Pharmacists In Hospital Settings Research Articles

Multidisciplinary perspectives on roles of hospital pharmacists in tertiary settings: a qualitative study.

In today's complex healthcare landscape, exacerbated by resource constraints at various levels, optimization of health professionals' roles is becoming increasingly paramount. Interprofessional collaboration, underpinned by role recognition and teamwork, leads to improved patient and organizational outcomes. Hospital pharmacists play a pivotal role in multidisciplinary teams, and it is imperative to understand multidisciplinary viewpoints on hospital pharmacists' roles to guide role prioritization and organizational efficiency. However, no study extensively investigated multidisciplinary views on values of diverse pharmacist roles in tertiary settings. This study aims to address this gap by examining non-pharmacist health professionals' views on hospital pharmacists' roles, recognizing their specialized niches as a crucial step towards optimizing their roles and services in Australia and internationally. Multiple focus group discussions and interviews were held via a virtual conferencing platform. Study participants were recruited using the study investigators' professional networks who were non-pharmacist health professionals with experience working with pharmacists in hospital settings. Data were collected from transcripts of the focus group recordings, which were later summarized using descriptive statistics and thematic analysis. Overarching themes were categorized and mapped against work system models to conceptualize organizational implications of multidisciplinary feedback, linking them to patient and organizational outcomes. Twenty-seven health professionals participated across focus groups and interviews, with the majority of professions being doctors and nurses. Three major themes were identified as follows: (i) overarching perceptions regarding hospital pharmacists; (ii) professional niches of hospital pharmacists; and (iii) future opportunities to optimize hospital pharmacy services. Valued professional niches included patient and health professional educators, transition-of-care facilitators, and quality use of medicines analysts. The study highlights critical insights into hospital pharmacists' roles in Australia, identifying their niche expertise as vital to healthcare efficiency and success. Based on multidisciplinary feedback, the study advocates for strategic role optimization and targeted research for enhanced clinical, economic, and organizational outcomes.

Validation of the specialized competency framework for pharmacists in hospital settings (SCF–PHS): a cross-sectional study

ObjectivesThis study aimed to validate the content of the specialized competency frameworks for pharmacists working in hospital settings (hospital and clinical pharmacists) and pilot the frameworks for practice assessment.MethodsThis online cross-sectional study was carried out between March and October 2022 among a sample of 96 Lebanese pharmacists working in hospital settings. The frameworks were distributed to full-time hospital and clinical pharmacists, who filled them out according to their role in the hospital.ResultsOverall, the competencies were distributed over five domains for hospital pharmacists (fundamental skills, safe and rational use of medicines, patient-centered care, professional skills, and preparedness for emergencies), while for clinical pharmacists, competencies were distributed over seven domains (quality improvement, clinical knowledge and skills, soft skills, ability to conduct clinical research, ability to provide effective education, use information technology to make decisions and reduce errors, and emergency preparedness). Moreover, Cronbach alpha values were appropriate, indicating sufficient to high internal consistency. Pharmacists were highly confident in most competencies, with some exceptions related to research in emergency settings (data evaluation, research, and reporting).ConclusionsThis study could validate competency frameworks for clinical and hospital pharmacists, with the competencies and their respective behaviors showing an adequate construct analysis. It also identified the domains that require further development, i.e., soft skills and research in emergency settings. Both these domains are timely and needed to overcome the current practice challenges in Lebanon.

Medication Error

Background: Medication errors are one of the patient safety problems with a high prevalence in severalcountries, and often involve a lack of collaborative communication between health professionals,including doctors, pharmacists, and nurses. This article aimed to review about medication error inhospital settings.Methods: Literature review was done through searching electronic database like PubMed, ResearchGate, Google Scholar, and Science Hub and create library via Zotero software to save data.Results: The review article found most of the medication error occurred in medical and surgical unitsof the hospital and in morning shift, the most of the nurses are accountable for avoiding medicationerrors, and it happens mostly during administering the drugs to the patients.Conclusion: Medication errors and difficulties associated to nurses, doctors and pharmacists in hospitalsettings must be carefully monitored in order to maintain patients’ safety.Keywords: Literature review, medication error, nurses, safety

Patients' Perceptions of Medication Counseling Provided by Inpatient Pharmacists: A Qualitative Study on Impact on Medication-Taking Behaviors and Treatment Understanding

This qualitative study investigates patients' perceptions of medication counseling provided by inpatient pharmacists in hospital settings. Semi-structured interviews were conducted with 20 participants to explore the impact of pharmacist-led counseling on medication-taking behaviors and treatment understanding. Thematic analysis identified key themes including the effectiveness of counseling in enhancing medication adherence and patient empowerment in self-management. Participants valued clear communication, personalized care, and the pharmacist's role in addressing medication concerns. Challenges such as time constraints and the need for post-discharge follow-up were also noted. Findings highlight the crucial role of pharmacist-led counseling in optimizing patient outcomes and suggest implications for improving pharmacy practice in hospital settings.

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Adventures in getting paid

Physicians' perceptions, expectations, and experiences of clinical pharmacists in Jordan-2017.

