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Schönenberger N, Blanc AL, Hug BL, Haschke M, Goetschi AN, Wernli U, Meyer-Massetti C. Developing indicators for medication-related readmissions based on a Delphi consensus study. Res Social Adm Pharm 2024; 20:92-101. [PMID: 38433064 DOI: 10.1016/j.sapharm.2024.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 02/14/2024] [Accepted: 02/18/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Medication-related readmissions challenge healthcare systems by burdening patients, increasing costs and straining resources. However, to date, there has been no consensus study on indicators for medication-related readmissions. OBJECTIVES This Delphi study aimed to develop a consensus-based set of indicators for detecting patients at risk of medication-related readmission. METHODS An expert panel of clinical pharmacists, physicians and nursing experts participated in a two-round Delphi study. In round 1, 31 indicators taken from the literature were rated for relevance on a scale from 1 to 9, with a median rating of 7 or higher suggesting relevance. The RAND/UCLA method was used to determine consensus. In round 2, indicators lacking consensus were re-rated together with a series of new indicators generated by the experts. Additional details were sought for some indicators. The main outcomes were the relevance of, consensus on, and completeness of the proposed indicators for identifying risks of 30-day medication-related readmission. RESULTS Thirty-eight experts participated in round 1. Consensus was found for all the indicators, with 25 included and 6 excluded. Thirty-four experts participated in round 2. Consensus was found for all 5 newly suggested indicators, and 4 were included. The expert panel prioritized the following indicators: (1) insufficient communication between different healthcare providers, (2) polypharmacy (≥7 medications), (3) low rates of medication adherence (twice-weekly mistakes or missing administration), (4) complex medication regimens (≥3 doses, ≥2 dosage forms and ≥2 administration routes per day), and (5) multimorbidity (≥3 chronic conditions). The final set comprised 29 indicators. CONCLUSIONS The indicator set developed for flagging potential medication-related readmissions could guide priorities for clinical pharmacy services at hospital discharge, improving patient outcomes and resource use. A validation study of these indicators is planned.
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Affiliation(s)
- Nicole Schönenberger
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland.
| | - Anne-Laure Blanc
- Pharmacy of the Eastern Vaud Hospitals, 1847, Rennaz, Switzerland; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, 1205, Geneva, Switzerland
| | - Balthasar L Hug
- Department of Internal Medicine, Lucerne Cantonal Hospital, 6000, Lucerne, Switzerland; University of Lucerne, Faculty of Health Sciences and Medicine, 6005, Lucerne, Switzerland
| | - Manuel Haschke
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland
| | - Aljoscha N Goetschi
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Ursina Wernli
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, 3012, Bern, Switzerland
| | - Carla Meyer-Massetti
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, 3010, Bern, Switzerland; Institute of Primary Healthcare (BIHAM), University of Bern, 3012, Bern, Switzerland
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Helgesen AK, Nome CM, Stenbjerg JK, Arnesen MH, Aardalen TR, Dilles T, Grøndahl VA. Pharmaceutical Care in Primary Healthcare-A Study of Nurses', Pharmacists', and Physicians' Experiences of Interprofessional Collaboration. Healthcare (Basel) 2024; 12:1100. [PMID: 38891175 PMCID: PMC11171861 DOI: 10.3390/healthcare12111100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Implementation of pharmaceutical care for the benefit of patients and health services has been highlighted worldwide. Interprofessional collaboration between nurses, pharmacists, and physicians may contribute to raising awareness of pharmacological challenges, increasing quality, and minimising errors in pharmaceutical care. This study aimed to investigate how nurses, pharmacists, and physicians experience interprofessional collaboration in pharmaceutical care within community healthcare in Norway. The study had an explorative and descriptive design with a qualitative approach. Individual interviews were conducted with 12 healthcare personnel with key roles in pharmaceutical care within community healthcare services. The data were analysed using systematic text condensation. The results revealed three categories and four subcategories: The category "Professional challenges" contained the subcategories "Blurred responsibilities" and "The importance of trust and continuity". The category "Organisational barriers" contained the subcategories "Lack of information exchange and suitable communications channels" and "Lack of time and meeting places". The third category was "Nurses-the important link". This study reveals challenges to and factors of success in increasing high-quality and safe pharmaceutical care, knowledge that can be used in quality work in the community health services and as input in curriculum development for the three professions.
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Affiliation(s)
- Ann Karin Helgesen
- Faculty of Health, Welfare, and Organisation, Østfold University College, P.O. Box 700, NO-1757 Halden, Østfold, Norway;
| | - Carina Marie Nome
- Haugvoll Nursing Home, Sarpsborg Kommune, Myrvollveien 25, NO-1743 Klavestadhaugen, Sarpsborg, Norway
| | - Julie Kjølhede Stenbjerg
- Emergency Room, Fredrikstad Kommune, Jens Wilhelmsens Gate 1, NO-1671 Kråkerøy, Fredrikstad, Norway
| | - Marie Helen Arnesen
- Home Nursing Care Centre, Fredrikstad Kommune, Faunsvei 3-6, NO-1654 Sellebakk, Fredrikstad, Norway
| | | | - Tinne Dilles
- Centre for Research and Innovation in Care, Nurse and Pharmaceutical Care, University of Antwerp, Prinsstraat 13, 2000 Antwerp, Belgium;
| | - Vigdis Abrahamsen Grøndahl
- Faculty of Health, Welfare, and Organisation, Østfold University College, P.O. Box 700, NO-1757 Halden, Østfold, Norway;
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Babu D, Marotti S, Rowett D, Lim R, Wisdom A, Kalisch Ellett L. What is impacting clinical pharmacists' participation in an interprofessional ward round: a thematic analysis of a national survey. J Interprof Care 2024; 38:444-452. [PMID: 38151971 DOI: 10.1080/13561820.2023.2289506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/25/2023] [Indexed: 12/29/2023]
Abstract
The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists' participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists' participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke's techniques. Five themes were constructed: "Clinical pharmacy service structure", "Ward round structure", "Pharmacist's capabilities", "Culture" and "Value". A culture supportive of pharmacist's contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists' participation in WR. Being physically "absent" from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual's role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.
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Affiliation(s)
- Dona Babu
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Sally Marotti
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Debra Rowett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Renly Lim
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Alice Wisdom
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Lisa Kalisch Ellett
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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4
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Manias E, Hughes C, Woodward-Kron R, Ozavci G, Jorm C, Bucknall T. Decision-making about changing medications across transitions of care: Opportunities for enhanced patient and family engagement. Res Social Adm Pharm 2024; 20:520-530. [PMID: 38403571 DOI: 10.1016/j.sapharm.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 12/19/2023] [Accepted: 02/05/2024] [Indexed: 02/27/2024]
Abstract
BACKGROUND Older patients often have complex medication regimens, which change as they move across transitions of care. Engagement of older patients and families in making medication decisions across transitions of care is important for safe and high-quality medication management. AIMS To explore decision-making between health professionals, older patients and families about medication changes across transitions of care, and to examine how patient and family engagement is enacted in the process of decision-making in relation to these medication changes. METHODS A focused ethnographic design was undertaken with semi-structured interviews, observations, and reflective focus groups or interviews. Reflexive thematic analysis was conducted on transcribed data. The study was undertaken at a public teaching acute care hospital and a public teaching community hospital in Australia. RESULTS In all, 182 older patients, 44 family members and 94 health professionals participated. Four themes were conceptualised from the data: different customs and routines, medication challenges, health professional interactions, and patient and family involvement. Environments had differences in their customs and routines, which increased the potential for medication delays or the substitution of unintended medications. Medication challenges included health professionals assuming that patients and families did not need information about regularly prescribed medications. Patients and families were informed about new medications after health professionals had already made decisions to prescribe these medications. Health professionals tended to work in disciplinary silos, and they had views about their role in interacting with patients and families. Patients and families were expected to take the initiative to participate in decision-making about medication changes. CONCLUSIONS Patient movements across transitions of care can create complex and chaotic medication management situations, which lacks transparency, especially for older patients and their families. A greater focus on pre-emptive and planned discussions about medication changes will contribute to improving patient and family involvement in medication decision-making.
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Affiliation(s)
- Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia; Alfred Health, 55 Commercial Road Melbourne, Victoria, 3004, Australia; School of Nursing and Midwifery, Monash University, 35 Rainforest Walk, Clayton, Victoria, 3800, Australia.
| | - Carmel Hughes
- School of Pharmacy, Queen's University Belfast, University Road, Belfast, Northern Ireland, BT9 7BL, United Kingdom.
| | - Robyn Woodward-Kron
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Grattan Street, Parkville, Victoria, 3010, Australia.
| | - Guncag Ozavci
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia; Alfred Health, 55 Commercial Road Melbourne, Victoria, 3004, Australia.
| | - Christine Jorm
- School of Public Health, The University of Sydney, Castlereagh Street, Camperdown, New South Wales, 2006, Australia.
| | - Tracey Bucknall
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, 221 Burwood Highway, Burwood, Victoria, 3125, Australia; Alfred Health, 55 Commercial Road Melbourne, Victoria, 3004, Australia.
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Gist-Mackey AN, Piercy CW, Bates JM. Pharmacy work: Intrinsic motivation and extrinsic rewards across role and setting. J Am Pharm Assoc (2003) 2024; 64:104-110. [PMID: 37940102 DOI: 10.1016/j.japh.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/13/2023] [Accepted: 11/02/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Pharmacists' and pharmacy technicians' stress and job turnover are at an all-time high. Both intrinsic motivations and extrinsic rewards play key roles in workplace satisfaction. Differences in workplace satisfaction have been identified when comparing chain pharmacies, independent pharmacies, and health systems work settings. OBJECTIVES Cognitive evaluation theory was applied to explore the influence of intrinsic motivations and extrinsic rewards on both pharmacists' and pharmacy technicians' perceptions of motivations and rewards across various workplace settings. METHODS A 92-item questionnaire was administered to 129 pharmacists and 111 pharmacy technicians. Participants were primarily recruited at a state pharmacy association annual meeting and via online forums. The questionnaire captured participant demographics including role and work setting (i.e., chain, independent, or health systems), demographic variables, and perceptions about work including autonomy, competence, relationships, pay satisfaction, and benefit satisfaction. RESULTS A 2-way multivariate analysis of covariance was conducted to test hypothesized differences by role (pharmacist or pharmacy technician) and setting (chain, independent, or health systems). Results show pharmacy personnel in independent and hospital systems settings felt more positive about relationships, competence, pay satisfaction, and benefit satisfaction than those in chain settings. There were no role differences between pharmacists and pharmacy technicians on these outcomes. DISCUSSION These findings highlight challenges of working in chain pharmacy environments. Results reveal that although pay does not differ across work settings, feelings about both the work and compensation satisfaction do vary across settings. Because role did not drive these relationships, this suggests a need to attend to working conditions for pharmacy personnel. CONCLUSION Intrinsic motivation elements of competence and relationships are statistically different among employment settings. Relationships and feelings of competence are perceived more favorably in independent and health systems, rather than chain settings. More studies on intrinsic motivations of pharmacy employees within these settings are needed.
