Gjone Helena, Burns Gemma, Teasdale Trudy, Hattingh H Laetitia
School of Pharmacy and Medical Sciences, Griffith University, QLD 4222, Australia.
Pharmacy Department, Royal Hobart Hospital, Tasmania, Australia.
Explor Res Clin Soc Pharm. 2023 Jan 24;9:100225. doi: 10.1016/j.rcsop.2023.100225. eCollection 2023 Mar.
Hospital pharmacists play an important role in the discharge process, including conducting medicine reconciliation, counselling patients or carers, and generating discharge medicine lists. These contribute to medicine handover at transition of care from hospital discharge. However, pharmacists face numerous barriers to providing comprehensive discharge services.
To gain a deeper understanding of the hospital pharmacists discharge processes.
Qualitative study design was used to explore pharmacists' experiences and opinions regarding (1) the use of technology and software to prepare patient discharges, (2) involvement of pharmacy assistants in discharge processes, and (3) challenges and facilitators in preparing patient discharges. An independent researcher conducted semi-structured interviews with 15 pharmacists between 29 October and 22 December 2021 (mean interview 21 min). Interview transcriptions were analysed using thematic analysis.
Interviews revealed four overarching themes: patient safety, staff involved in discharge processes, discharge handover procedures and electronic health software. Barriers to completing discharges included staff workloads, poor medical record software integration and lack of advanced discharge notice. Good communication between pharmacists and other clinicians, including the presence of a discharge nurse on the inpatient unit, made discharges more efficient, and most pharmacists favoured utilisation of pharmacy assistants in preparing discharge medicine lists.
Poor integration between medical software systems negatively impacts pharmacists' ability to complete discharge medicine lists. Pharmacists require advance notice of upcoming discharges to effectively prioritise high workloads, while increased utilisation of trained pharmacy assistants may facilitate discharge workflows.
医院药剂师在出院流程中发挥着重要作用,包括进行用药核对、为患者或护理人员提供咨询以及生成出院用药清单。这些有助于在从医院出院的护理过渡阶段进行药物交接。然而,药剂师在提供全面的出院服务方面面临诸多障碍。
更深入地了解医院药剂师的出院流程。
采用定性研究设计,以探讨药剂师对于以下方面的经验和看法:(1)使用技术和软件来准备患者出院,(2)药房助理参与出院流程,以及(3)准备患者出院过程中的挑战和促进因素。一名独立研究人员在2021年10月29日至12月22日期间对15名药剂师进行了半结构化访谈(平均访谈时长21分钟)。使用主题分析法对访谈转录本进行分析。
访谈揭示了四个总体主题:患者安全、参与出院流程的工作人员、出院交接程序和电子健康软件。完成出院的障碍包括工作人员工作量、医疗记录软件集成不佳以及缺乏提前出院通知。药剂师与其他临床医生之间的良好沟通,包括住院病房有出院护士,使出院效率更高,并且大多数药剂师赞成在准备出院用药清单时利用药房助理。
医疗软件系统之间的不良集成对药剂师完成出院用药清单的能力产生负面影响。药剂师需要提前收到即将出院的通知,以便有效地对高工作量进行优先排序,而增加对训练有素的药房助理的利用可能会促进出院工作流程。