Background A decade ago, clinical pharmacy was a new concept in hospital settings in Jordan, as evidenced in our 2006/2007 study. Changes in the perceptions, expectations, and experiences of physicians regarding the role of clinical pharmacists need to be investigated. Objective To document physicians' perceptions and expectations of, and experiences with, clinical pharmacists in hospital settings in 2017, and to assess differences in these areas between the 2017 and the 2006/2007 samples. Setting: The study was conducted at four hospitals in the north of Jordan. Method Physicians completed a self-administered questionnaire similar to the one used in our 2006/2007 study, which recorded demographics and assessed physicians' perceptions, expectations, and experiences regarding clinical pharmacists. Data of the 2017 sample were analyzed and compared descriptivelyto those of the 2006/2007 sample. Main outcome measure Physicians' perceptions, expectations, and experiences of pharmacists in hospital settings in 2017. Results Two hundred and ninety-five physicians completed the questionnaire. Physiciansin the 2017 sample were most comfortable with pharmacists suggesting theuse of prescription medications suchas antibiotics (53.6%). Physicians in the2017 cohort agreed with the eight expectations stated in the questionnaire. Physicians' experiences with clinical pharmacists improved in 2017 from 2006/2007 in all eight areas evaluated. Conclusion Physicians' perceptions, expectations, and experiences towards the professional role of pharmacists have changed over the past 10years in Jordan.

Evaluating Pharmacy Practice in Hospital Settings in Jeddah City, Saudi Arabia: Prescribing and Transcribing-2018.

Purpose: The aim of this study was to evaluate the prescription and transcription processes in hospital settings in Jeddah city, Saudi Arabia. Method: A customized version of the original American Society of Health-System Pharmacists (ASHP) survey was distributed to a total of 26 hospitals in Jeddah city that fits our criteria starting from December 2017. Hospitals' names were adopted from the Ministry of Health and Jeddah Municipality websites. All questionnaires were collected in June 2018. After that, they were classified according to the type of care provided by the hospital, size, ownership, teaching affiliation, and accreditation. Data were entered electronically using Google forms, and then Microsoft Excel was used to conduct descriptive statistics. Results: The survey had a response rate of 57%. A strict formulary system was adopted in 53.3% of hospitals, and clinical practice guidelines were used to optimize medication use in 86.7% of hospitals. Pharmacists do not have the authority to write medication orders in about 86.7% of hospitals and only 40.0% of hospitals have pharmacists routinely assigned to patient care units. However, Pharmacists actively provided consultation, mostly in drug information (80.0%). Computerized prescriber order entry (CPOE) is used to receive medication orders electronically in 80.0% of hospitals, and electronic health record (EHR) is used in about 53.3% of hospitals and 50.0% of those hospitals have pharmacists who document their clinical intervention in EHR. Conclusion: Survey results suggest that pharmacists in hospital settings have not yet been positioned to improve the prescribing and transcribing components of the medication-use process.

Medication Prescribing Error:A Source of Concern

Background: There are different types of medication errors which are experienced by the pharmacists in hospital settings.In Pakistan number of attending Pharmacist per bed is low and is a major cause of fatal and life threatening events. Aim: The aim of present retrospective study was to assess the extent and type of medication error in inpatient medical charts. Method: The physician’s orders were analyzed by the clinical pharmacists in hospital setting during 2007- 2008 in different wards. Various types of prescription errors had been reported and expressed in percentages. Result:Out of 450 medical treatment charts, 381 medication errors were found in 350 charts. The highest rate of error was the wrong dose (25%) prescribed by physicians.Infrequent errors were lack of dosage frequency, protocol for treatment, dosage form and continuation of antibiotic after prescribed treatment days. However, most frequently occurring serious errors were wrong dosing frequency (17%) and no dose adjustment according to creatinine clearance (12.8%).3.41% errors were related to directions for use of medicines. Conclusion:Our study has demonstrated large number of prescription errors and high proportion of themwere of serious nature therefore careful counter checking of medical charts is suggested.

Physicians’ and Pharmacists’ Experience and Expectations of the Roles of Pharmacists: Insights into Hospital Setting in Macau

Purpose: To investigate physicians’ and pharmacists’ experience and expectations of the roles of pharmacists in hospital setting in Macau for the development of physician-pharmacist collaborative working relationship (CWR). Methods: A survey was conducted to address the research questions. The study population included the physicians and pharmacists working in hospitals in Macau. A self-administered survey was designed correspondingly to physicians and pharmacists with same series of questions, which composed of 4 parts: demographics, collaboration status, roles of pharmacist based on experience, and roles of pharmacist based on expectations. RESULTS: Sixty six out of the 120 physician surveys and 18 out of the 30 pharmacist surveys were returned, giving a response rate of 55.00% and 60.00% respectively. 33.33% of physicians and 77.8% of pharmacists claimed they collaborated with the other professional at least once a week. The main reason for collaboration was prescription order queries. Both professionals indicated that “medication dispensing” and “identification and prevention of prescription errors” were currently the top responsibilities of pharmacists. It was anticipated by the physicians that pharmacists would remain focused on “medication dispensing” but should put in more effort. Pharmacists, on the other hand, would like to develop their role in direct patient care such as “patient counseling”. Conslusion: There were discrepancies in physicians’ and pharmacists’ expectations of the roles of pharmacists. The 6 most important responsibilities of pharmacists were determined in consultation with physicians’ opinions. Capacity building of pharmacists, communication between the two professionals and administrative co-ordinations were considered important elements in developing CWR.

