Khumra Sharmila, Mahony Andrew A, Stewart Kay, Bergen Phillip J, Elliott Rohan A
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria 3052, Australia.
Department of Pharmacy, Austin Health, 145 Studley Road, Heidelberg, Victoria 3084, Australia.
Explor Res Clin Soc Pharm. 2022 Mar 29;5:100131. doi: 10.1016/j.rcsop.2022.100131. eCollection 2022 Mar.
Ward pharmacists are well-positioned to enhance the activities of hospital antimicrobial stewardship (AMS) programs by reviewing the appropriateness of antimicrobials and making recommendations to prescribers. However, recent studies have identified gaps in ward pharmacists' AMS practice, knowledge, skills, and confidence which suggests education and training programs are needed.
To describe, for the first time, an interactive educational activity - coaching in AMS - targeted at ward pharmacists and explore their perceptions of coaching as a mode of delivering education to improve AMS knowledge, skills, confidence, and practice. A secondary objective was to describe the type, frequency, and acceptance of AMS recommendations made by coached pharmacists.
This was a descriptive pilot study with a qualitative evaluation of pharmacists' perceptions and experiences of coaching. AMS coaching was delivered over 2 months in 2019 to pharmacists providing clinical pharmacy services to general medical and surgical wards. A focus group was conducted one month after the coaching period to elicit pharmacists' perceptions of coaching as a mode of delivering AMS education and how it impacted their AMS knowledge, skills, confidence, and practice. AMS recommendations made by coached pharmacists were prospectively recorded, and the prescriber acceptance rate was determined.
Ward pharmacists reported positive experiences with AMS coaching and believed it helped them identify a range of recommendations to improve antimicrobial prescribing and increased their confidence to communicate recommendations to prescribers. Workload issues were identified as the main barrier to implementation. Suggestions were provided to improve coaching implementation feasibility. During coaching, 162 AMS recommendations were identified for a range of antimicrobials, and 69% (113/162) were accepted and implemented.
Ward pharmacists believed coaching improved their AMS knowledge, skills, confidence, and practice, including their confidence to discuss recommendations with prescribers. These results can assist with the design and evaluation of future hospital-based AMS educational initiatives.
病房药师通过审查抗菌药物的合理性并向开处方者提出建议，在加强医院抗菌药物管理（AMS）计划的活动方面具有有利地位。然而，最近的研究发现病房药师在AMS实践、知识、技能和信心方面存在差距，这表明需要开展教育和培训项目。
首次描述一项针对病房药师的互动式教育活动——AMS辅导，并探讨他们对辅导作为一种提供教育以提高AMS知识、技能、信心和实践的方式的看法。第二个目的是描述接受辅导的药师提出的AMS建议的类型、频率和接受情况。
这是一项描述性试点研究，对药师对辅导的看法和经历进行定性评估。2019年，在两个月的时间里，对为普通内科和外科病房提供临床药学服务的药师进行了AMS辅导。辅导期结束一个月后，进行了一次焦点小组讨论，以了解药师对辅导作为一种提供AMS教育的方式的看法，以及它如何影响他们的AMS知识、技能、信心和实践。前瞻性记录接受辅导的药师提出的AMS建议，并确定开处方者的接受率。
病房药师报告了AMS辅导的积极经历，并认为这有助于他们确定一系列改进抗菌药物处方的建议，并增强了他们向开处方者传达建议的信心。工作量问题被确定为实施的主要障碍。提出了一些建议以提高辅导实施的可行性。在辅导期间，针对一系列抗菌药物确定了162条AMS建议，其中69%（113/162）被接受并实施。
病房药师认为辅导提高了他们的AMS知识、技能、信心和实践，包括他们与开处方者讨论建议的信心。这些结果可为未来基于医院的AMS教育举措的设计和评估提供帮助。