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Przymuszała P, Fabianowska S, Zielińska-Tomczak Ł, Cerbin-Koczorowska M, Marciniak R. Factors influencing behavioral intentions of graduating pharmacy students regarding interprofessional collaboration - a theory-driven qualitative study. BMC Health Serv Res 2023; 23:1207. [PMID: 37926826 PMCID: PMC10626734 DOI: 10.1186/s12913-023-10224-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/27/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Interprofessional collaboration enhances the use of competencies of different medical team members. Additionally, pharmacists' involvement in patient care has been shown to improve their outcomes and seems particularly valuable in chronic diseases. Therefore, due to the aging of society and the increasing prevalence of chronic diseases, efforts are needed to involve pharmacists more broadly in patient care. However, there is a limited understanding of what factors could influence their willingness to participate in an interprofessional care team, especially among pharmacy students only entering the profession. This study aimed to fill these knowledge gaps by exploring graduating pharmacy students' intentions in this regard guided by the theory of planned behavior. METHODS We conducted seventeen semi-structured interviews with graduating pharmacy students of Poznan University of Medical Sciences, which were then thematically analyzed by two researchers. RESULTS Positive attitudes of respondents, who mentioned the possibility of acquiring new knowledge, skills, and competencies, increased prestige and appreciation of the pharmacist's profession, a better quality of patient care, and the support and relief offered to other team members as a result of collaboration, seem to strengthen their intentions. However, they also expressed their worries about potential errors and knowledge gaps, which constituted an example of some existing negative feelings. The identified sources of generally mixed social pressure toward the behavior included other pharmacists and pharmacy students, physicians, patients, their relatives and friends, and the decision and policymakers. Finally, their intentions may also be weakened by the mentioned perceived behavioral control aspects, like their level of pharmaceutical and clinical knowledge, skills, and experience, their knowledge of representatives of other professions and collaboration, the atmosphere at their future place of work, co-workers' potential reluctance to collaborate with them, finding time for collaboration, the existence of incentives and gratification system, and existing legal regulations. CONCLUSIONS The attitudes of graduating pharmacy students toward interprofessional collaboration seem mostly positive, but their intentions might be weakened by the mixed sense of social pressure and factors decreasing their perceived behavioral control.
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Affiliation(s)
- Piotr Przymuszała
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland.
| | - Sandra Fabianowska
- Students' Scientific Club of Medical Education, Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | - Łucja Zielińska-Tomczak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland
| | - Magdalena Cerbin-Koczorowska
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland
- Edinburgh Medical School: Medical Education, Chancellor's Building, University of Edinburgh, Edinburgh, Scotland, UK
| | - Ryszard Marciniak
- Department of Medical Education, Poznan University of Medical Sciences, 7 Rokietnicka St, Poznan, 60-806, Poland
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7
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Num KSF, Aizuddin AN, Tong SF, Mohamed Said MS. A grounded theory research protocol on an attempt to practice interprofessional collaborative care by a primary care clinic health professional fresh graduate in diabetes care. Front Med (Lausanne) 2023; 10:1133948. [PMID: 37601799 PMCID: PMC10435291 DOI: 10.3389/fmed.2023.1133948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/06/2023] [Indexed: 08/22/2023] Open
Abstract
Interprofessional collaborative care (IPCC) can improve the quality of care in patients with chronic diseases in primary care settings. In Malaysia, many medical and healthcare universities have adopted the concept of the interprofessional collaborative practice (IPCP) framework by the World Health Organization (WHO) and implemented interprofessional learning (IPL) in their curriculum to prepare fresh graduates for interprofessional collaboration (IPC) in the health workforce albeit in various degrees. However, there are potential challenges in putting what they have learned into practice, especially in managing chronic diseases due to the complexity of behavior changes required. Diabetes care is a classic example of such chronic disease management. This article presents a qualitative research protocol exploring the processes and challenges of fresh graduates attempting to practice IPC when managing diabetes mellitus (DM) in primary care clinics. A grounded theory (GT) approach will be adopted.
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Affiliation(s)
- Kelly Sze Fang Num
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Division of Nutrition and Dietetics, School of Health Sciences, International Medical University, Kuala Lumpur, Malaysia
| | - Azimatun Noor Aizuddin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- International Centre for Casemix and Clinical Coding, Hospital Canselor Tuanku Muhriz, Kuala Lumpur, Malaysia
| | - Seng Fah Tong
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Shahrir Mohamed Said
- Department of Internal Medicine, Universiti Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur, Malaysia
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AlRuthia Y, Bashatah A, Batis AA, Alradhi SA, Almohammed O, Sales I, Kalagi N, Alharbi MK, Alghadeer S, Mobrad AB, Albaker AM, Asiri Y. Exploring the opportunities and challenges to implementing interprofessional education in Saudi Arabia: a qualitative study among faculty. J Interprof Care 2023; 37:47-57. [PMID: 34979851 DOI: 10.1080/13561820.2021.2004097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Interprofessional education (IPE) has potential benefits for improving the quality of patient care, but its implementation is challenged with multiple barriers. The primary objectives of this study were to explore the challenges, benefits, and incentives to establishing IPE from the perspective of healthcare faculty at King Saud University. Forty-five faculty members attended six focus groups, each consisting of 6-8 faculty members representing the five colleges. The focus group interview guide included the benefits of and barriers to establishing IPE in this academic institution, curricular design, and the feasibility of support from the colleges and University administration. A SWOC (Strengths, Weaknesses, Opportunities, Challenges) frame work was utilized to guide the focus group discussions, and the data were analyzed inductively using thematic analysis. Three main themes emerged and were related to (i) barriers, (ii) benefits, (iii) opportunities to facilitate the introduction of IPE, and (iv) suggestions on how to implement IPE and overcome challenges to establish an IPE curriculum. Participants were generally supportive of IPE and aware of the constraints that might impede its implementation. Moreover, they identified potential barriers and incentives to promote IPE. Although participants appreciated the long-term benefits of IPE, creating a supportive environment will require the involvement of the academic community, including students, faculty members, and the University's top management.
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Affiliation(s)
- Yazed AlRuthia
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Pharmacoeconomics Research Unit, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Adel Bashatah
- Department of Nursing Education and Administration, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Afaf A Batis
- National Health Information Center, Saudi Health Council, Riyadh, Saudi Arabia
| | - Sarah A Alradhi
- National Health Information Center, Saudi Health Council, Riyadh, Saudi Arabia
| | - Omar Almohammed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ibrahim Sales
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Nora Kalagi
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad K Alharbi
- Department of Nursing Education and Administration, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Sultan Alghadeer
- Department of Emergency Medicine, College of Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
| | - Abdulmajeed Bin Mobrad
- Department of Emergency Medicine, College of Emergency Medical Services, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz M Albaker
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Yousif Asiri
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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9
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Grimes TC, Guinan EM. Interprofessional education focused on medication safety: a systematic review. J Interprof Care 2023; 37:131-149. [PMID: 35050843 DOI: 10.1080/13561820.2021.2015301] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Safe medication use necessitates interprofessional working, with calls to enhance interprofessional education (IPE) focusing on medication safety (MS) in healthcare professional (HCP) curricula. Little is known about the design, delivery or evaluation of such activities. This systematic literature review describes MS-focused IPE activities in pre-qualification HCP programmes. MedLine, EMBASE, CINAHL and ERIC were searched, relevant studies identified and data extracted. The McGill Mixed Methods Appraisal Tool was employed. The 3P (presage-process-product) theory structured deductive analysis. Thirty-one studies were included, reporting on 30 activities, mostly undertaken in North America or United Kingdom. Presage/Design: Most reported activities involved pharmacy, nursing, medical or physician assistant students learning with one or more other HCP group. Few studies matched student groups' skills or experiences. Few studies reported theoretical underpinnings. Process/Delivery: Multiple pedagogical approaches were employed, mostly social construction, and low- and high-fidelity simulation-based learning. Few studies reported learning outcomes or summative assessment, more reported formative assessment. Product/evaluation: Outcomes measured were learners' opinions, satisfaction or attitudes toward interprofessional working and findings were generally positive. Few studies reported on student development or outcomes specific to medication safety. Lack of integration of qualitative/quantitative components of mixed methods studies and limited outcome measurements' validity or reliability weakened study quality. MS-focused IPE for pre-qualification HCPs is well received by students. Design of future activities could be enhanced by employing theory and ensuring matching of students' and groups' skills, professional identity and learner attributes to enhance learning in an interprofessional setting. Future delivery should embed MS-focused IPE into the standard curricula to optimize constructive alignment, learner engagement, quality and drive development. The required skillset in pre-qualification HCP programmes to facilitate future safe medication practice, together with the associated learning outcomes and assessment approaches, should be defined. The quality of scholarly studies examining these activities needs improvement.
