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优化护理模式:一种新型社区药房实践模式的最终研究结果,该模式利用技术人员产品核查来加强患者护理服务。

The Optimizing Care Model: Final findings of a novel community pharmacy practice model to enhance patient care delivery using technician product verification.

作者信息

Hohmeier Kenneth C, Sain Alec, Garst Aaron, Shell Lucy, Desselle Shane, Gatwood Justin, Cost Micah

出版信息

J Am Pharm Assoc (2003). 2022 Jan-Feb;62(1):112-119. doi: 10.1016/j.japh.2021.09.006. Epub 2021 Sep 30.

Abstract

BACKGROUND

The community pharmacy represents a convenient health care access point for patients and is increasingly used to deliver direct patient care services; however, several barriers exist that hinder widespread patient service implementation and scalability. Such barriers include scope of practice restrictions, a dearth of sustainable payment models, lack of pharmacist capacity given other responsibilities, and workflow models developed for dispensing medications rather than clinical care. In an effort to overcome the lack of pharmacist time and capacity, further task delegation to pharmacy technicians has been suggested.

OBJECTIVES

The primary objective of this study was to present the final outcomes of the Optimizing Care Model's impact. The model's impact on pharmacist patient care, workday composition, and rates of product selection errors not identified during final product verification are reported.

METHODS

The Optimizing Care Model is an innovative approach to community pharmacy practice aiming to foster a new patient-centered care delivery model that expands clinical service delivery and fosters collaboration across health care settings through task delegation, primarily through technician product verification (TPV). To investigate the impact of its sustained implementation, a quasi-experimental, 1-group pretest-posttest design was used. Outcomes assessed included medication errors, clinical activities, and workday composition.

RESULTS

Six chain and 3 independent pharmacies completed the final, continuation phase of the study. Overall pharmacist time spent delivering patient care services increased significantly upon implementation of the Optimizing Care Model (21% vs. 43%; P < 0.05), whereas pharmacist time spent performing dispensing-related activities decreased significantly (67% vs. 37%; P < 0.05). Total undetected error rates were significantly less in the Optimizing Care Model phase compared with the traditional model (0.05% vs. 0.01%; P < 0.001).

CONCLUSION

This study presented the final results of a 2-year assessment of the Optimizing Care Model. Results reaffirmed initial published findings that the model and its use of TPV increase the array and frequency of direct patient care services rendered while resulting in lower undetected error rates. Final project results of the Optimizing Care Model demonstrate increased clinical service delivery versus the traditional model, while also improving patient safety with lower rates of undetected dispensing errors within the Optimizing Care Model. The Optimizing Care Model continues to show promise as a future practice model for community pharmacies.

摘要

背景

社区药房是患者获取医疗保健服务的便捷途径,并且越来越多地用于提供直接的患者护理服务;然而,存在一些障碍阻碍了患者服务的广泛实施和扩大规模。这些障碍包括执业范围限制、缺乏可持续的支付模式、由于承担其他职责导致药剂师能力不足,以及为配药而非临床护理设计的工作流程模式。为了克服药剂师时间和能力的不足,有人建议进一步将任务委托给药房技术员。

目的

本研究的主要目的是展示优化护理模式的最终影响结果。报告了该模式对药剂师患者护理、工作日构成以及最终产品验证期间未发现的产品选择错误率的影响。

方法

优化护理模式是一种创新的社区药房实践方法,旨在建立一种以患者为中心的新护理模式,通过任务委托,主要是通过技术员产品验证(TPV),扩大临床服务范围并促进跨医疗保健机构的协作。为了调查其持续实施的影响,采用了准实验性的单组前测-后测设计。评估的结果包括用药错误、临床活动和工作日构成。

结果

6家连锁药房和3家独立药房完成了研究的最终延续阶段。实施优化护理模式后,药剂师提供患者护理服务的总时间显著增加(21%对43%;P<0.05),而从事配药相关活动的药剂师时间显著减少(67%对37%;P<0.05)。与传统模式相比,优化护理模式阶段的总未检测错误率显著更低(0.05%对0.01%;P<0.001)。

结论

本研究展示了对优化护理模式进行的为期2年评估的最终结果。结果再次证实了最初发表的研究结果,即该模式及其对TPV的使用增加了提供直接患者护理服务的范围和频率,同时降低了未检测到的错误率。优化护理模式的最终项目结果表明,与传统模式相比,临床服务有所增加,同时在优化护理模式下未检测到的配药错误率更低,从而提高了患者安全性。优化护理模式作为社区药房未来的实践模式仍显示出前景。

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