Leslie Katie F, Probst M Kate, Hawkins Taylor L
Sullivan University College of Pharmacy and Health Sciences.
Hosparus Health.
Innov Pharm. 2021 Sep 22;12(4). doi: 10.24926/iip.v12i4.4004. eCollection 2021.
The purpose of this mixed-methods study was to evaluate an interprofessional academic-practice partnership in end of life care by examining patient medication outcomes, the contributions of student pharmacists and a pharmacy preceptor to care teams, and student learning experiences. Retrospective chart review assessed polypharmacy differences in hospice patients with a primary terminal diagnosis of non-Alzheimer's dementia between two patient groups; Group 1 managed on interprofessional care teams within the pharmacy partnership, and Group 2, managed on teams without a pharmacist. Team members who interacted with student pharmacists and the pharmacy preceptor participated in semi-structured key informant interviews to document perceptions of pharmacy contributions to care teams and the organization. At the end of their APPE, students completed reflective writings regarding their learning. Patients in Group 1 were on statistically significant fewer medications than Group 2 at both week 4 and weeks 7-12 following admission. Five conceptual themes emerged from interviews: pharmacists as team medication experts, improved patient outcomes, interprofessional collaboration, patient/caregiver trust in medication regimens, and desire for sustainability. Student reflections included the following learning themes: teamwork, respect, value, and patient-centered care. The addition of a pharmacist on interprofessional care teams decreased the average number of medications in the non-Alzheimer's end of life patient population. Team members identified value-added contributions of student pharmacists and the pharmacy preceptor that enhanced team efficiency and patient care. Student pharmacists recognized these contributions and the experience served as an exemplar of interprofessional practice.
这项混合方法研究的目的是通过检查患者用药结果、学生药剂师和药房带教老师对护理团队的贡献以及学生的学习经历，来评估临终关怀方面的跨专业学术-实践伙伴关系。回顾性病历审查评估了两组患者中以非阿尔茨海默病性痴呆为主要终末期诊断的临终关怀患者的多重用药差异；第1组在药房伙伴关系内的跨专业护理团队中接受管理，第2组在没有药剂师的团队中接受管理。与学生药剂师和药房带教老师互动的团队成员参与了半结构化关键信息人访谈，以记录对药房对护理团队和组织贡献的看法。在他们的高级药学实践经验（APPE）结束时，学生们完成了关于他们学习的反思性写作。第1组患者在入院后第4周以及第7至12周服用的药物数量在统计学上显著少于第2组。访谈中出现了五个概念主题：药剂师作为团队用药专家、改善患者结局、跨专业协作、患者/护理人员对用药方案的信任以及对可持续性的渴望。学生的反思包括以下学习主题：团队合作、尊重、价值和以患者为中心的护理。在跨专业护理团队中增加一名药剂师减少了非阿尔茨海默病临终患者群体的平均用药数量。团队成员确定了学生药剂师和药房带教老师的增值贡献，这些贡献提高了团队效率和患者护理水平。学生药剂师认识到这些贡献，并且这段经历成为了跨专业实践的典范。
