scholarly journals 179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Claire Kavanagh ◽  
Eimear O'Dwyer ◽  
Róisín Purcell ◽  
Niamh McMahon ◽  
Morgan Crowe ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Residential Care ◽  
Clinical Pharmacist ◽  
Comparative Evaluation ◽  
Positive Impact ◽  
Standard Of Care ◽  
Pharmacist Interventions ◽  
Medication Reviews

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

scholarly journals Assessment of the potential impact of resolving drug-related problems by clinical pharmacists in Japan: a retrospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Toshiya Oki ◽  
Sachi Ishii ◽  
Koya Furukawa ◽  
Aiko Shono ◽  
Manabu Akazawa
Keyword(s):  
Patient Care ◽  
Positive Impact ◽  
Anatomical Therapeutic Chemical ◽  
Hospitalized Patients ◽  
Drug Related Problems ◽  
Clinical Pharmacists ◽  
Pharmacist Interventions ◽  
Medication Reviews ◽  
Potential Impact

Abstract Background Clinical pharmacists play a role in limiting the disadvantages of pharmacotherapy for patients by detecting and resolving drug-related problems (DRPs) through medication reviews. Although their contributions to patient care have been analyzed and understood in various countries, the role of Japanese clinical pharmacists in this context remains to be clearly elucidated. Thus, in this study, we aimed to elucidate the detection of DRPs by clinical pharmacists and determine the potential impact of pharmacist interventions in Japan. Methods This study was conducted in a 273-bed hospital and targeted hospitalized patients over a period of 6 months. DRPs detected by clinical pharmacists during the study period were investigated and classified into 10 types. Furthermore, medications were categorized according to the Anatomical Therapeutic Chemical classification. A review committee consisting of two pharmacists independently reviewed the pharmacist interventions on a six-point scale (extremely significant, very significant, significant, somewhat significant, no significance, adverse significance) according to the potential impact on patient care. Results During the study period, 1711 patients (mean age: 71.2 years, 54.1% male) were included, and 2149 DRPs were detected (1.26 DRPs/patient). Pharmacists intervened in all the DRPs detected. The most common DRP was supratherapeutic dosage (19.3%), followed by untreated indication (18.1%). The most common medication classification causing DRPs was “Antiinfectives for Systemic Use” (25.1%), followed by “Alimentary Tract and Metabolism” (19.9%). Most of the pharmacist interventions (99.6%) were rated “somewhat significant” or more significant, of which 1.1% were rated “extremely significant,” and none were rated as “adverse significance.” Conclusions Our results show that in Japan, as in other countries, clinical pharmacists detect and resolve DRPs in hospitalized patients through medication review. Our findings also show that clinical pharmacists have a positive impact on patient care and suggest the need for their involvement.

scholarly journals Pharmacists as Care Providers for Stroke Patients: A Systematic Review

2017 ◽  
Vol 45 (1) ◽  
pp. 49-55 ◽  
Author(s):  
Jade E. Basaraba ◽  
Michelle Picard ◽  
Kirsten George-Phillips ◽  
Tania Mysak
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Acute Stroke ◽  
Patient Care ◽  
Patient Outcomes ◽  
Stroke Patient ◽  
Full Text ◽  
Stroke Patients ◽  
Pharmacist Interventions ◽  
The Impact

AbstractBackground:Pharmacists have become an integral member of the multidisciplinary team providing clinical patient care in various healthcare settings. Although evidence supporting their role in the care of patients with other disease states is well-established, minimal literature has been published evaluating pharmacist interventions in stroke patients. The purpose of this systematic review is to summarize the evidence evaluating the impact of pharmacist interventions on stroke patient outcomes.Methods: Study abstracts and full-text articles evaluating the impact of a pharmacist intervention on outcomes in patients with an acute stroke/transient ischemic attack (TIA) or a history of an acute stroke/TIA were identified and a qualitative analysis performed.Results: A total of 20 abstracts and full-text studies were included. The included studies provided evidence supporting pharmacist interventions in multiple settings, including emergency departments, inpatient, outpatient, and community pharmacy settings. In a significant proportion of the studies, pharmacist care was collaborative with other healthcare professionals. Some of the pharmacist interventions included participation in a stroke response team, assessment for thrombolytic use, medication reconciliation, participation in patient rounds, identification and resolution of drug therapy problems, risk-factor reduction, and patient education. Pharmacist involvement was associated with increased use of evidence-based therapies, medication adherence, risk-factor target achievement, and maintenance of health-related quality of life.Conclusions: Available evidence suggests that a variety of pharmacist interventions can have a positive impact on stroke patient outcomes. Pharmacists should be considered an integral member of the stroke patient care team.