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Affiliation(s)
- T C Grimes
- School of Pharmacy and Pharmaceutical Sciences, Panoz Institute, Trinity College Dublin, Dublin 2, Ireland
| | - E M Guinan
- School of Medicine, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
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10
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Kurniasih DAA, Setiawati EP, Pradipta IS, Subarnas A. Interprofessional collaboration in the breast cancer unit: how do healthcare workers see it? BMC Womens Health 2022; 22:227. [PMID: 35698115 PMCID: PMC9195208 DOI: 10.1186/s12905-022-01818-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/02/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Interprofessional collaboration has an important role in health care for breast cancer patients who are undergoing treatment at the hospital. Interprofessional collaboration has been reported to provide significant benefits for patients. However, qualitative research on interprofessional collaboration in the breast cancer department is rarely done, therefore, a study was conducted to determine the perception of health practitioners about interprofessional collaboration in the breast care unit at a referral centre hospital in West Java, Indonesia. METHODS A qualitative study was carried out using in-depth interviews and focus group discussions (FGDs) with 15 healthcare personnel using total sampling. Participants were chosen among healthcare professionals who treat and in charge for outpatient breast cancer, but were not resident physicians. The FGD approach was used for nurses and pharmacists, and interviews were used for oncologists. The audio recordings of all interviews and FGDs were transcribed verbatim and evaluated using thematic analysis. RESULT The findings were categorized into two categories to obtain health care workers' perspectives on interprofessional collaboration: (1) impediment factors: personality, lack of leadership, seniority, healthcare workers with double positions, the need for a clinical meeting, hospital bureaucracy, national health insurance implementation, issues with patients, hospital infrastructure, and evaluation and synchronisation; (2) existing supportive elements: effective cooperation, effective communication, clear job description, interpersonal relationships, Standard Operational Procedure (SOP) for cancer therapy, legality for inter-discipline cancer team, professional responsibility, integrated clinical pathway, patient centred care, and comprehensive health services. CONCLUSIONS Interprofessional collaboration was seen positively by the respondents. However, there are several hurdles that must be overcome to apply interprofessional collaboration works effectively. The findings of this study can be used to build interprofessional collaborations targeted at enhancing quality health care in breast cancer units.
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Affiliation(s)
- Dea Anita Ariani Kurniasih
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Raya Bandung Sumedang Km. 21, Hegarmanah, Jatinangor, Kabupaten Sumedang, 45363, Jawa Barat, Indonesia.,Doctoral Program of Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia.,Pharmacy Study Program, Akademi Farmasi YPF, Bandung, Indonesia
| | - Elsa Pudji Setiawati
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Sumedang, Indonesia
| | - Ivan Surya Pradipta
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Raya Bandung Sumedang Km. 21, Hegarmanah, Jatinangor, Kabupaten Sumedang, 45363, Jawa Barat, Indonesia.,Drug Utilization and Pharmacoepidemiology Research Group, Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia
| | - Anas Subarnas
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Raya Bandung Sumedang Km. 21, Hegarmanah, Jatinangor, Kabupaten Sumedang, 45363, Jawa Barat, Indonesia.
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11
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Thelen M. Medication competence: a concept analysis. NURSE EDUCATION TODAY 2022; 111:105292. [PMID: 35149327 DOI: 10.1016/j.nedt.2022.105292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 01/09/2022] [Accepted: 01/31/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This paper aims to provide a thorough concept analysis of medication competence, within the context of nursing education. Also, to establish a clear definition of the concept for research purposes, and to improve the communication and use of the concept in healthcare practice. DESIGN & METHODS The Walker and Avant concept analysis was utilized as a framework to develop a comprehensive understanding of the phenomena of medication competence in nursing education. DATA SOURCES A review of literature on medication competence was conducted using the electronic databases of EBSCOhost, CINAHL Complete, Web of Science, Ovid full text, ERIC, ScienceDirect, International Nursing Association for Clinical Simulation and Learning (INASCL), PubMed, Google Scholar, and PsychLit. Search terms included medication competence, medication safety, medication management, medication skills, healthcare, nursing, and nursing students. RESULTS The literature search resulted in 39 articles that met the inclusion criteria. Three defining attributes were identified: pharmacovigilant, effective skills competence, and interprofessionality. Antecedents, consequences, and empirical referents of the concept medication competence were also highlighted. CONCLUSIONS Insight gleaned from this concept analysis will enhance the ability of nurse educators to effectively educate and assess medication competence among nursing students. By defining medication competence it validates the importance of further quantitative and qualitative research exploration of medication competence among nursing students and other healthcare specialties. Thus, this concept analysis establishes the springboard for innovative educational interventions, as well as future research in nursing education.
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Affiliation(s)
- Melynda Thelen
- South Dakota State University, United States of America.
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Flood B, Smythe L, Hocking C, Jones M. Interprofessional practice: the path toward openness. J Interprof Care 2021; 36:635-642. [PMID: 34702121 DOI: 10.1080/13561820.2021.1981264] [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: 10/20/2022]
Abstract
This article seeks to shed light on the meanings healthcare practitioners attach to practicing interprofessionally and how interprofessional relationships play out in "everyday" practice. It draws on findings from a hermeneutic phenomenological study of health professionals' lived experience of practice, interpreted in relation to Martin Heidegger's concept of a path through the dense forest which leads to an open space where there is no predefined path to follow. Analysis of data from in-depth, semi-structured interviews with 12 health professionals from medicine, midwifery, nursing, occupational therapy, physiotherapy, speech and language therapy, and social work suggests that health practitioners come upon the clearing having walked their own track toward practicing interprofessionally. Our argument is that when: getting to know others; genuine dialogue; trust; and respect are in play, a spirit of interprofessional practice flourishes. The ontological view presented, sheds light on the nature of the relationships and the personal qualities that foster a spirit of interprofessional practice in these human-to-human interactions. It highlights how health practitioners need to be free to enact their humanity; to move beyond the "professional" pathway, which encourages them to leave "who they are" at home.
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Affiliation(s)
- Brenda Flood
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Liz Smythe
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Clare Hocking
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Marion Jones
- Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand
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Young J, Zolio L, Brock T, Harrison J, Hodgkinson M, Kumar A, Morphet J, Kent F. Interprofessional learning about medication safety. CLINICAL TEACHER 2021; 18:656-661. [PMID: 34669259 DOI: 10.1111/tct.13430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/18/2021] [Accepted: 09/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Safe medication management requires collaboration between health professionals. APPROACH A mixed academic and clinician team co-designed and co-facilitated a 2-h interprofessional medication safety workshop, covering medication history taking, perioperative medication management, discharge planning, incident review and dosing and administration calculations. Three workshop sessions were delivered across three sites during September 2019 at a large metropolitan healthcare network. Senior nursing, medical and pharmacy students were invited to participate in the workshops and evaluation. EVALUATION We evaluated satisfaction, learning experience and perceived clinical application for medical, pharmacy and nursing students. Surveys were conducted immediately after each workshop and at 4 weeks. Quantitative data was analysed descriptively and qualitative data analysed using thematic analysis. Forty-five students participated in the evaluative component of the workshops. Mean student response scores demonstrated a high level of satisfaction with the workshop's relevance and utility to their learning. Students expressed strong agreement that the workshop promoted communication across professions for medication safety. Analysis of the qualitative data identified seven key themes, with consistently positive responses provided in each: interactions within the interprofessional team; recognising the importance of teams; learning the process of medication use; acknowledging and working with difference; role playing; thinking patient safety; and authenticity. IMPLICATIONS A 2-h interprofessional workshop about medication safety provided positive learning experiences with high satisfaction to medical, nursing and pharmacy students, and had strong perceived applicability to their future clinical practice.
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Affiliation(s)
- Joanne Young
- Pharmacy Department, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Luigi Zolio
- Department of General Medicine, Alfred Health, Melbourne, Victoria, Australia.,Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Tina Brock
- Faculty of Pharmacy & Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia
| | - Julia Harrison
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | | | - Arunaz Kumar
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Julia Morphet
- Nursing & Midwifery, Monash University, Frankston, Victoria, Australia
| | - Fiona Kent
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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Hoyos MC, Velásquez Palacio SM. Educación interprofesional y seguridad del paciente: una revisión sistemática. INVESTIGACIÓN EN ENFERMERÍA: IMAGEN Y DESARROLLO 2021. [DOI: 10.11144/javeriana.ie23.eisp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Introducción: la educación interprofesional (EIP) se dene como una iniciativa educativa, formativa o docente que involucra a más de una profesión en el aprendizaje conjunto e interactivo. La formación del recurso humano en salud tiene como desafío plantear soluciones a la escasez de personal sanitario en el mundo y formar profesionales que tengan un desempeño óptimo. Objetivo: caracterizar las publicaciones relacionadas con la implementación de modelos en educación interprofesional y el impacto generado en algunos aspectos relacionados con la seguridad del paciente. Método: se realizó una revisión sistemática de la literatura cientíca en Pubmed, Science Direct, Scielo, LILACS y Google Scholar con siete estrategias de búsqueda garantizando la exhaustividad y reproducibilidad en las fases de la guía PRISMA. Resultados: se incluyeron n = 33 estudios de los cuales n = 19 (57,5%) fueron aplicados en el contexto hospitalario, n = 14 (42,4%) utilizaron metodologías cuasiexperimentales, de estos n = 4 estudios miden desenlaces directos relacionados con la seguridad del paciente, y en los otros n = 29 (87,8%) se encontró una mejora en la comunicación, percepción y conocimiento en los equipos de trabajo. Conclusión: el aprendizaje interprofesional mejora la comunicación y la interacción entre los profesionales de salud. No obstante, es difícil generalizar los resultados debido a la diversidad de metodologías de interacción interprofesional aplicadas en los estudios.
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De Baetselier E, Dilles T, Feyen H, Haegdorens F, Mortelmans L, Van Rompaey B. Nurses' responsibilities and tasks in pharmaceutical care: A scoping review. Nurs Open 2021; 9:2562-2571. [PMID: 34268910 PMCID: PMC9584497 DOI: 10.1002/nop2.984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/27/2021] [Accepted: 06/08/2021] [Indexed: 11/22/2022] Open
Abstract
Aim To provide an overview of responsibilities and tasks of nurses in pharmaceutical care. Design Scoping review. Methods Two databases were systematically searched (MEDLINE and Scopus) for recent original research papers concerning nurses’ responsibilities and tasks in pharmaceutical care. The definition of responsibility was based on literature, moral and ethical discussions. Existing responsibilities and tasks beyond preparation and administration of medication were collected and synthesized. This main study outcome was extracted from titles and abstracts only. Results were reported in accordance with PRISMA‐ScR guidelines. Results Of the 3,805 titles and abstracts reviewed, 453 abstracts were included. A total of seven responsibilities were identified: (a) management of therapeutic and adverse effects of medication, (b) management of medication adherence, (c) management of patient medication self‐management, (d) management of patient education and information about medication, (e) prescription management, (f) medication safety management and (g) (transition of) care coordination. Within these responsibilities, all tasks performed by nurses were described.
