Clinical Education Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK.
Clinical Education Department, St. Helens and Knowsley Hospitals NHS Trust, Whiston, Merseyside, L35 5DR, UK.
Res Social Adm Pharm. 2021 Nov;17(11):2006-2014. doi: 10.1016/j.sapharm.2021.03.007. Epub 2021 Mar 13.
To explore the impact of a prescribing feedback intervention on insulin prescribing.
This was a mixed-methods study in a hospital setting. An insulin prescribing feedback intervention was delivered verbally and in writing to twelve doctors. Insulin prescribing error frequency was compared to ten doctors who had not received the feedback intervention. Insulin prescribing was audited over four weeks at the start and end of the intervention period. Semi-structured interviews were conducted with participating doctors who had received feedback, and qualitative data analysed thematically to explore the impact of the intervention on their prescribing practice.
Prescribing data were collected on 370 insulin prescriptions with 241 errors identified. A significant reduction (χ2 = 22.6, p=<0.05) in insulin prescribing error frequency was observed in the intervention group, with a non-significant increase reported in the control group. Feedback was received positively and considered valuable by doctors, supporting development of their knowledge and skills and encouraging reflection on their prescribing performance. Doctors described enhanced confidence in insulin prescribing and a desire to improve as a prescriber and avoid harm, with feedback raising awareness of their development needs. Prescribers also described enhanced team work, with greater information and feedback seeking behavior to inform future prescribing decisions.
Feedback has potential to improve insulin prescribing and is a valued and acceptable process intervention for doctors. The impact on insulin prescribing practice is varied and complex influencing the capability, opportunity and motivation of prescribers to adapt and evolve their behavior in response to ongoing feedback.
探索处方反馈干预对胰岛素处方的影响。
这是一项在医院环境中进行的混合方法研究。对 12 名医生进行了口头和书面的胰岛素处方反馈干预。将胰岛素处方错误的频率与未接受反馈干预的 10 名医生进行了比较。在干预期开始和结束时，对参与的医生进行了四周的胰岛素处方审核。对接受反馈的医生进行了半结构化访谈，并对定性数据进行了主题分析，以探讨干预对其处方实践的影响。
共收集了 370 份胰岛素处方数据，其中 241 份存在错误。干预组胰岛素处方错误频率显著降低（χ2=22.6，p<0.05），而对照组则无显著增加。医生对反馈持积极态度，认为其有价值，有助于提高他们的知识和技能，并鼓励他们反思自己的处方表现。医生表示，他们对胰岛素处方的信心增强了，并渴望提高自己作为处方者的水平，避免造成伤害，反馈提高了他们对自身发展需求的认识。医生还描述了团队合作的增强，他们更愿意寻求信息和反馈，以影响未来的处方决策。
反馈有可能改善胰岛素的处方，是一种有价值且可接受的医生过程干预措施。反馈对胰岛素处方实践的影响是多样且复杂的，影响了处方者适应和改变行为的能力、机会和动机，以应对持续的反馈。
