Hung Man Yui, Wright David John, Blacklock Jeanette, Needle Richard John
Pharmacy Department, Colchester Hospital University NHS Foundation Trust, Colchester.
School of Pharmacy, University of East Anglia, Norwich, UK.
Integr Pharm Res Pract. 2017 Nov 13;6:181-190. doi: 10.2147/IPRP.S146630. eCollection 2017.
A high nurse-vacancy rate combined with high numbers of applications for junior pharmacist roles resulted in Colchester Hospital University National Health System Foundation Trust trial employing junior pharmacists into traditional nursing posts with the aim of integrating pharmacists into the ward team and enhancing local medicines optimization. The aim of the evaluation was to describe the implementation process and practice of the integrated care pharmacists (ICPs) in order to inform future innovations of a similar nature.
Four band 6 ward-based ICPs were employed on two wards funded within current ward staffing expenditure. With ethical committee approval, interviews were undertaken with the ICPs and focus groups with ward nurses, senior ward nurses and members of the medical team. Data were analyzed thematically to identify service benefits, barriers and enablers. Routine ward performance data were obtained from the two ICP wards and two wards selected as comparators. Appropriate statistical tests were performed to identify differences in performance.
Four ICPs were interviewed, and focus groups were undertaken with three junior nurses, four senior nurses and three medical practitioners. Service enablers were continuous ward time, undertaking drug administration, positive feedback and use of effective communication methods. Barriers were planning, funding model, career development, and interprofessional working and social isolation. ICPs were believed to save nurse time and improve medicines safety. The proportion of patients receiving medicine reconciliation within 24 hours increased significantly in the ICP wards. All ICPs had resigned from their role within 12 months.
It was believed that by locating pharmacists on the ward full time and allowing them to undertake medicines administration and medicines reconciliation, the nursing time would be saved and medicines safety improved. There was however significant learning to be derived from the implementation process, which may enable similar future models to be introduced more successfully.
高护士空缺率加上初级药剂师岗位的大量申请，导致科尔切斯特医院大学国民保健服务基金会信托基金进行了一项试验，将初级药剂师安排到传统护理岗位，目的是让药剂师融入病房团队并加强当地药物优化。评估的目的是描述综合护理药剂师（ICP）的实施过程和实践，以便为未来类似性质的创新提供参考。
在当前病房人员配置支出范围内资助的两个病房雇佣了四名6级病房ICP。经伦理委员会批准，对ICP进行了访谈，并与病房护士、高级病房护士和医疗团队成员进行了焦点小组讨论。对数据进行主题分析，以确定服务的益处、障碍和促进因素。从两个ICP病房和两个作为对照的病房获取常规病房绩效数据。进行了适当的统计测试以确定绩效差异。
对四名ICP进行了访谈，并与三名初级护士、四名高级护士和三名医生进行了焦点小组讨论。服务促进因素包括在病房的连续工作时间、进行药物给药、积极反馈和使用有效的沟通方法。障碍包括规划、资金模式、职业发展、跨专业合作和社交孤立。据信ICP节省了护士时间并提高了用药安全性。ICP病房中在24小时内接受用药核对的患者比例显著增加。所有ICP在12个月内都辞去了他们的职务。
人们认为，通过让药剂师全职在病房工作并允许他们进行药物给药和用药核对，可以节省护理时间并提高用药安全性。然而，从实施过程中可以获得重要的经验教训，这可能使未来能够更成功地引入类似模式。
