Teoh Stephanie, Mukadam Nabeelah, Petrovski Michael
King Edward Memorial Hospital, Subiaco, WA, Australia.
Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Hosp Pharm. 2024 Apr;59(2):202-209. doi: 10.1177/00185787231207752. Epub 2023 Oct 27.
Accuracy of medication charts on admission to hospital has previously shown that inadvertent omission of therapy was the most common discrepancy, accounting for 40% to 60% of errors. Partnered Pharmacist Medication Charting (PPMC) has shown to reduce medicationrelated problems. The aim of this study was to evaluate the implementation of Pharmacist Medication Charting (PMC), a derivative of PPMC, in a maternity and gynecological hospital. The occurrence of medication omission identified by the pharmacists was assessed and the pharmacist interventions involving PMC analyzed. The pharmacist interventions documented from 1st July 2022 to 30th June, 2023 were evaluated using PowerBI for data and trends on the Medication-Related Problems (MRPs) identified, occurrence of PMC, common medications charted by the pharmacists and the pharmacist recommendation and action following the identification of MRPs. A total of 4898 pharmacy interventions was documented in the 12-month period. Of the total interventions documented, 1321 (26.97%) were related to pharmacist medication charting. Of all the interventions related to PMC, 53.29% involved pharmacists charting medications for the continuation or initiation of over-the-counter medications, 13.32% involved pharmacist partnered charting of Prescription Only Medications and Controlled Medications with medical staff, and 33.3% were referred to a credentialled pharmacist for PMC service. With regards to action taken following interventions involving PMC, 1065 (80.62%) were resolved following PMC. Common medications charted by the pharmacists include: macrogol and docusate laxatives (288), pregnancy multivitamin containing iron, iodine and folate (169), colecalciferol (133), iron (127), asthma inhaler (99), paracetamol and ibuprofen (88), nicotine (38), calcium (29), folic acid (26), and pantoprazole (15). Our study demonstrated that hospital pharmacists contribute to the reduction of MRPs, and PMC enables pharmacist to address prescribing omission and conditions untreated in the hospital. This study also reflects skills enhancement in practice for clinical pharmacists and resulted in successful implementation of PMC.
此前关于入院时用药记录准确性的研究表明，治疗的无意遗漏是最常见的差异，占错误的40%至60%。药剂师合作用药记录（PPMC）已被证明可减少与用药相关的问题。本研究的目的是评估PPMC的衍生形式——药剂师用药记录（PMC）在一家妇产科医院的实施情况。评估了药剂师发现的用药遗漏情况，并分析了涉及PMC的药剂师干预措施。使用PowerBI对2022年7月1日至2023年6月30日记录的药剂师干预措施进行评估，以获取有关所发现的与用药相关问题（MRP）、PMC的发生情况、药剂师记录的常用药物以及发现MRP后药剂师的建议和行动的数据及趋势。在这12个月期间共记录了4898次药房干预措施。在记录的所有干预措施中，1321次（26.97%）与药剂师用药记录有关。在所有与PMC相关的干预措施中，53.29%涉及药剂师为非处方药的继续使用或开始使用记录用药情况，13.32%涉及药剂师与医务人员合作记录仅处方药物和管制药物，33.3%被转介给有资质的药剂师进行PMC服务。关于涉及PMC的干预措施后采取的行动，1065次（80.62%）在PMC后得到解决。药剂师记录的常用药物包括：聚乙二醇和多库酯泻药（288次）、含铁、碘和叶酸的孕期复合维生素（169次）、骨化三醇（133次）、铁（127次）、哮喘吸入器（99次）、对乙酰氨基酚和布洛芬（88次）、尼古丁（38次）、钙（29次）、叶酸（26次）和泮托拉唑（15次）。我们的研究表明，医院药剂师有助于减少MRP，并且PMC使药剂师能够解决医院中处方遗漏和未治疗的病症问题。本研究还反映了临床药剂师实践技能的提升，并成功实施了PMC。
