Prescribing errors intercepted by clinical pharmacists in paediatrics and obstetrics in a tertiary hospital in Spain

Fernández-Llamazares, Cecilia M.; Calleja-Hernández, Miguel-Ángel; Manrique-Rodríguez, Silvia; Pérez-Sanz, Cristina; Durán-García, Esther; Sanjurjo‐Sáez, María

doi:10.1007/s00228-012-1257-y

Cited by 40 publications

(35 citation statements)

References 31 publications

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“…Physicians may consider the benefits of certain medications outweigh their risks. In contrast, a study in a pediatric and obstetric hospital in Spain found that the physician acceptance of pharmacist recommendations was three times (92.2%) higher than in Iraq [27].…”

Section: Discussionmentioning

confidence: 75%

“…Although several studies have investigated pharmacist interventions in prescribing errors around the world [6,8,[19][20][21][22][23][24][25], almost all of these studies were limited to evaluations of the incidence rate, causes, clinical significance and types of prescribing errors. However, a little is known about physician acceptance rate of pharmacist recommendations and only a couple of studies have focused on implementation of recommendations [26,27]. None of the previous prescribing error studies in hospitals (to our knowledge) investigated factors influencing physician agreement with pharmacist recommendations.…”

Section: Introductionmentioning

confidence: 99%

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Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals

Al‐Jumaili¹,

Jabri²,

Al-Rekabi³

et al. 2016

Innov Pharm

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Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals

Al‐Jumaili¹,

Jabri²,

Al-Rekabi³

et al. 2016

Innov Pharm

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“…15 More recent studies in Spain have shown that paediatric patients had a fourfold higher risk of serious errors than the maternity population. 49 When considering harm from medicines (with or without error), research undertaken using parental reporting in over 4,000 Finnish children found that the lifetime prevalence of adverse medication events in children was 17%. 8 The ADVISE trial across five countries found that 16.5% of hospitalised children experienced an adverse drug reaction, and 16.6% of these were considered to be preventable.…”

Section: What Do We Know About Adverse Medication Events In Children?mentioning

confidence: 99%

“…Likewise, a recent study from Spain found that paediatrics had a four fold higher risk of serious errors in comparison to the maternity population, and pharmacists made 19 interventions per 1000 patient days in the paediatric population, versus 16 per 1000 patient days in the maternity population. 49 Although these two studies were more than a decade apart, and from very different health care environments, they both found a significantly increased role for a pharmacist in the paediatric setting. An interesting finding from the study by Barber et al, was that higher grade pharmacists have 1.4 times as many interventions as a base grade pharmacist, which implies pharmacist with more advanced skills make more interventions to improve patient care.…”

Section: How Can We Measure the Value Of A Pharmacist In Paediatric Hmentioning

confidence: 99%

“…49 Although these two studies were more than a decade apart, and from very different health care environments, they both found a significantly increased role for a pharmacist in the paediatric setting. An interesting finding from the study by Barber et al, was that higher grade pharmacists have 1.4 times as many interventions as a base grade pharmacist, which implies pharmacist with more advanced skills make more interventions to improve patient care.…”

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confidence: 99%

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Advanced practice in paediatric pharmacy: What is it, how do you get there, and what does it mean for children?