Acceptability and Face Validity of a Geriatric Self-Medication Assessment Tool

A majority of community-dwelling older adults manage their own medication regimens. This study describes the development and first phase of testing of the Self-Medication Assessment Tool (SMAT), designed to screen for cognitive and functional deficits in relation to medication self-management among community-dwelling geriatric patients. To evaluate the face validity of the SMAT and to determine its acceptability among pharmacists. An instrument was designed, with 5 assessment scales to measure function, cognition, medication recall, and 2 aspects of adherence. The instrument included a standardized test kit and instructions for testers. Focus groups interviews, individual interviews, and surveys were used to determine the reactions of community and hospital-based pharmacists to the tool. Transcripts of the focus group and individual interviews were coded for main themes. Pharmacists' ratings of usefulness, thoroughness, and ease of use, as well as their willingness to use the instrument, were compared with a neutral rating on a 7-point scale by means of 1-sample t tests. Focus group interviews or individual interviews were conducted with 17 pharmacists and 3 pharmacy students (out of a potential population of about 300) who responded to an invitation to participate. The pharmacists felt that the tool would be useful in identifying difficulties with medication management and potential interventions, and they expressed a willingness to use it in their respective practices. Pharmacists working in hospital settings were slightly more willing than community pharmacists to use the tool. Interviewees highlighted ways to improve the tool before testing of its psychometric properties in the planned second phase of this project. The SMAT had strong face validity and was particularly acceptable for use by pharmacists in hospital settings.

Perceptions, experiences, and expectations of physicians in hospital settings in Jordan regarding the role of the pharmacist

Background To initiate a collaborative working relationship (CWR) between physicians and pharmacists, current physicians' perceptions, expectations, and experiences with pharmacists should be determined. Objective The purpose of this study was to investigate physicians' perceptions, expectations, and their actual experiences with pharmacists in hospital settings in Jordan. Methods A self-administered questionnaire was delivered to 284 physicians selected randomly from 4 main hospitals in northern Jordan. The questionnaire was composed of 4 parts investigating physicians' expectations, experiences, and perceptions of the pharmacists. Results Two hundred and forty-five questionnaires were completed (response rate, 86.3%). More than half of the physicians were comfortable with pharmacists providing patient education. Similarly, just fewer than half (48.2%) were uncomfortable with pharmacists suggesting the use of prescription medications to patients. Most physicians (62.5%) expect the pharmacist to educate their patients about safe and appropriate use of drugs; however, approximately one third (33.9%) of them do not expect the pharmacist to be available for consultation during rounds. Approximately, 54% of the physicians agreed that pharmacists were always a reliable source of information. Nevertheless, only 28.2% agreed that pharmacists frequently inform them that their patients have experienced some problem with their medications. Conclusions Physicians in hospitals in Jordan were more likely to accept or recognize traditional pharmacy services than newer clinical services. Increasing physician awareness of these clinical pharmacy skills will be an important step in developing CWRs.

ASHP national survey of pharmacy practice in hospital settings: prescribing and transcribing--2001.

Results of the 2001 ASHP national survey of pharmacy practice in hospital settings that pertain to prescribing and transcribing are presented. A stratified random sample of pharmacy directors at 1091 general and children's medical-surgical hospitals in the United States was surveyed by mail. SMG Marketing Group, Inc., supplied data on hospital characteristics; the survey sample was drawn from SMG's hospital database. The response rate was 49.0%. During 2001, nearly all hospitals are estimated to have pharmacy and therapeutics (P&T) committees that meet an average of seven times per year. It is estimated that more than 90% of P&T committees are responsible for formulary development and management, drug policy development, adverse-drug-reaction review, and medication-use evaluation. More than 90% of hospitals use clinical and therapeutic, cost, and pharmacoeconomic information in the formulary management process, while nearly two thirds consider quality-of-life issues. Nearly 70% use clinical practice guidelines in the formulary management process, and 78% have a medication-use evaluation program designed to improve prescribing. Pharmacists in more than 75% of hospitals provide consultations on drug information, dosage adjustments for patients with renal impairment, antimicrobials, and pharmacokinetics. Further, a majority of hospitals ensure accurate transcription of medication orders by clarifying illegible orders before transcription or entry into medication administration records (MARs), using standardized prescriber order forms, requiring prescribers to countersign all oral orders, and reconciling MARs and pharmacy patient profiles at least daily. In 2001, large hospitals are most likely to use prescriber order-entry systems to improve patient safety and are least likely to require the reentry of medication orders into the pharmacy computer system. The 2001 ASHP survey results suggest that pharmacists in hospital settings have positioned themselves well to improve the prescribing and transcribing components of the medication-use process.