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Affiliation(s)
- Elyne De Baetselier
- Department of Nursing and Midwifery Science, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Tinne Dilles
- Department of Nursing and Midwifery Science, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Hilde Feyen
- Department of Nursing and Midwifery Science, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Filip Haegdorens
- Department of Nursing and Midwifery Science, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Laura Mortelmans
- Department of Nursing and Midwifery Science, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Bart Van Rompaey
- Department of Nursing and Midwifery Science, Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Guidance for Safe and Appropriate Use of Antibiotics in Hospice Using a Collaborative Decision Support Tool. J Hosp Palliat Nurs 2021; 22:276-282. [PMID: 32568934 DOI: 10.1097/njh.0000000000000655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Infections often impact care of hospice patients; however, limited guidance exists for end-of-life infection management. Regardless of patient prognosis, appropriate antibiotic use is necessary for maintaining quality of life. Antibiotics may be associated with serious adverse events, posing safety risks to patients that should be factored into the appropriateness determination. Fluoroquinolone antibiotics are prescribed frequently in hospice. There are 8 fluoroquinolone drug safety warnings regarding risk for serious adverse events communicated by the US Food and Drug Administration. A retrospective chart review at a hospice pharmacy services provider identified decedents who used a fluoroquinolone during a 1-month period. Charts were evaluated for the presence of risk factors for serious adverse events, including advanced age (86.0%), orders for multiple QTc prolongation risk medications (51.5%), hypertension (64.1%), and concomitant corticosteroids (22.9%). Findings demonstrate notable risk with the use of at least 1 class of antibiotics in a hospice population. STAMPS is a hospice decision support tool, developed to guide symptom-driven antibiotic use that incorporates safety assessment and individual goals of care into infection management planning. The tool can also serve as a framework for patient-centered communications about appropriate antibiotic use in hospice between providers, patients, and families.
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De Baetselier E, Dilles T, Batalha LM, Dijkstra NE, Fernandes MI, Filov I, Friedrichs J, Grondahl VA, Heczkova J, Helgesen AK, Jordan S, Keeley S, Klatt T, Kolovos P, Kulirova V, Ličen S, Lillo-Crespo M, Malara A, Padysakova H, Prosen M, Pusztai D, Riquelme-Galindo J, Rottkova J, Sino CG, Talarico F, Tziaferi S, Van Rompaey B. Perspectives of nurses' role in interprofessional pharmaceutical care across 14 European countries: A qualitative study in pharmacists, physicians and nurses. PLoS One 2021; 16:e0251982. [PMID: 34043650 PMCID: PMC8158867 DOI: 10.1371/journal.pone.0251982] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 05/07/2021] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). DESIGN Qualitative study conducted through semi-structured in-depth interviews. SETTING Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. PARTICIPANTS In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. DATA COLLECTION AND ANALYSIS All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. RESULTS 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. CONCLUSIONS European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.
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Affiliation(s)
- Elyne De Baetselier
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- * E-mail:
| | - Tinne Dilles
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Luis M. Batalha
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Nienke E. Dijkstra
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Maria I. Fernandes
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), Coimbra, Portugal
| | - Izabela Filov
- University "St. Kliment Ohridski" Bitola, Bitola, Republic of North-Macedonia
| | - Juliane Friedrichs
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Vigdis A. Grondahl
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Jana Heczkova
- Institute of Nursing Theory and Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea, Wales, United Kingdom
| | - Sarah Keeley
- Department of Nursing and Clinical Science, Bournemouth University, Bournemouth, England, United Kingdom
| | - Thomas Klatt
- Medical Faculty, Institute of Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Petros Kolovos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Sparti, Greece
| | - Veronika Kulirova
- Institute of Nursing Theory and Practice, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Sabina Ličen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Izola, Slovenia
| | - Manuel Lillo-Crespo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | | | - Hana Padysakova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovak Republic
| | - Mirko Prosen
- Faculty of Health Sciences, Department of Nursing, University of Primorska, Izola, Slovenia
| | - Dorina Pusztai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Jorge Riquelme-Galindo
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | - Jana Rottkova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovak Republic
| | - Carolien G. Sino
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | | | - Styliani Tziaferi
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponnese, Sparti, Greece
| | - Bart Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Interprofessional and Intraprofessional Communication about Older People's Medications across Transitions of Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083925. [PMID: 33918010 PMCID: PMC8068321 DOI: 10.3390/ijerph18083925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
Communication breakdowns contribute to medication incidents involving older people across transitions of care. The purpose of this paper is to examine how interprofessional and intraprofessional communication occurs in managing older patients' medications across transitions of care in acute and geriatric rehabilitation settings. An ethnographic design was used with semi-structured interviews, observations and focus groups undertaken in an acute tertiary referral hospital and a geriatric rehabilitation facility. Communication to manage medications was influenced by the clinical context comprising the transferring setting (preparing for transfer), receiving setting (setting after transfer) and 'real-time' (simultaneous communication). Three themes reflected these clinical contexts: dissemination of medication information, safe continuation of medications and barriers to collaborative communication. In transferring settings, nurses and pharmacists anticipated communication breakdowns and initiated additional communication activities to ensure safe information transfer. In receiving settings, all health professionals contributed to facilitating safe continuation of medications. Although health professionals of different disciplines sometimes communicated with each other, communication mostly occurred between health professionals of the same discipline. Lack of communication with pharmacists occurred despite all health professionals acknowledging their important role. Greater levels of proactive preparation by health professionals prior to transfers would reduce opportunities for errors relating to continuation of medications.
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Hatton K, Bhattacharya D, Scott S, Wright D. Barriers and facilitators to pharmacists integrating into the ward-based multidisciplinary team: A systematic review and meta-synthesis. Res Social Adm Pharm 2021; 17:1923-1936. [PMID: 33676862 DOI: 10.1016/j.sapharm.2021.02.006] [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] [Received: 09/11/2020] [Revised: 02/05/2021] [Accepted: 02/07/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pharmacists who are integrated into the ward team are involved in initial decision making, therefore pre-empting pharmaceutical problems and optimising therapy from the outset. Identifying the barriers and facilitators (determinants) to successful pharmacist integration within a multidisciplinary ward team will facilitate design of strategies to support integration. OBJECTIVE The study aimed to identify the modifiable barriers and facilitators to pharmacist integration into the ward-based multidisciplinary team. METHOD Searches were conducted in May 2018 across 5 databases: MEDLINE, Embase, CINAHL, PsychINFO and ASSIA, combined with grey literature and manual searches. Qualitative and mixed-methods studies using a qualitative method of data collection and analysis were eligible if reporting at least 1 modifiable determinant. Framework synthesis using the Theoretical Domains Framework (TDF) as the a priori coding framework was undertaken. Behaviour change techniques for addressing the identified determinants were selected. RESULTS Twenty studies were included indicating 9 facilitators and 5 barriers to pharmacist integration. These were grouped into 3 themes. Professional knowledge and skills of the pharmacist were a facilitator to integration; interpersonal skills and relationships when representing positive interactions with team members were a facilitator whilst hierarchy was a barrier; working patterns were a facilitator when pharmacists were co-located with team members whilst profession-specific goals and excessive workload were barriers. These mapped to the TDF domains 'knowledge', 'social/professional role and identity', 'skills', 'reinforcement', 'social influence', 'goals', and 'environmental context and resources' respectively. CONCLUSION The identified determinants within TDF domains and their associated behaviour change techniques now enable researchers to design theory- and evidence-based interventions to facilitate pharmacist integration into the ward-based multidisciplinary team. Pharmacist integration is facilitated by their knowledge and skills being valued and through demonstrating effective interpersonal skills. Re-structuring pharmacist responsibilities and working patterns to align with those of multidisciplinary team members also promotes integration.
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Affiliation(s)
- Katie Hatton
- Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, United Kingdom.
| | - Debi Bhattacharya
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, United Kingdom
| | - Sion Scott
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, United Kingdom
| | - David Wright
- School of Pharmacy, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, United Kingdom
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Powell B, Jardine KD, Steed M, Adams J, Mason B. Enhanced nursing self-awareness and pharmacotherapy knowledge-base: peer-teaching and nursing/pharmacy interprofessional education. MEDICAL EDUCATION ONLINE 2020; 25:1814551. [PMID: 32865155 PMCID: PMC7482749 DOI: 10.1080/10872981.2020.1814551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 07/13/2020] [Accepted: 08/20/2020] [Indexed: 06/11/2023]
Abstract
Peer-teaching and interprofessional education can help students define individual healthcare roles, establish improved interprofessional relationships, and improve overall knowledge-base. Peer-teaching was provided by student pharmacists completing Advanced Pharmacy Practice Experiences (APPEs) for nine weeks to undergraduate student nurses. 4 student pharmacists and 25 student nurses participated in this study. Knowledge-base was measured with quizzes that were pre and post educational intervention. Confidence, self-awareness, and interprofessional perception were assessed using a modified ISVS-9A. Data were analyzed using a paired t-test. The mean difference between pre and post-knowledge-based tests averaged an improvement of 3.15 points (out of an average of 10.8 points per test) showing an overall improvement (p < 0.003). A total of 25 nursing students completed a pre and post-ISVS-9A questionnaire. The mean difference between the pre and post-questionnaire items showed an average improvement of 0.87 points (p < 0.05). Interprofessional peer-teaching showed overall improvement in student nurse knowledge-base and perceived value of and socialization to interprofessional care. This study required no financial funding, and there are no conflicts of interest to disclose.
