BackgroundDuring the process of implementation of clinical pharmacy services, internal and external factors may favor or hinder the incorporation of care into the hospital routine. This study aimed to understand the perceptions of a group of hospital pharmacists and other professionals of the implementation of clinical pharmacy at a high complexity public hospital in Brazil.MethodsA focus group with 16 pharmacists and interviews with tree key stakeholders including managers in the pharmaceutical, medical, and nursing profession were conducted to understand their perceptions of the implementation clinical pharmacy services in a high complexity public hospital in Brazil. The service proposal was presented to the selected participants before conducting the focus group. Professionals with an overview of the hospital and influence on the relevant departments for the implementation of clinical pharmacy at the institution were selected. Data collected were transcribed and analyzed using the Bardin Content Analysis technique. Data analyzed were systematized into categories and registration units. The methodology involves the organization and analysis of reported content to make inferences.ResultsThe data obtained were divided into four categories: “Perception of the current situation”, “Implementation expectations”, “Barriers to implementation”, “Implementation facilitators”. Participants discussed the stagnation of clinical activities of the pharmaceutical profession in Brazil, a reality that results from a lack of clinical training in the country. Pharmacists expressed their expectations for changes in professional performance. According to the managers, such services would positively affect clinical outcomes for patients. Gaps in academic education, lack of knowledge, and poor communication skills were barriers reported in this study. Pharmacists’ clinical experience has been reported to facilitate the provision of services.ConclusionsThis study highlights factors that may influence the implementation of clinical pharmacy services in the institution analyzed, such as resistance, fear, and frustration as barriers, as well the experience in clinical pharmacy of some pharmacists in the institution was one of the facilitators most cited by participants. This knowledge may aid future planning for the implementation of clinical pharmacy in hospitals.
Background:
Despite the increasing complexity of medication therapies and the expansion
of pharmaceutical clinical services to optimize patient care working in
collaboration with physicians. In this sense, interdisciplinary education
has been encouraged. However, no instrument is available to measure
attitudes toward collaborative relationships.
Objective:
To translate, cross-cultural adaptation and validation an instrument to
measure collaboration attitudes toward students of medicine/pharmacy and
physicians/pharmacists.
Methods:
The process of cross-cultural adaptation was carried out using international
recommendations and was performed from January 2014 to April 2015. The
instrument under consideration was translated and re-translated. A panel of
experts compared the generated documents and the translation was evaluated
for 20 undergraduate students of Pharmacy, 20 undergraduate students of
Medicine and professionals (20 pharmacists and 20 physicians).
Results:
The process of cross-cultural translation and validation result in the
Portuguese version. Modifications to the grammatical structures were made in
order to establish a cross-cultural similarity between the English and
Portuguese versions. Regarding the evaluation of the expert panel, six
questions required modifications.
Conclusions:
Psychometric evaluation demonstrated and confirmed the validity of the
Brazilian-Portuguese version to assess collaborative attitudes among
pharmacists and physicians. Moreover, the scale can be used to evaluate
undergraduates and postgraduates and foster the development of teaching
methods that promote comprehensive attitudes in patient care.
ObjectiveTo determine the incidence of medication discrepancies in transition points of care of hospitalised children.DesignA prospective observational multicentre study was carried out between February and August 2019. Data collection consisted of the following steps: sociodemographic data collection, clinical interview with the patient’s caregiver, review of patient prescriptions and evaluation of medical records. Medication discrepancies were classified as intentional (documented or undocumented) and unintentional. In addition, discrepancies identified were categorised according to the medication discrepancy taxonomy. Unintentional discrepancies were assessed for potential clinical harm to the patient.SettingPaediatric clinics of four teaching hospitals in Brazil.PatientsChildren aged 1 month–12 years.FindingsA total of 248 children were included, 77.0% (n=191) patients had at least one intentional discrepancy; 20.2% (n=50) patients had at least one unintended discrepancy and 15.3% (n=38) patients had at least one intentional discrepancy and an unintentional one. The reason for the intentional discrepancy was not documented in 49.6% (n=476) of the cases. The most frequent unintentional discrepancy was medication omission (54.1%; n=66). Low potential to cause discomfort was found in 53 (43.4%) unintentional discrepancies, while 55 (45.1%) had the potential to cause moderate discomfort and 14 (11.5%) could potentially cause severe discomfort.ConclusionsAlthough most medication discrepancies were intentional, the majority of these were not documented by the healthcare professionals. Unintentional discrepancies were often related to medication omission and had a potential risk of causing harm to hospitalised children.
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