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药剂师对儿科肿瘤门诊出院随访教育的影响:一项质量改进研究。

Pharmacist Effect on Discharge Follow-Up Education in Pediatric Oncology Outpatient Clinics: A Quality Improvement Study.

作者信息

Drennan Chelsea N, Pauley Jennifer L, Christensen Anthony M, Jacobs Timothy W, Bragg Allison W, Porter Jerlym S, Bourque Melissa S

机构信息

Department of Pharmacy and Pharmaceutical Sciences (CND, JLP, AMC, TWJ, AWB, MSB), St. Jude Children's Research Hospital, Memphis, TN.

Department of Psychology (JSP), St. Jude Children's Research Hospital, Memphis, TN.

出版信息

J Pediatr Pharmacol Ther. 2023;28(3):262-267. doi: 10.5863/1551-6776-28.3.262. Epub 2023 Jun 2.

Abstract

OBJECTIVE

We aimed to describe the effect of education provided by a clinical pharmacy specialist at a patient's follow-up appointment after discharge, and to assess caregiver satisfaction.

METHODS

A single-center, quality improvement study was conducted. A standardized data collection tool was created to characterize interventions made by clinical pharmacy specialists during an outpatient clinic appointment scheduled shortly after discharge. Pediatric patients with cancer who met the following criteria were included: 1) initial diagnosis without receiving chemotherapy, 2) first course of chemotherapy after initial diagnosis or relapsed disease, and 3) post-hematopoietic stem cell transplantation or cellular therapy. A survey was provided to families after the follow-up discharge appointment to assess the caregiver's satisfaction of the new process.

RESULTS

From January to May 2021, a total of 78 first-time discharge appointments were completed. The most common reason for follow-up was discharge after first course of chemotherapy (77%). The average duration of each appointment was 20 minutes (range, 5-65). The clinical pharmacy specialist made an intervention during 85% of appointments. The most common intervention made during the visit was reinforcement of medications (31%). Thirteen surveys were completed by caregivers; 100% of the caregivers reported the follow-up appointment was helpful. Additionally, they reported the most useful resource provided at discharge was the medication calendar (85%).

CONCLUSIONS

Investing clinical pharmacy specialist time with patients and caregiver after discharge appears to have a meaningful effect on patient care. Caregivers report this process is helpful in better understanding their child's medications.

摘要

目的

我们旨在描述临床药学专家在患者出院后的随访预约中提供教育的效果,并评估照顾者的满意度。

方法

开展了一项单中心质量改进研究。创建了一个标准化的数据收集工具,以描述临床药学专家在出院后不久安排的门诊预约期间所进行的干预措施。纳入符合以下标准的儿科癌症患者:1)初次诊断未接受化疗;2)初次诊断或疾病复发后的首个化疗疗程;3)造血干细胞移植或细胞治疗后。在随访出院预约后向家庭提供了一项调查,以评估照顾者对新流程的满意度。

结果

2021年1月至5月,共完成了78次首次出院预约。随访的最常见原因是首个化疗疗程后出院(77%)。每次预约的平均时长为20分钟(范围为5 - 65分钟)。临床药学专家在85%的预约中进行了干预。就诊期间最常见的干预措施是强化用药指导(31%)。照顾者完成了13份调查问卷;100%的照顾者报告随访预约很有帮助。此外,他们报告出院时提供的最有用资源是用药日历(85%)。

结论

出院后投入临床药学专家的时间与患者及照顾者相处,似乎对患者护理有显著影响。照顾者报告这一过程有助于更好地了解其孩子的用药情况。

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