Stacey¹

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The quality and safety of medicines use is as important in paediatrics as in adult medicine, and closely linked to the skills, knowledge, attitudes and behaviours of health professionals responsible for patient care. The aim of this research was to investigate advanced paediatric pharmacy practice; how to develop and assess advanced skills; and how these skills improve outcomes for children.Prevention of adverse medication events (AMEs) is the most researched pharmacy impact on patient outcomes. However, there is limited evidence in paediatrics. The first phase of this research investigated AMEs in children, with the hypothesis that: Voluntary reports of AMEs can be used to identify trends over time in response to safety improvement initiatives, and identify associated skills required of health practitioners.The first component of this phase reviewed six months of potential and actual AMEs identified from three databases: clinical incident reports, pharmacist intervention reports and administrative coding using the International Classification of Diseases 10 th Revision (ICD-10). Analysis identified 447 individual AMEs. Little duplication between data sources was found. ICD-10 coding identified the most cases of harm, and intervention and incident reports identified the most cases of error. ICD-10 events rarely involved error and were time-consuming to retrieve, hence this method was not used in subsequent research. The second phase of research tested the hypothesis that:iii Paediatric hospital pharmacists value formal recognition of advanced pharmacy practice, can describe the characteristics of advanced practitioners and identify preferred methods of assessment of advanced practice.Four focus groups, involving 31 Australian paediatric pharmacists, concluded that advanced practice should be formally recognised, and include a foundation in clinical practice, together with education, research and service improvement outside the institution. Multiple methods of assessment were recommended; most preferred were direct observation of practice, peer review and portfolio review. Knowledge of paediatric diseases and drug handling, and skills in communication with children and families, were important.The third phase of the project reviewed two existing datasets to test two hypotheses, the first of which was: Pharmacist interventions can document progression to advanced practice.Six hundred interventions recorded by four pharmacists from one paediatric hospital were retrospectively reviewed over three separate periods from 2005 to 2012. Skills demonstrated in these interventions were rated using a pilot scale from 1 to 5, representing skills typical of intern pharmacists through to advanced practice. Skills increased over time, with more Level 3-5 interventions recorded in the later time periods, and mean skill level increasing from 1.9 to 2.6 (p<0.01).The second hypothesis in this phase was: Training and development priorities in paediatric pharmacy can be identified by direct observation of pharmacists working ...

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Analysis of clinical intervention records by pharmacists in an Australian principal referral and specialist women's and newborns' hospital

Teoh

Hattingh

Lebedevs

et al. 2017

Pharmacy Practice and Res

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Aim: The objectives of this study were to evaluate clinical interventions recorded by pharmacists in an Australian principal referral and specialist women's and newborns' hospital, as well as to identify common medications involved in each specialty area (neonatology, obstetrics and gynaecology), to assess the risks of medication-related problems (MRPs) likely to have been prevented, and to obtain institution-specific MRPs for future staff education. Methods: This retrospective, observational study involved an analysis of all interventions documented by pharmacists from January 2005 to December 2014. The interventions recorded were collated according to ward, medication involved, description of the intervention and the risk classification. Results: There were a total of 14 085 interventions documented over 10 years; 60.33% made in obstetric patients, 28.71% in gynaecology patients and 10.96% in neonates. The three main intervention types were: (i) dose/frequency/time incorrect (25.70%, n = 3260); (ii) prescribing clarification (21.77%, n = 3066); and (iii) medicine omission (15.21%, n = 2143). An average of 12.02% of the interventions were regarded as high-risk and 0.85% as extreme-risk. Of the MRPs documented within each specialty, the prevalence of extreme risk interventions was higher in the neonatal ward. Discussion: The most common intervention was identifying incorrect medication dose/frequency/time. Common medications involved in the MRPs included: opioids and antihypertensives in gynaecology; parenteral nutrition and gentamicin in neonatology; and opioids and non-steroidal anti-inflammatory drugs (NSAIDs) in obstetrics. The medications involved in high and extreme risk MRPs included gentamicin, opioids and NSAIDs. Conclusion: This study demonstrates that hospital pharmacists contribute to the reduction of MRPs, including some potentially fatal adverse medicine events. These findings also enable targeted, site-specific education, which is valuable in improving patient safety. Analysis of pharmacists interventions ina women's and newborns' hospital 1 (1.8) Antiviral 1 (1.8) GORD = gastro-oesophageal reflux disease; NSAIDs = nonsteroidal anti-inflammatory drugs. Only the ten most common medications are reported for each specialty each year. Analysis of pharmacists interventions in a women's and newborns' hospital 141 (86.57) 894 (72.1) 1848 (70.53) NSAIDs = nonsteroidal anti-inflammatory drugs.

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Prescribing errors intercepted by clinical pharmacists in paediatrics and obstetrics in a tertiary hospital in Spain

Abstract: Paediatric patients had a fourfold higher risk of serious errors than the maternity population. Pharmacist intervention had a major impact on reducing prescribing errors in the study period, thus improving the quality and efficiency of care provided.

Cited by 40 publications

References 31 publications

Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals

Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals

Advanced practice in paediatric pharmacy: What is it, how do you get there, and what does it mean for children?

Analysis of clinical intervention records by pharmacists in an Australian principal referral and specialist women's and newborns' hospital

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