The Value of Library and Information Services in Nursing and Patient Care

2014 ◽  
Vol 19 (3) ◽  
Author(s):  
Joanne Marshall ◽  
Jennifer Morgan ◽  
Mary Klem ◽  
Cheryl Thompson ◽  
Amber Wells
Keyword(s):  
Patient Care ◽  
Patient Outcomes ◽  
Critical Incident ◽  
Nurse Managers ◽  
Positive Impact ◽  
Survey Methods ◽  
Evidence Based ◽  
Study Results ◽  
Library Resources ◽  
Background Events

Libraries are a primary resource for evidence-based practice. This study, using a critical incident survey administered to 6,788 nurses at 118 hospitals, sought to explore the influence of nurses’ use of library resources on both nursing and patient outcomes. In this article, the authors describe the background events motivating this study, the survey methods used, and the study results. They also discuss their findings, noting that use of library resources showed consistently positive relationships with changing advice given to patients, handling patient care differently, avoiding adverse events, and saving time. The authors discuss the study limitations and conclude that the availability and use of library and information resources and services had a positive impact on nursing and patient outcomes, and that nurse managers play an important role both by encouraging nurses to use evidence-based library resources and services and by supporting the availability of these resources in healthcare settings.

SP5 A study exploring the opinions and attitudes of medical staff towards pharmacist independent prescribing in a neonatal intensive care unit

2018 ◽  
Vol 103 (2) ◽  
pp. e1.45-e1
Author(s):  
Williams Lauren ◽  
McIntosh Trudi
Keyword(s):  
Intensive Care Unit ◽  
Patient Safety ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Patient Care ◽  
Medical Staff ◽  
Neonatal Intensive Care ◽  
Positive Impact ◽  
List Type ◽  
Independent Prescribing

AimExisting published literature supports the implementation of pharmacist independent prescribing (PIP). A positive impact on patient care1 has been reported, with an encouraging response from patients2 and other healthcare professionals when asked about their views. There have also been reported patient safety benefits from PIP in secondary care.3 There is a gap in the literature regarding the utilisation of PIP in neonatal practice. The views of neonatal pharmacists across the UK towards PIP have been considered4 but to date there has been no research published on the opinions of medical staff about PIP in Neonatal Intensive Care Units (NICU). This study aimed to explore the opinions and attitudes of medical staff towards PIP in NICU, identifying any barriers and facilitators to the current service.MethodSemi-structured interviews were conducted with a purposively selected sample of senior registrars and consultants working within NICU. An interview schedule was developed, assessed for content validity and then piloted with two initial interviews (total interviews=10). Interviews were digitally recorded then transcribed verbatim. Framework Analysis principles were applied to data analysis. Ethics approval was granted by Robert Gordon University.ResultsParticipants displayed a positive attitude towards PIP, stating that it has been beneficial to the overall service provided in NICU. Improved patient safety, shared workload for medical staff and increased efficiency in prescribing were cited as important benefits. Collaborative working as a multi-disciplinary team when making prescribing decisions for the patient was noted to be essential, as was ensuring junior medical staff still receive the prescribing experience required for them to be competent prescribers. Although medical staff reported no concerns with PIP, lack of a service at weekends and PIP being limited by multiple concomitant ward rounds were identified barriers. The interpersonal skills and knowledge displayed by neonatal pharmacist prescribers, acceptance by the medical team and positivity towards new developments shown by all staff were highlighted as important facilitators.ConclusionAll participants were fully supportive of the PIP service provided in NICU. Utilising the knowledge and skills of pharmacist prescribers has improved the efficiency and quality of prescribing in the unit and has had a positive impact on patient care.ReferencesLatter S, Blekinsopp A, Smith A, et al. Evaluation of nurse and pharmacist independent prescribing 2010. London: University of Southampton. http://eprints.soton.ac.uk/184777/2/ENPIPexecsummary.pdf [accessed: 2016 August 17].Tinelli M, Blekinsopp A, Later S, et al. Survey of patients‘ experiences and perceptions of care provided by nurse and pharmacist independent prescribers in primary care. Health Expectations 2013;18:1241–1255.Baqir W, Crehan O, Murray R, et al. Pharmacist prescribing within a UK NHS hospital trust: Nature and extent of prescribing, and prevalence of errors. Eur J Hosp Pharm 2015;22:79–82.Mulholland PJ. Pharmacists as non-medical prescribers; what role can they play? The evidence in a neonatal intensive care unit. E J Hosp Pharm 2014;21:335–338.

