Cargando…

Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool

BACKGROUND: The number and complexity of patients being admitted to hospitals is rising and some patients may not receive a full clinical pharmacy review or be reviewed as regularly as needed during their inpatient stay. This is a risk factor for medication errors. Clinical prioritisation identifies...

Descripción completa

Detalles Bibliográficos
Autores principales: Clarke, Rebecca, Colleran, Maeve, Melanophy, Gail, Bermingham, Margaret
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542416/
https://www.ncbi.nlm.nih.gov/pubmed/37790885
http://dx.doi.org/10.1016/j.rcsop.2023.100335
_version_ 1785114092416008192
author Clarke, Rebecca
Colleran, Maeve
Melanophy, Gail
Bermingham, Margaret
author_facet Clarke, Rebecca
Colleran, Maeve
Melanophy, Gail
Bermingham, Margaret
author_sort Clarke, Rebecca
collection PubMed
description BACKGROUND: The number and complexity of patients being admitted to hospitals is rising and some patients may not receive a full clinical pharmacy review or be reviewed as regularly as needed during their inpatient stay. This is a risk factor for medication errors. Clinical prioritisation identifies patients who are high-risk and most in need of a pharmacist review, targeting finite pharmacy resources to patients who will benefit the most. OBJECTIVES: Assess and enhance clinical prioritisation within a hospital pharmacy department. METHODS: The study was conducted in a large urban academic teaching hospital. A cross-sectional survey of clinical pharmacists in the hospital was conducted to establish the patient clinical criteria they prioritise in their work. A clinical prioritisation tool was developed based on survey findings and was integrated into an existing electronic pharmacy care interface. A pre- and post-intervention study was conducted, consisting of data collection for five days pre- and five days post-implementation of the tool. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were analysed by thematic analysis. RESULTS: Of 39 eligible pharmacists, 37 (95%) responded to the survey. The top-rated prioritisation criteria, including medicines reconciliation tasks and high-risk medicines, helped to inform the content of the clinical prioritisation tool. Post-intervention, there were more Level 1 complex patients reviewed by pharmacists and fewer Level 3 stable patients compared to pre-intervention. Tool sensitivity ranged from 51 to 88%, depending on the experience of the pharmacist using the tool. High levels of satisfaction with clinical prioritisation were reported by those using the tool. CONCLUSION: This newly developed clinical prioritisation tool has the potential to support pharmacists in identifying and reviewing patients in a more targeted manner than practice prior to tool development. Continued development and validation of the tool is essential, with a focus on developing a fully automated tool.
format Online
Article
Text
id pubmed-10542416
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-105424162023-10-03 Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool Clarke, Rebecca Colleran, Maeve Melanophy, Gail Bermingham, Margaret Explor Res Clin Soc Pharm Article BACKGROUND: The number and complexity of patients being admitted to hospitals is rising and some patients may not receive a full clinical pharmacy review or be reviewed as regularly as needed during their inpatient stay. This is a risk factor for medication errors. Clinical prioritisation identifies patients who are high-risk and most in need of a pharmacist review, targeting finite pharmacy resources to patients who will benefit the most. OBJECTIVES: Assess and enhance clinical prioritisation within a hospital pharmacy department. METHODS: The study was conducted in a large urban academic teaching hospital. A cross-sectional survey of clinical pharmacists in the hospital was conducted to establish the patient clinical criteria they prioritise in their work. A clinical prioritisation tool was developed based on survey findings and was integrated into an existing electronic pharmacy care interface. A pre- and post-intervention study was conducted, consisting of data collection for five days pre- and five days post-implementation of the tool. Quantitative data were analysed using descriptive and inferential statistics. Qualitative data were analysed by thematic analysis. RESULTS: Of 39 eligible pharmacists, 37 (95%) responded to the survey. The top-rated prioritisation criteria, including medicines reconciliation tasks and high-risk medicines, helped to inform the content of the clinical prioritisation tool. Post-intervention, there were more Level 1 complex patients reviewed by pharmacists and fewer Level 3 stable patients compared to pre-intervention. Tool sensitivity ranged from 51 to 88%, depending on the experience of the pharmacist using the tool. High levels of satisfaction with clinical prioritisation were reported by those using the tool. CONCLUSION: This newly developed clinical prioritisation tool has the potential to support pharmacists in identifying and reviewing patients in a more targeted manner than practice prior to tool development. Continued development and validation of the tool is essential, with a focus on developing a fully automated tool. Elsevier 2023-09-21 /pmc/articles/PMC10542416/ /pubmed/37790885 http://dx.doi.org/10.1016/j.rcsop.2023.100335 Text en © 2023 The Authors. Published by Elsevier Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Article
Clarke, Rebecca
Colleran, Maeve
Melanophy, Gail
Bermingham, Margaret
Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
title Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
title_full Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
title_fullStr Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
title_full_unstemmed Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
title_short Enhancing the clinical pharmacy service of a large teaching hospital: Development of a new clinical prioritisation tool
title_sort enhancing the clinical pharmacy service of a large teaching hospital: development of a new clinical prioritisation tool
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10542416/
https://www.ncbi.nlm.nih.gov/pubmed/37790885
http://dx.doi.org/10.1016/j.rcsop.2023.100335
work_keys_str_mv AT clarkerebecca enhancingtheclinicalpharmacyserviceofalargeteachinghospitaldevelopmentofanewclinicalprioritisationtool
AT colleranmaeve enhancingtheclinicalpharmacyserviceofalargeteachinghospitaldevelopmentofanewclinicalprioritisationtool
AT melanophygail enhancingtheclinicalpharmacyserviceofalargeteachinghospitaldevelopmentofanewclinicalprioritisationtool
AT berminghammargaret enhancingtheclinicalpharmacyserviceofalargeteachinghospitaldevelopmentofanewclinicalprioritisationtool