacists.
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Pharmacist-Prescribed Hormonal Contraception: Does Didactic Hormonal Contraception Education Affect Student Pharmacist Perceptions of This Professional Activity? PHARMACY 2021; 9:pharmacy9030145. [PMID: 34449736 PMCID: PMC8396284 DOI: 10.3390/pharmacy9030145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022] Open
Abstract
Since 2014, select states have allowed pharmacists to prescribe hormonal contraception (HC). This study describes student pharmacists’ perceptions of a pharmacist’s scope of practice, education, and interest, and identifies differences between students who have completed didactic HC content in their professional curriculum versus those who have not. A voluntary online survey was emailed to all students in three Georgia pharmacy schools. Descriptive statistics were reported. Likert square responses were dichotomized, and Chi square testing identified differences between groups. A total of 1256 students were invited, 35% completed the survey, of those 68% had received HC didactic content in their curriculum. Regardless of HC education, most students “agree” or “strongly agree” that pharmacists are adequately educated to prescribe HC (92% vs. 86%, p = 0.05) and prescribing HC is within the pharmacist’s scope of practice (89% vs. 84%, p = 0.12). Although not currently permitted in Georgia, most are interested in prescribing (97% vs. 96%, p = 0.5). Of the students who have received HC didactic content, 87% felt “moderately”, “well”, or “extremely well-educated” regarding HC prescribing clinical skills. Regardless of didactic training, pharmacy students believe pharmacists are prepared to prescribe HC and support pharmacist-prescribed HC as a part of their future professional scope of practice.
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