Strategies for improving medication safety in hospitals: Evolution of clinical pharmacy services

Schepel, Lotta; Aronpuro, Kirsi; Kvarnström, Kirsi; Holmström, Anna-Riia; Lehtonen, Lasse; Lapatto‐Reiniluoto, Outi; Laaksonen, Raisa; Carlsson, Kerstin; Airaksinen, Marja

doi:10.1016/j.sapharm.2019.02.004

Cited by 21 publications

(25 citation statements)

References 16 publications

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“…Thus, it is not surprising that the cpKPI 'Time spent on training' was considered relevant by our expert panel, as well as by several studies [26,34,38]. According to this last study, participation in continuing long-term higher education usually includes areas such as expertise in ward pharmacy, medication reviews, or accreditation for comprehensive medication reviews [38].…”

Section: Discussionmentioning

confidence: 95%

Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique

Lopes

Lopes²,

Farinha

et al. 2021

Int J Clin Pharm

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Background Although clinical pharmacy is a crucial part of hospital pharmacist’s day-to-day activity, its performance is not usually subject to a holistic assessment. Objective To define a set of relevant and measurable clinical pharmacy and support activities key performance indicators (cpKPI and saKPI, respectively). Setting Portuguese Hospital Pharmacies. Method After a comprehensive literature review focusing on the metrics already in use in other countries, several meetings with directors of hospital pharmacies were conducted to obtain their perspectives on hospital pharmacy practices and existing metrics. Finally, five rounds with a panel of 8 experts were performed to define the final set of KPIs, where experts were asked to score each indicator’ relevance and measurability, and encouraged to suggest new metrics. Main outcome measure The first Portuguese list of KPIs to assess pharmacists’ clinical and support activities performance and quality in hospital pharmacies. Results A total of 136 KPIs were assessed during this study, of which 57 were included in the original list and 79 were later added by the expert panel. By the end of the study, a total of 85 indicators were included in the final list, of which 40 are considered to be saKPI, 39 cpKPI and 6 neither. Conclusion A set of measurable KPIs was established to allow for benchmarking within and between Portuguese hospital Pharmacies and to elevate professional accountability and transparency. Future perspectives include the use of both cpKPIs and saKPIs on a national scale to identify the most efficient performances and areas of possible improvement.

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Section: Discussionmentioning

confidence: 95%

Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique

Lopes

Lopes²,

Farinha

et al. 2021

Int J Clin Pharm

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“…The efficacy of clinical pharmacists in improving medication safety has been emphasized (Lotta et al., 2019). Thus, the last strategy implemented was the introduction of ward pharmacists in the ED based on qualitative data analysed in first‐cycle reflection phase.…”

Section: Discussionmentioning

confidence: 99%

Behavioural changes in medication safety: Consequent to an action research intervention

et al. 2020

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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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“…The issues discussed in the 20 courses are encountered in all countries, 1 – 4 despite global differences in healthcare systems and resources. Prescription errors are an international problem with serious consequences, 5 – 7 and so must be addressed.…”

Section: Discussionmentioning

confidence: 99%

“…2 Approximately 6% of inpatients in Finland have experienced adverse drug events. 3 Glanzmann et al 4 showed that in a paediatric intensive care unit in Switzerland, 14% of prescriptions contained errors (50% were dose errors), most of which should have been avoided. Prospective prescription checking by pharmacists can ensure the safety and rationality of medication [5][6][7] and reduce non-rational drug treatment, drug waste 8,9 and the number of emergency department visits and hospital readmissions.…”

Section: Introductionmentioning

confidence: 99%

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Satisfaction and needs of pharmacists in prescription-checking training: a cross-sectional survey

Cheng

Wang

et al. 2020

J Int Med Res

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Objective Prescription checking is becoming increasingly prevalent in medical institutions. However, the prescription-checking ability of pharmacists requires improvement. The study aim was to explore the main aspects of prescription-checking training and provide an empirical reference for the training of pharmacists in medical institutions. Methods Participants were pharmacists willing to complete a Likert questionnaire. Descriptive statistics were used to examine percentages and composition ratios. The chi-square test and exploratory factor analysis were used for inferential analysis. Results The questionnaire showed good internal consistency reliability and validity. A total of 90% of participants were satisfied with the training. Exploratory factor analysis extracted three satisfaction dimensions: training organization, teaching method, and knowledge consolidation and assessment. The average examination score for the 20 courses was 89.21/100. Regarding trainee needs, 94.66% preferred face-to-face lectures, 89.33% expected high professional skills of the lecturers and 62.67% believed that clinical expertise was highly desirable. Conclusions There was a high demand for prescription-checking training among pharmacists. Trainees in this study showed high satisfaction. The most important aspects of prescription-checking training were training organization and knowledge consolidation and assessment. It is recommended that training should be stratified. Pharmacists preferred face-to-face and interactive lectures as a supplement to clinical knowledge.

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Strategies for improving medication safety in hospitals: Evolution of clinical pharmacy services

Cited by 21 publications

References 16 publications

Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique

Defining clinical pharmacy and support activities indicators for hospital practice using a combined nominal and focus group technique

Behavioural changes in medication safety: Consequent to an action research intervention

Satisfaction and needs of pharmacists in prescription-checking training: a cross-sectional survey

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