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Affiliation(s)
- Brecon Powell
- Idaho State University College of Pharmacy, Pocatello, ID, USA
| | | | - Michelle Steed
- Idaho State University College of Pharmacy, Pocatello, ID, USA
| | - Jennifer Adams
- Idaho State University College of Pharmacy, Meridian, ID, USA
| | - Barb Mason
- Idaho State University College of Pharmacy, Meridian, ID, USA
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Medication management during transitions from hospital to home: a focus group study with hospital and primary healthcare providers in the Netherlands. Int J Clin Pharm 2020; 43:698-707. [PMID: 33128661 DOI: 10.1007/s11096-020-01189-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 10/26/2020] [Indexed: 10/23/2022]
Abstract
Background Medication management is jeopardized during a patient's transition from hospital to home. Insight is required from both hospital and primary healthcare providers on how care should be organised to achieve continuity of medication management. Objective This study aimed to identify perspectives of hospital and primary healthcare providers on barriers to the continuity of medication management during a patient's transition from hospital to home and facilitators to overcome these. Setting A qualitative descriptive study was conducted within hospital and primary healthcare settings in the Netherlands. Method Two focus groups were performed with two community care registered nurses, two community pharmacists, four general practitioners, two hospital nurses, two hospital pharmacists, four outpatient pharmacists, two pharmacy technicians, and one physician. A semi-structured interview guide was used to identify perspectives of participants on barriers to continuity of medication management and facilitators to overcome these. Data were analysed following thematic content analysis. Main outcome measure Barriers to the continuity of medication management during a patient's transition from hospital to home would be enumerated, along with facilitators to overcome these barriers. Results Three main themes of barriers and facilitators were identified: (1) healthcare provider collaboration, including the transfer of medication information and effective collaboration; (2) patient's medication use, including information about medication, personalised care, and supervision after discharge; and (3) organisation of healthcare, including the connection between information systems and the supply of medication. Conclusion Barriers and facilitators to continuity of medication management during the transition from hospital to home occur at the provider, patient, and healthcare-system levels. Future interventions should focus on all levels through interprofessional healthcare teams, tailoring care to patient needs, and on the use of a uniform, nationwide patient electronic health record.
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Vaismoradi M, Jordan S, Vizcaya-Moreno F, Friedl I, Glarcher M. PRN Medicines Optimization and Nurse Education. PHARMACY 2020; 8:E201. [PMID: 33114731 PMCID: PMC7712763 DOI: 10.3390/pharmacy8040201] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/19/2020] [Accepted: 10/23/2020] [Indexed: 12/11/2022] Open
Abstract
Medicines management is a high-risk and error prone process in healthcare settings, where nurses play an important role to preserve patient safety. In order to create a safe healthcare environment, nurses should recognize challenges that they face in this process, understand factors leading to medication errors, identify errors and systematically address them to prevent their future occurrence. ''Pro re nata'' (PRN, as needed) medicine administration is a relatively neglected area of medicines management in nursing practice, yet has a high potential for medication errors. Currently, the international literature indicates a lack of knowledge of both the competencies required for PRN medicines management and the optimum educational strategies to prepare students for PRN medicines management. To address this deficiency in the literature, the authors have presented a discussion on nurses' roles in medication safety and the significance and purpose of PRN medications, and suggest a model for preparing nursing students in safe PRN medicines management. The discussion takes into account patient participation and nurse competencies required to safeguard PRN medication practice, providing a background for further research on how to improve the safety of PRN medicines management in clinical practice.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, UK;
| | - Flores Vizcaya-Moreno
- Nursing Department, Faculty of Health Sciences, University of Alicante, 03080 Alicante, Spain;
| | - Ingrid Friedl
- Hospital Graz II, A Regional Hospital of the Health Care Company of Styria, 8020 Graz, Austria;
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria;
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Wang P, Zhou L, Mu D, Zhang D, Shao Q. What makes clinical documents helpful and engaging? An empirical investigation of experience sharing in an online medical community. Int J Med Inform 2020; 143:104273. [PMID: 32979649 DOI: 10.1016/j.ijmedinf.2020.104273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Social media have emerged as a platform for experience and knowledge sharing in the medical community. The online medical community is garnering increasing research attention; however, there is a lack of understanding of what factors influence the helpfulness and engagement of experience sharing in the community. METHODS Clinical documents manifest physicians' experience and knowledge. This study fills the knowledge gap by investigating what elements of clinical documents contribute to the helpfulness of sharing clinical documents online and what influence member engagement. Clinical documents follow certain architecture to specify their structure and semantics for exchange (e.g., HL7 C-CDA). Accordingly, the structural elements of clinical documents may influence document helpfulness for the online community. Member engagement is one of the indicators of community success. We collected 6514 clinical documents from a real-world online medical community, and normalized them with the structural elements of HL7 C-CDA. We performed regression analyses to identify the structural elements that have significant impacts on document helpfulness and member engagement. RESULTS The results show that some structural elements of clinical documents such as assessment, chief complaints, medications, physical exams, procedures, results, and vital signs sections have positive effects whereas assessment and plan, general status, history and past illness of patients, instructions, problem and review of systems have negative effects on the helpfulness of clinical documents. The results also reveal that structural elements such as family history, history of past illness, medication, physical exam, review of systems, and vital signs positively; whereas assessment, assessment and plan, instruction, and result negatively; influence member engagement. CONCLUSIONS The findings provide guide on how to improve the effectiveness of sharing clinical experience online. The new and in-depth insights may contribute to the success of online medical communities and the quality of medical decisions.
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Affiliation(s)
- Ping Wang
- Division of Clinical Research, The First Hospital of Jilin University, Changchun, 130021, China; Belk College of Business, The University of North Carolina at Charlotte, 28223, USA; School of Public Health, Jilin University, Changchun, 130021, China
| | - Lina Zhou
- Belk College of Business, The University of North Carolina at Charlotte, 28223, USA.
| | - Dongmei Mu
- Division of Clinical Research, The First Hospital of Jilin University, Changchun, 130021, China.
| | - Dongsong Zhang
- Belk College of Business, The University of North Carolina at Charlotte, 28223, USA
| | - Qi Shao
- Division of Clinical Research, The First Hospital of Jilin University, Changchun, 130021, China; School of Public Health, Jilin University, Changchun, 130021, China
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24
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Bakhshi F, Mitchell R, Nasrabadi AN, Varaei S, Hajimaghsoudi M. Behavioural changes in medication safety: Consequent to an action research intervention. J Nurs Manag 2020; 29:152-164. [PMID: 32955774 DOI: 10.1111/jonm.13128] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/29/2020] [Accepted: 08/03/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore the extent to which action research assists developing medication safety behaviours among emergency medicine staff. BACKGROUND Health care staff involved in medication therapy are frequently required to implement progressive changes. To permanently improve medication safety, we must consider staff behaviour. This study utilizes action research to engage health care workers and engender behavioural changes. METHOD Two cycles of action research were implemented. Data were collected through pre- and post-medication safety surveys, unstructured interviews and field notes. Staff in the emergency department worked together to progress the study cycles. RESULTS The pre-evaluation phase revealed deficiencies in staff medication safety behaviour. Subsequent to the implementation of safety initiatives, pre- to post-evaluation comparison indicated significant improvement in medication safety behaviours. In response to qualitative reflection phase data in reflection, ward pharmacists were placed in the emergency department and anew policy on responding to medication error was developed. Analysed field notes revealed improved safe patient care, enhanced pharmaceutical knowledge and changes in the emergency department climate. CONCLUSIONS Through action research, this study introduced actions to improve medication safety behaviours in the emergency department. Staff involvement led to changed safety behaviours. IMPLICATION FOR NURSING MANAGEMENT This study advises nurse managers of the benefit of pharmacist-led medication therapy, interprofessional medication safety courses and active communication between front-line staff and managers regarding medication safety.
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Affiliation(s)
- Fatemeh Bakhshi
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran.,Macquarie Business School, Macquarie University, Sydney, NSW, Australia
| | - Rebecca Mitchell
- Macquarie Business School, Macquarie University, Sydney, NSW, Australia
| | | | - Shokoh Varaei
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Hajimaghsoudi
- Research Development Center of Shahid Rahnemoon Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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25
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Bushell M, Frost J, Deeks L, Kosari S, Hussain Z, Naunton M. Evaluation of Vaccination Training in Pharmacy Curriculum: Preparing Students for Workforce Needs. PHARMACY 2020; 8:E151. [PMID: 32825470 PMCID: PMC7559293 DOI: 10.3390/pharmacy8030151] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND To introduce and evaluate a university vaccination training program, preparing final year Bachelor of Pharmacy (BPharm) and Master of Pharmacy (MPharm) students to administer vaccinations to children and adults in community pharmacy and offsite (mobile and outreach) settings. METHODS Final year BPharm and MPharm students were trained to administer intramuscular vaccinations to adults and children. The education program embedded in pharmacy degree curriculum was congruent with the requirements of the Australian National Immunisation Education Framework. The training used a mix of pedagogies including online learning; interactive lectures; and simulation, which included augmented reality and role play. All pharmacy students completing the program in 2019 were required to carry out pre- and post-knowledge assessments. Student skill of vaccination was assessed using an objective structured clinical assessment rubric. Students were invited to complete pre and post questionnaires on confidence. The post questionnaire incorporated student evaluation of learning experience questions. RESULTS In both cohorts, student vaccination knowledge increased significantly after the completion of the vaccination training program; pre-intervention and post-intervention mean knowledge score (SD) of BPharm and MPharm were (14.3 ± 2.7 vs. 22.7 ± 3.3; p < 0.001) and (15.7 ± 2.9 vs. 21.4 ± 3.2; p < 0.001) respectively. There was no difference between the BPharm and MPharm in the overall knowledge test scores, (p = 0.81; p = 0.95) pre and post scores respectively. Using the OSCA rubric, all students (n = 52) were identified as competent in the skill of injection and could administer an IM deltoid injection to a child and adult mannequin. Students agreed that the training increased their self-confidence to administer injections to both children and adults. Students found value in the use of mixed reality to enhance student understanding of the anatomy of injection sites. CONCLUSION The developed vaccination training program improved both student knowledge and confidence. Pharmacy students who complete such training should be able to administer vaccinations to children and adults, improving workforce capability. Mixed reality in the education of pharmacy students can be used to improve student satisfaction and enhance learning.
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Affiliation(s)
- Mary Bushell
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, Canberra 2617, Australia; (J.F.); (L.D.); (S.K.); (Z.H.); (M.N.)