Linking Nurses' Clinical Leadership to Patient Care Quality: The Role of Transformational Leadership and Workplace Empowerment

2017 ◽  
Vol 50 (1) ◽  
pp. 9-19 ◽  
Author(s):  
Sheila Boamah
Keyword(s):  
Transformational Leadership ◽  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Care Quality ◽  
Direct Patient Care ◽  
Equation Modeling ◽  
Staff Nurse ◽  
Structural Empowerment ◽  
Clinical Leadership

Background While improving patient safety requires strong nursing leadership, there has been little empirical research that has examined the mechanisms by which leadership influences patient safety outcomes. Aim To test a model examining relationships among transformational leadership, structural empowerment, staff nurse clinical leadership, and nurse-assessed adverse patient outcomes. Methods A cross-sectional survey was conducted with a randomly selected sample of 378 registered nurses working in direct patient care in acute care hospitals across Ontario, Canada. Structural equation modeling was used to test the hypothesized model. Results The model had an acceptable fit, and all paths were significant. Transformational leadership was significantly associated with decreased adverse patient outcomes through structural empowerment and staff nurse clinical leadership. Discussion This study highlights the importance of transformational leadership in creating empowering practice environments that foster high-quality care. The findings indicate that a more complete understanding of what drives desired patient outcomes warrants the need to focus on how to empower nurses and foster clinical leadership practices at the point of care. Conclusion In planning safety strategies, managers must demonstrate transformational leadership behaviors in order to modify the work environment to create better defenses for averting adverse events.

Clinical Cybersecurity Training Through Novel High Fidelity Simulations (Preprint)

2018 ◽  
Author(s):  
Christian Dameff ◽  
Jordan Selzer ◽  
Jonathan Fisher ◽  
James Killeen ◽  
Jeffrey Tully
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Medical Devices ◽  
Healthcare Systems ◽  
High Fidelity ◽  
Protected Health Information ◽  
Patient Harm ◽  
Security Vulnerabilities ◽  
Clinical Simulations ◽  
Medical Infrastructure

BACKGROUND Cybersecurity risks in healthcare systems have traditionally been measured in data breaches of protected health information but compromised medical devices and critical medical infrastructure raises questions about the risks of disrupted patient care. The increasing prevalence of these connected medical devices and systems implies that these risks are growing. OBJECTIVE This paper details the development and execution of three novel high fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices. METHODS Clinical simulations were developed which incorporated patient care scenarios with hacked medical devices based on previously researched security vulnerabilities. RESULTS Clinician participants universally failed to recognize the etiology of their patient’s pathology as being the result of a compromised device. CONCLUSIONS Simulation can be a useful tool in educating clinicians in this new, critically important patient safety space.

74 Improving Handover Between Doctors and Nurses on An Elderly Care Ward

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
K Suseeharan ◽  
T Vedutla
Keyword(s):  
High Risk ◽  
Patient Care ◽  
Positive Impact ◽  
Elderly Care ◽  
Task Completion ◽  
Risk Area ◽  
High Risk Area ◽  
Staff Members ◽  
Care Ward ◽  
Doctors And Nurses

Abstract Background The Royal College of Physician guidelines (2011) identified handover as a “high risk step” in patient care, especially in recent times within the NHS where shift patterns lead to more disjointed care with a high reliance on effective handover by all staff members. Introduction At Cannock Chase hospital, Fairoak ward is an elderly care rehabilitation ward where there is a large multi-disciplinary team. While working on the ward as doctors we noticed that handover between the MDT was poor. Anecdotal evidence from both doctors and nurses felt that this was a high risk area in need of improvement. Aim to improve handover between doctors and nurses on this elderly care ward. Method To measure the quality of current handover practice we did a questionnaire. A total of 12 questionnaires were completed which showed that 92% of staff felt that handover on the ward was very poor and 50% preferred both written and verbal handover. We measured the number of tasks verbally handed over between doctors and nurses over 3 days. On average 65% of the tasks were completed. We then made the below interventions and re-audited to see if there was any improvement. Interventions over 3 week period: Results Questionnaire: Measuring task completion after interventions; Conclusion This project has made a positive change qualitatively and quantitatively to the ward handover practice. Staff satisfaction regarding handover has improved and the number of “handed over” tasks completed daily has significantly improved. The written handover sheet had poor utilisation by staff but in 4 months we are going to re-audit and trial the handover sheet again to further improve service delivery. We hope this improvement will have a positive impact on patient care on this elderly care ward.

scholarly journals 4CPS-229 Analysis of clinical pharmacist interventions in the heart failure day hospital

2021 ◽  
Author(s):  
M Eguiluz Solana ◽  
A Gomez Sanchez ◽  
M Saez Rodriguez ◽  
M Miranda Magaña ◽  
B Tortajada Goitia
Keyword(s):  
Heart Failure ◽  
Clinical Pharmacist ◽  
Day Hospital ◽  
Pharmacist Interventions
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