Barry Arden R, Egan Greg, Turgeon Ricky D, Leung Marianna
, BSc, BSc(Pharm), PharmD, ACPR, is with Chilliwack General Hospital, Lower Mainland Pharmacy Services, Chilliwack, British Columbia, and the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
, BSc(Pharm), PharmD, ACPR, is with Vancouver General Hospital, Lower Mainland Pharmacy Services, Vancouver, British Columbia.
Can J Hosp Pharm. 2019 Jan-Feb;72(1):27-33. Epub 2018 Feb 28.
Pharmacists are now seeking to incorporate physical assessment (PA) into their practices. This trend prompted the creation, by the British Columbia Branch of the Canadian Society of Hospital Pharmacists, of a 30-h course specifically designed for practising pharmacists.
To evaluate pharmacists' knowledge, skills, and confidence in performing PA after completing the course.
All course participants were invited to complete 2 anonymous online surveys, immediately and 6 months after course completion.
Of the 218 participants, 82 (38%) responded to the survey administered immediately after the course, and 77 (35%) completed this survey in full. About half of the respondents (39/79 [49%]) reported use of PA on a real patient before taking the course. Lack of formal training and lack of comfort were the most frequently selected barriers to performing PA. All respondents (79/79) agreed that the course had improved their knowledge of PA, 96% (76/79) agreed that it had improved their skills, and 90% (71/79) agreed that it had improved their ability to care for patients. In addition, 61% (48/79) and 67% (53/79), respectively, agreed that they felt confident performing PA and intervening with regard to a patient's drug therapy on the basis of physical findings. Thirty-eight (17%) of the course participants completed the 6-month follow-up survey. In that survey, the most frequently selected barrier to performing PA was lack of time. Paired data, available for 23 respondents, showed a significant increase in use of PA on real patients over time ( = 0.013 by χ test). However, there was no significant improvement in confidence in performing PA or intervening on a patient's drug therapy on the basis of physical findings ( > 0.05 by 2-sided test). The primary limitation of this study was potential responder bias.
A PA course designed for pharmacists improved participants' self-reported knowledge and skills, as well as self-perceived ability to care for patients. Six months after the course, two-thirds of respondents had used PA in practice. However, there was no improvement in confidence in performing such assessments or using the findings to intervene on a patient's drug therapy.
药剂师目前正寻求将体格检查(PA)纳入其业务范畴。这一趋势促使加拿大医院药剂师协会不列颠哥伦比亚分会专门为执业药剂师开设了一门时长30小时的课程。
评估药剂师在完成该课程后进行体格检查的知识、技能和信心。
邀请所有课程参与者在课程结束后立即以及结束6个月后完成2份匿名在线调查问卷。
在218名参与者中,82名(38%)对课程结束后立即进行的调查做出了回应,77名(35%)完整填写了这份调查问卷。约一半的受访者(39/79[49%])报告在参加课程之前曾对真实患者进行过体格检查。缺乏正规培训和不自在是进行体格检查时最常被提及的障碍。所有受访者(79/79)都认为该课程提高了他们对体格检查的知识,96%(76/79)的人认为提高了他们的技能,90%(71/79)的人认为提高了他们照顾患者的能力。此外,分别有61%(48/79)和67%(53/79)的人表示他们对基于体格检查结果进行体格检查和干预患者药物治疗有信心。38名(17%)课程参与者完成了6个月的随访调查。在那次调查中,进行体格检查时最常被提及的障碍是缺乏时间。23名受访者的配对数据显示,随着时间推移,对真实患者进行体格检查的情况有显著增加(χ检验P = 0.013)。然而,在基于体格检查结果进行体格检查或干预患者药物治疗的信心方面没有显著提高(双侧t检验P>0.05)。本研究的主要局限性是可能存在应答偏倚。
为药剂师设计的体格检查课程提高了参与者自我报告的知识和技能,以及自我感知的照顾患者的能力。课程结束6个月后,三分之二的受访者在实践中使用了体格检查。然而,在进行此类评估或利用检查结果干预患者药物治疗的信心方面没有提高。