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26
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Courtenay M, Burnett E, Castro-Sánchez E, Du Toit B, Figueiredo RM, Gallagher R, Gotterson F, Kennedy H, Manias E, McEwen J, Ness V, Olans R, Padoveze MC. Preparing nurses for COVID-19 response efforts through involvement in antimicrobial stewardship programmes. J Hosp Infect 2020; 106:176-178. [PMID: 32531230 PMCID: PMC7283056 DOI: 10.1016/j.jhin.2020.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 06/03/2020] [Indexed: 10/25/2022]
Affiliation(s)
- M Courtenay
- School of Health Sciences, Cardiff University, Cardiff, UK.
| | - E Burnett
- School of Health Sciences, University of Dundee, Scotland, UK
| | - E Castro-Sánchez
- NIHR Health Protection Unit in Healthcare Associated Infection and Antimicrobial Resistance at Imperial College London, London, UK
| | - B Du Toit
- Mediclinic Southern Africa, Stellenbosch, South Africa
| | | | | | - F Gotterson
- The University of Melbourne, National Centre for Antimicrobial Stewardship, Australia
| | | | - E Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety, Institute for Health Transformation, Deakin University, Australia
| | | | - V Ness
- Glasgow Caledonian University, Glasgow, UK
| | - R Olans
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - M C Padoveze
- School of Nursing, University of São Paulo, Brazil
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27
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De Baetselier E, Van Rompaey B, Batalha LM, Bergqvist M, Czarkowska-Paczek B, De Santis A, Dijkstra NE, Fernandes MI, Filov I, Grøndahl VA, Heczkova J, Helgesen AK, Isfort M, Jordan S, Karnjus I, Keeley S, Kolovos P, Langer G, Lillo-Crespo M, Logan V, Malara A, Meyer G, Olah A, Padysakova H, Prosen M, Pusztai D, Sino CG, Tziaferi S, Ziakova E, Dilles T. EUPRON: nurses' practice in interprofessional pharmaceutical care in Europe. A cross-sectional survey in 17 countries. BMJ Open 2020; 10:e036269. [PMID: 32499269 PMCID: PMC7282395 DOI: 10.1136/bmjopen-2019-036269] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Safe pharmaceutical care (PC) requires an interprofessional team approach, involving physicians, nurses and pharmacists. Nurses' roles however, are not always explicit and clear, complicating interprofessional collaboration. The aim of this study is to describe nurses' practice and interprofessional collaboration in PC, from the viewpoint of nurses, physicians and pharmacists. DESIGN A cross-sectional survey. SETTING The study was conducted in 17 European countries, each with their own health systems. PARTICIPANTS Pharmacists, physicians and nurses with an active role in PC were surveyed. MAIN OUTCOME MEASURES Nurses' involvement in PC, experiences of interprofessional collaboration and communication and views on nurses' competences. RESULTS A total of 4888 nurses, 974 physicians and 857 pharmacists from 17 European countries responded. Providing patient education and information (PEI), monitoring medicines adherence (MMA), monitoring adverse/therapeutic effects (ME) and prescribing medicines were considered integral to nursing practice by 78%, 73%, 69% and 15% of nurses, respectively. Most respondents were convinced that quality of PC would be improved by increasing nurses' involvement in ME (95%), MMA (95%), PEI (91%) and prescribing (53%). Mean scores for the reported quality of collaboration between nurses and physicians, collaboration between nurses and pharmacists and interprofessional communication were respectively <7/10, ≤4/10, <6/10 for all four aspects of PC. CONCLUSIONS ME, MMA, PEI and prescribing are part of nurses' activities, and most healthcare professionals felt their involvement should be extended. Collaboration between nurses and physicians on PC is limited and between nurses and pharmacists even more.
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Affiliation(s)
- Elyne De Baetselier
- Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Bart Van Rompaey
- Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
| | - Luis M Batalha
- Higher School of Nursing of Coimbra Health Sciences Research Unit Nursing, Coimbra, Portugal
| | - Monica Bergqvist
- Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | | | | | - Nienke E Dijkstra
- Research Group Care for the Chronically Ill, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Maria I Fernandes
- Higher School of Nursing of Coimbra Health Sciences Research Unit Nursing, Coimbra, Portugal
| | - Izabela Filov
- Saint Kliment Ohridski University Bitola, Bitola, Bitola, The former Yugoslav Republic of Macedonia
| | | | - Jana Heczkova
- Institute of Nursing Theory and Practice, Charles University First Faculty of Medicine, Praha, Czech Republic
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Michael Isfort
- Deutsches Institut für angewandte Pflegeforschung e V, Köln, Germany
| | | | - Igor Karnjus
- Department of Nursing, University of Primorska College of Health Care, Izola, Slovenia
| | - Sarah Keeley
- Department of Nursing and Clinical Science, Bournemouth University, Dorset, UK
| | - Petros Kolovos
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponesse, Sparti, Greece
| | - Gero Langer
- Medical Faculty, Institute of Health and Nursing Sciences, Martin-Luther-Universitat Halle-Wittenberg, Halle (Saale), Germany
| | | | - Vera Logan
- Nursing, Swansea University, Swansea, UK
| | | | - Gabriele Meyer
- Medical Faculty, Institute of Health and Nursing Sciences, Martin-Luther-Universitat Halle-Wittenberg, Halle (Saale), Germany
| | - Andras Olah
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, University of Pecs Faculty of Health Sciences, Pecs, Hungary
| | - Hana Padysakova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Mirko Prosen
- Faculty of Health Sciences, Department of Nursing, University of Primorska College of Health Care, Izola, Slovenia
| | - Dorina Pusztai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, University of Pecs Faculty of Health Sciences, Pecs, Hungary
| | - Carolien G Sino
- Research Group Care for the Chronically Ill, HU University of Applied Sciences Utrecht, Utrecht, The Netherlands
| | - Styliani Tziaferi
- Department of Nursing, Laboratory of Integrated Health Care, University of Peloponesse, Sparti, Greece
| | - Elena Ziakova
- Faculty of Nursing and Professional Health Studies, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Tinne Dilles
- Nursing and Midwifery, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Graber ML, Grice GR, Ling LJ, Conway JM, Olson A. Pharmacy Education Needs to Address Diagnostic Safety. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2019; 83:7442. [PMID: 31507297 PMCID: PMC6718490 DOI: 10.5688/ajpe7442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 02/14/2019] [Indexed: 06/10/2023]
Abstract
The American Association of Colleges of Pharmacy, the Accreditation Council for Pharmacy Education, and the Center for the Advancement of Pharmacy Education frame patient safety from the perspective of medication management, which is also the current focus of pharmacy education and training. With the growing appreciation that diagnostic errors represent an urgent and actionable patient safety concern, the National Academy of Medicine has recommended diagnostic safety training for all health care professions. The Society to Improve Diagnosis in Medicine has worked with an interprofessional consensus group to identify a set of 12 key competencies necessary to achieve diagnostic quality and safety that focuses on individual, team-based, and system-related competencies. Much of this already exists in pharmacy education, but pharmacy training programs need to give graduates more guidance on how they contribute to the diagnostic process and the prevention and detection of diagnostic errors. We describe the current state of progress in this regard, and what steps are needed by training programs to provide content and assessment so that graduates achieve the requisite competencies. Governing and advisory bodies need to expand the expectations around patient safety to include diagnostic safety.
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Affiliation(s)
- Mark L Graber
- The Society to Improve Diagnosis in Medicine, Plymouth, Massachusetts
| | | | - Louis J Ling
- Accreditation Council for Graduate Medical Education, Chicago, Illinois
| | - Jeannine M Conway
- University of Minnesota, College of Pharmacy, Minneapolis, Minnesota
| | - Andrew Olson
- University of Minnesota Medical School, Minneapolis, Minnesota
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29
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Bucknall T, Fossum M, Hutchinson AM, Botti M, Considine J, Dunning T, Hughes L, Weir-Phyland J, Digby R, Manias E. Nurses' decision-making, practices and perceptions of patient involvement in medication administration in an acute hospital setting. J Adv Nurs 2019; 75:1316-1327. [PMID: 30697809 DOI: 10.1111/jan.13963] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/26/2018] [Accepted: 11/20/2018] [Indexed: 12/28/2022]
Abstract
AIMS To describe nurses' decision-making, practices and perceptions of patient involvement in medication administration in acute hospital settings. BACKGROUND Medication errors cause unintended harm to patients. Nurses have a major role in ensuring patient safety in medication administration practices in hospital settings. Investigating nurses' medication administration decision-making and practices and their perceptions of patient involvement, may assist in developing interventions by revealing how and when to involve patients during medication administration in hospital. DESIGN A descriptive exploratory study design. METHODS Twenty nurses were recruited from two surgical and two medical wards of a major metropolitan hospital in Australia. Each nurse was observed for 4 hr, then interviewed after the observation. Data were collected over six months in 2015. Observations were captured on an electronic case report form; interviews were audio-recorded and transcribed verbatim. Data were analysed using descriptive statistics and content and thematic analysis. RESULTS Ninety-five medication administration episodes, of between two and eight episodes per nurse, were observed. A total of 56 interruptions occurred with 26 of the interruptions being medication related. Four major themes emerged from the interviews: dealing with uncertainty; facilitating, framing and filtering information; managing interruptions and knowing and involving patients. CONCLUSION Nurses work in complex adaptive systems that change moment by moment. Acknowledging and understanding the cognitive workload and complex interactions are necessary to improve patient safety and reduce errors during medication administration. Knowing and involving the patient is an important part of a nurses' medication administration safety strategies.
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Affiliation(s)
- Tracey Bucknall
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Alfred Health, Melbourne, Vic., Australia
| | - Mariann Fossum
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Alfred Health, Melbourne, Vic., Australia.,Centre for Caring Research-Southern Norway, Department of Health and Nursing Science, University of Agder, Grimstad, Norway
| | - Alison M Hutchinson
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Monash Health, Melbourne, Vic., Australia
| | - Mari Botti
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Epworth HealthCare, Melbourne, Vic., Australia
| | - Julie Considine
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Eastern Health, Melbourne, Vic., Australia
| | - Trisha Dunning
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia.,Barwon Health, Geelong, Vic., Australia
| | - Lee Hughes
- Alfred Health, Melbourne, Vic., Australia
| | | | - Robin Digby
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia
| | - Elizabeth Manias
- School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Faculty of Health, Deakin University, Geelong, Vic., Australia
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30
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Cerbin-Koczorowska M, Zielinska-Tomczak L, Waszyk-Nowaczyk M, Michalak M, Skowron A. As the twig is bent, so is the tree inclined: a survey of student attitudes toward interprofessional collaboration supported with the curricula analysis. J Interprof Care 2019; 33:636-644. [PMID: 30739538 DOI: 10.1080/13561820.2019.1572598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Pharmaceutical care was legally introduced as an interprofessional service in Poland in 2009. However, a collaboration between physicians and pharmacists remains incidental. Proper education at the undergraduate level is necessary to shape the attitudes of students toward establishing interprofessional relations. The aim of the study was to assess the perception of physician-pharmacist collaboration among final-year medical and pharmacy students through questionnaires with both closed-ended and open-ended questions. The study also includes an analysis of medicine and pharmacy curricula in terms of promoting interprofessional collaboration between the two fields. The statistical analysis of data obtained from 502 respondents revealed significant differences between the perceived areas for such collaboration. Moreover, the division of roles and responsibilities during the pharmacotherapy process between both professions seems to be unclear. Importantly, only 10.14% of the respondents evaluated these professional relations as 'good' or 'very good'. Also, 66.87% of the students emphasized the importance of educational interventions to improve interprofessional collaboration between pharmacists and physicians. Although 70% of medical and 87% of pharmacy students wish to establish such collaboration in the future, only 15% and 35%, respectively feel adequately prepared for the task. Understanding similarities and differences in this field appears to be the key to designing effective educational solutions for promoting interprofessional attitudes among healthcare undergraduates.
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Affiliation(s)
| | | | - Magdalena Waszyk-Nowaczyk
- Department of Pharmaceutical Technology (Pharmacy Practice Division), Poznan University of Medical Sciences, Poznan, Poland
| | - Michal Michalak
- Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
| | - Agnieszka Skowron
- Department of Social Pharmacy, Jagiellonian University Medical College, Krakow, Poland
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31
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Nordström A, Wihlborg M. A Phenomenographic Study of Swedish Nurse Anesthetists' and OR Nurses' Work Experiences. AORN J 2019; 109:217-226. [PMID: 30694551 DOI: 10.1002/aorn.12582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In the complex OR environment, perioperative team members need to practice communication and teamwork to ensure safe, high-quality care. A lack of collaboration among professionals in the OR during surgery results in inefficiency, increased tension, and suboptimal patient care. The purpose of this study was to determine how nurse anesthetists and OR nurses experienced their work in the OR. We used a qualitative design with a phenomenographic approach and conducted 12 interviews in two surgical departments in the southern part of Sweden. We identified four categories of description: team member approach, professional awareness, lifelong learning approach, and safety and the patient's interest. We found that the nurses' work experiences in the OR were multifaceted and correlated with concepts of teamwork, safety, and communication.
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Wen A, Wong L, Ma C, Arndt R, Katz AR, Richardson K, Deutsch M, Masaki K. An interprofessional team simulation exercise about a complex geriatric patient. GERONTOLOGY & GERIATRICS EDUCATION 2019; 40:16-29. [PMID: 30513067 DOI: 10.1080/02701960.2018.1554568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Interprofessional collaboration is an essential skill to optimize the care of older adults with complex problems. We successfully developed and evaluated an interprofessional teamwork simulation exercise for medical, nursing, pharmacy, and social work students. Pharmacy students participated via video conferencing. Before the simulation, students watched a teamwork video and reviewed the patient case. Following an icebreaker exercise, interdisciplinary faculty facilitated a discussion highlighting effective teamwork strategies. Students then collaborated to develop a discharge plan, followed by a simulated family meeting with a theater student. Interdisciplinary faculty again provided structured debriefing highlighting principles of effective teamwork. Students self-rated interprofessional practice core competencies were evaluated using a retrospective pre/post survey and analyzed using paired t-tests. We qualitatively examined the use of distance technology and assessed learner's satisfaction with the project. All core competency categories for all disciplines demonstrated significant improvements in mean scores. Students' qualitative comments demonstrated positive impact on learning interprofessional core competencies.
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Affiliation(s)
- Aida Wen
- a The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Lorrie Wong
- b School of Nursing and Dental Hygiene , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Carolyn Ma
- c The Daniel K. Inouye College of Pharmacy , University of Hawaii at Hilo , Hilo , HI , USA
| | - Robin Arndt
- d Myron B. Thompson School of Social Work , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Alan R Katz
- e Office of Public Health Studies , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Karol Richardson
- b School of Nursing and Dental Hygiene , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Melodee Deutsch
- b School of Nursing and Dental Hygiene , University of Hawaii at Manoa , Honolulu , HI , USA
| | - Kamal Masaki
- a The John A. Hartford Foundation Center of Excellence in Geriatrics, Department of Geriatric Medicine, John A. Burns School of Medicine , University of Hawaii at Manoa , Honolulu , HI , USA
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Cutler S, Morecroft C, Carey P, Kennedy T. Are interprofessional healthcare teams meeting patient expectations? An exploration of the perceptions of patients and informal caregivers. J Interprof Care 2018; 33:66-75. [DOI: 10.1080/13561820.2018.1514373] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Suzanne Cutler
- School of Pharmacy and Bimolecular Sciences, Liverpool, UK
| | | | - Phil Carey
- School of Nursing and Alled Health, Liverpool, UK
| | - Tom Kennedy
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, UK
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34
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Hayes C, Power T, Davidson PM, Daly J, Jackson D. Learning to liaise: using medication administration role-play to develop teamwork in undergraduate nurses. Contemp Nurse 2018; 55:278-287. [PMID: 30092706 DOI: 10.1080/10376178.2018.1505435] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Aim: To describe undergraduate nursing students' situational awareness and understanding of effective liaison and collaboration within the nursing team during interrupted medication administration.Background: Medication errors related to interruptions are a major problem in health care, impacting on patient morbidity and mortality and increasing the burden of related costs. Effective liaison, teamwork and situation awareness are requisite skills for nurses to facilitate the safe management of interruptions during medication administration.Method: A role-play simulation was offered to 528 second-year undergraduate Bachelor of Nursing students. Qualitative written reflective responses were subsequently collected and subject to thematic analysis to derive themes.Results: Participants (451:528) reported an improved understanding of an unfamiliar and challenging situation that required cooperation and collaboration amongst the nursing team to improve outcomes.Conclusion(s): This simulation exposed undergraduate nurses with limited clinical experience to a situation otherwise unavailable to them. The skills required to engage in effective liaison and teamwork in dynamic situations are vital elements in achieving quality care and must begin to be taught at an undergraduate level.
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Affiliation(s)
- Carolyn Hayes
- Faculty of Health, University of Technology Sydney, Building 10 level 6, 235 Jones Street, Broadway, NSW, 2007, Australia
| | - Tamara Power
- Faculty of Health, University of Technology Sydney, Building 10 level 7, 235 Jones Street, Broadway, NSW, 2007, Australia
| | - Patricia M Davidson
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205-2110, USA
| | - John Daly
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia
| | - Debra Jackson
- Faculty of Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia
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Omura M, Stone TE, Maguire J, Levett-Jones T. Exploring Japanese nurses' perceptions of the relevance and use of assertive communication in healthcare: A qualitative study informed by the Theory of Planned Behaviour. NURSE EDUCATION TODAY 2018; 67:100-107. [PMID: 29852398 DOI: 10.1016/j.nedt.2018.05.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 01/10/2018] [Accepted: 05/12/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The hierarchical nature of healthcare environments presents a key risk factor for effective interprofessional communication. Power differentials evident in traditional healthcare cultures can make it difficult for healthcare professionals to raise concerns and be assertive when they have concerns about patient safety. This issue is of particular concern in Japan where inherent cultural and social norms discourage assertive communication. AIM The aim of this study was to (a) explore nurses' perceptions of the relevance and use of assertive communication in Japanese healthcare environments; and (b) identify the factors that facilitate or impede assertive communication by Japanese nurses. DESIGN A belief elicitation qualitative study informed by the Theory of Planned Behaviour was conducted and reported according to the COnsolidated criteria for REporting Qualitative research. SETTINGS AND PARTICIPANTS Twenty-three practicing Japanese registered nurses were recruited by snowball sampling from October 2016 to January 2017. METHODS Individual face-to-face semi-structured interviews were conducted and transcribed in Japanese and then translated into English. Two researchers independently conducted a directed content analysis informed by the Theory of Planned Behaviour. Participants' responses were labelled in order of frequency for behavioural beliefs about the consequences of assertive communication, sources of social pressure, and factors that facilitate or impede assertive communication in Japanese healthcare environments. FINDINGS Although person-centred care and patient advocacy were core values for many of the participants, strict hierarchies, age-based seniority, and concerns about offending a colleague or causing team disharmony impeded their use of assertive communication. Novice nurses were particularly reluctant to speak up because of their perception of having limited knowledge and experience. CONCLUSION This study identified Japanese nurses' behavioural, normative, and control beliefs in relation to assertive communication. The findings will be used to inform the development of a culturally appropriate assertiveness communication training program for Japanese nurses and nursing students.
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Affiliation(s)
- Mieko Omura
- Faculty of Health and Medicine, The University of Newcastle, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia.
| | - Teresa E Stone
- Faculty of Nursing, Chiang Mai University, 110 Intavaroros Road Sripum District, Muang, Chiang Mai 50200, Thailand.
| | - Jane Maguire
- Faculty of Health, University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia.
| | - Tracy Levett-Jones
- Faculty of Health, University of Technology Sydney, 235 Jones St, Ultimo, NSW 2007, Australia.
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Interprofessional Pharmacokinetics Simulation: Pharmacy and Nursing Students' Perceptions. PHARMACY 2018; 6:pharmacy6030070. [PMID: 30036982 PMCID: PMC6163764 DOI: 10.3390/pharmacy6030070] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 07/10/2018] [Accepted: 07/14/2018] [Indexed: 11/16/2022] Open
Abstract
Interprofessional practice between pharmacists and nurses can involve pharmacokinetic dosing of medications in a hospital setting. This study describes student perceptions of an interprofessional collaboration pharmacokinetics simulation on the Interprofessional Education Collaborative (IPEC) 2016 Core Competencies. The investigators developed a simulation activity for senior undergraduate nursing and second-year pharmacy students. Nursing and pharmacy students (n = 54, 91 respectively) participated in the simulation using medium-fidelity manikins. Each case represented a pharmacokinetic dosing consult (vancomycin, tobramycin, phenytoin, theophylline, or lidocaine). Nursing students completed head-to-toe assessment and pharmacy students gathered necessary information and calculated empiric and adjusted doses. Students communicated using SBAR (Situation, Background, Assessment, and Recommendation). Students participated in debrief sessions and completed an IRB-approved online survey. Themes from survey responses revealed meaningful perceptions in all IPEC competencies as well as themes of safety, advocacy, appreciation, and areas for improvement. Students reported learning effectively from the simulation experience. Few studies relate to this type of interprofessional education experience and this study begins to explore student perceptions of interprofessional education (IPE) in a health sciences clinical context through simulation. This real-world application of nursing and pharmacy interprofessional collaboration can positively affect patient-centered outcomes and safety.
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Díaz de León-Castañeda C, Gutiérrez-Godínez J, Colado-Velázquez JI, Toledano-Jaimes C. Healthcare professionals' perceptions related to the provision of clinical pharmacy services in the public health sector: A case study. Res Social Adm Pharm 2018; 15:321-329. [PMID: 29731375 DOI: 10.1016/j.sapharm.2018.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services. OBJECTIVES To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision. METHODS A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti. RESULTS Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision. CONCLUSIONS The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision.
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Affiliation(s)
- Christian Díaz de León-Castañeda
- Consejo Nacional de Ciencia y Tecnología - Infotec, Circuito Tecnopolo Sur 112, Tecnopolo Pocitos, 20313, Aguascalientes, Ags., Mexico.
| | - Jéssica Gutiérrez-Godínez
- Hospital General "Dr. Manuel Gea González", Secretaría de Salud, Calzada de Tlalpan 4800, Tlalpan Centro I, 14080, Tlalpan, Ciudad de México, Mexico.
| | - Juventino Iii Colado-Velázquez
- Departamento de Ciencias de la Salud, Universidad Autónoma de Occidente, Boulevard Lola Beltrán s/n, 4 de Marzo, 80107, Culiacán, Sinaloa, Mexico.
| | - Cairo Toledano-Jaimes
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Avenida Universidad 1001, Chamilpa, 62210, Cuernavaca, Morelos, Mexico.
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Levett-Jones T, Burdett T, Chow YL, Jönsson L, Lasater K, Mathews LR, McAllister M, Pooler A, Tee S, Wihlborg J. Case Studies of Interprofessional Education Initiatives From Five Countries. J Nurs Scholarsh 2018; 50:324-332. [PMID: 29608245 DOI: 10.1111/jnu.12384] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although teamwork and interprofessional collaboration are critical to patient safety, nursing, medical, and allied health graduates often feel ill-prepared to confidently communicate and collaborate with other team members. While interprofessional education (IPE) has been advocated as a way of addressing this issue, there are multiple barriers to its systematic and sustained integration in undergraduate healthcare programs. Despite these challenges, examples of effective IPE initiatives have emerged. INNOVATION This article profiles seven case studies of innovative interprofessional education activities that have been successfully implemented across five countries, for a variety of learners, using different delivery modalities, and with evaluation results attesting to their success. CONCLUSIONS The case studies demonstrate innovative ideas that have the potential to overcome some of the barriers to IPE through the use of creative and targeted approaches. This article provides a wealth of ideas for the successful design and implementation of IPE initiatives and will be of benefit to educators wishing to expand their repertoire of teaching approaches. CLINICAL RELEVANCE A body of research attests to the relationship between interprofessional communication, teamwork, and patient outcomes. IPE is imperative for facilitating the development of nursing graduates' communication and teamwork skills; however, innovative approaches are needed to overcome the perceived and actual impediments to its implementation.
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Affiliation(s)
- Tracy Levett-Jones
- Professor of Nursing Education, Discipline Lead, Faculty of Health, University of Technology Sydney Ultimo, NSW, Australia
| | - Teresa Burdett
- Lecturer in Integrated Health Care, Faculty of Health and Social Sciences Bournemouth University, Bournemouth, Dorset, England
| | - Yeow Leng Chow
- Associate Professor, National University of Singapore, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, Singapore
| | - Lisbeth Jönsson
- Lecturer, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Kathie Lasater
- Professor, Oregon Health & Science University, School of Nursing, Portland, OR, USA
| | - Launa Rae Mathews
- Clinical Assistant Professor, Oregon Health & Science University, School of Nursing, Portland, OR, USA
| | - Margaret McAllister
- Professor of Nursing, CQUniversity, The School of Nursing and Midwifery, Noosaville, Australia
| | - Alison Pooler
- Director of learning and teaching, lead for IPE and prescribing education, Lecturer in adult nursing, School of Nursing and Midwifery, Keele University, Stoke on Trent, UK
| | - Stephen Tee
- Professor and Executive Dean, Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, Dorset, England
| | - Jonas Wihlborg
- Lecturer, Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Scantlebury K, Bixley M, Williamson I. Exploring accounts of collaborative working between speech and language therapists and stroke association communication support coordinators following stroke. J Interprof Care 2018. [PMID: 29521553 DOI: 10.1080/13561820.2018.1446921] [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: 10/17/2022]
Abstract
In the United Kingdom, speech and language therapists (SLTs) and Stroke Association communication support coordinators (CSCs) are both employed to provide services for people with communication difficulties following stroke. There is very little literature of this type of collaborative working. This research is unique because it explores collaborative working between SLTs who are employed by the National Health Service and CSCs who are employed by the Stroke Association. Five CSCs and seven SLTs from the East of England participated in a series of in-depth interviews. Data were analysed using thematic analysis informed by an interpretative phenomenological approach. The analysis suggested complex negotiation processes occur at a number of different levels. These levels include negotiation of individual relationships between SLTs and CSCs, negotiating the particular challenges involved in working across organisations and professions, and the need for both roles to negotiate and promote the value of their services at a societal level. The findings of this research are discussed in relation to existing theories and research within the field of collaborative working. Clinical applications are suggested for collaborative working within communication services. We propose that our findings may have relevance to other individuals and organisations delivering services collaboratively.
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Affiliation(s)
- Katherine Scantlebury
- a Speech and Language Therapy Department , West Suffolk NHS Foundation Trust , Bury St Edmunds , UK
| | - Morag Bixley
- b Speech and Language Therapy Division , De Montfort University , Leicester , UK
| | - Iain Williamson
- c Psychology Division , De Montfort University , Leicester , UK
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Schaffler-Schaden D, Pitzer S, Schreier M, Dellinger J, Brandauer-Stickler B, Lainer M, Flamm M, Osterbrink J. Improving medication appropriateness in nursing home residents by enhancing interprofessional cooperation: A study protocol. J Interprof Care 2018. [DOI: 10.1080/13561820.2018.1448372] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Dagmar Schaffler-Schaden
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Stefan Pitzer
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Magdalena Schreier
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Johanna Dellinger
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | | | - Miriam Lainer
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Jürgen Osterbrink
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Kent F, Nankervis K, Johnson C, Hodgkinson M, Baulch J, Haines T. 'More effort and more time.' Considerations in the establishment of interprofessional education programs in the workplace. J Interprof Care 2017; 32:89-94. [PMID: 29083262 DOI: 10.1080/13561820.2017.1381076] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The argument for integrating interprofessional education (IPE) activities into the workplace has been made concurrently with the call for collaborative clinical practice. An exploratory case study investigation of existing activities in a large metropolitan health care network was undertaken to inform the development of future IPE initiatives. Purposive sampling invited clinicians involved in the design or delivery of workplace IPE activities to participate in a semi-structured interview to discuss their existing programs and the opportunities and challenges facing future work. Interviews were audiotaped, transcribed and thematically analysed. In total, 15 clinicians were interviewed representing medicine, nursing, occupational therapy, pharmacy, physiotherapy, psychology, social work and speech pathology. The IPE programs identified included one medical and midwifery student workshop, several dedicated new graduate or intern programs combining the professions and multiple continuing professional development programs. Three dominant themes were identified to inform the development of future work: clinician factors, organisational factors and IPE considerations. In addition to the cultural, physical and logistical challenges associated with education that integrates professions in the workplace, the time required for the design and delivery of integrated team training should be accounted for when establishing such programs. Considerations for sustainability include ongoing investment in education skills for clinicians, establishment of dedicated education roles and expansion of existing education activities.
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Affiliation(s)
- Fiona Kent
- a WISER Unit, Monash Health and Faculty Medicine, Nursing Health Sciences , Monash University , Melbourne , Australia
| | - Katrina Nankervis
- b Nursing and Midwifery Education and Strategy , Monash Health , Melbourne , Australia
| | - Christina Johnson
- c Monash Doctors Education and General Medicine, Monash Health and Faculty Medicine, Nursing Health Sciences , Monash Health , Melbourne , Australia
| | | | - Julie Baulch
- e School of Clinical Sciences, Monash Health and Faculty Medicine, Nursing Health Sciences , Monash University , Melbourne , Australia
| | - Terry Haines
- f Allied Health Research Unit, Monash Health and School of Primary and Allied Health , Monash University , Melbourne , Australia
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Interprofessional communication between community pharmacists and general practitioners: a qualitative study. Int J Clin Pharm 2017; 39:495-506. [PMID: 28315115 DOI: 10.1007/s11096-017-0450-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 03/01/2017] [Indexed: 10/19/2022]
Abstract
Background While collaboration between community pharmacists (CPs) and general practitioners (GPs) is essential to provide comprehensive patient care, their communication often is scarce and hampered by multiple barriers. Objective We aimed to assess both professions' perceptions of interprofessional communication with regard to content and methods of communication as a basis to subsequently develop best-practice recommendations for information exchange. Setting Ambulatory care setting in Germany. Method CPs and GPs shared their experience in focus groups and in-depth interviews which were conducted using a semi-structured interview guideline. Transcribed recordings were assessed using qualitative content analysis according to Mayring. Main outcome measure Specification of existing barriers, CPs'/GPs' general perceptions of interprofessional communication and similarities and differences regarding prioritization of specific information items and how to best communicate with each other. Results Four focus groups and fourteen interviews were conducted. Seven internal (e.g. professions were not personally known to one another) and nine external barriers (e.g. mutual accessibility) were identified. Ten organizational, eight medication-related, and four patient-related information items were identified requiring interprofessional communication. Their relevance varied between the professions, e.g. CPs rated organizational issues higher than GPs. Both professions indicated communication via phone to be the most frequently used method of communication. Conclusion CPs and GPs opinions often differ. However, communication between CPs and GPs is perceived as crucial suggesting that a future concept has to offer standardized recommendations, while leaving CPs and GPs room to adjust it to their individual needs.
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