A carregar...
Publicação
Ordering medication for hospital inpatients in an english teaching hospital organisation: pharmacy staff decisions on the type and duration of supply
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 2.44 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Introdução: No Reino Unido, ao efetuar pedidos de medicação individual para doentes
hospitalizados, profissionais de farmácia têm de decidir o tipo de dispensa, entre “one-stop” ou
inpatient, e a quantidade de medicamentos a dispensar. Atualmente, as orientações fornecidas
por protocolos oficiais são limitadas e os fatores envolvidos nessas decisões pouco conhecidos.
O objetivo deste estudo foi explorar o processo de decisão quanto ao tipo e duração da dispensa
de medicação para doentes internados, numa trust hospitalar inglesa.
Métodos: O estudo foi aprovado como uma avaliação de serviço na respetiva organização, não
exigindo aprovação ética. Dezanove fatores, identificados através de um focus group, foram
avaliados quantitativamente na tomada de decisões quanto ao tipo e duração da dispensa de
medicação. Esta avaliação foi efetuada através de um questionário online realizado por
profissionais de farmácia, utilizando escalas Likert de 5 pontos, de 1 ("nada") a 5 ("muito"). As
respostas foram submetidas a análise estatística descritiva em Microsoft Excel, e um
subconjunto de fatores comparado entre grupos de profissionais usando testes U de Mann-Whitney, com a aplicação da correção de Bonferroni para múltiplas comparações.
Resultados: O questionário obteve 57 respostas de entre 180 profissionais elegíveis, refletindo
uma taxa de resposta de 32%. Para decisões quanto ao tipo e duração da dispensa, catorze
fatores foram considerados muito importantes (medianas de 4 ou 5), onde "paciente requerendo
dose unitária" e "duração do tratamento" registaram medianas de 5. O fator "competências de
enfermagem" foi considerado menos importante (mediana de 2).
O fator "medicação verificada por um farmacêutico" revelou menor importância para os
farmacêuticos em comparação com os técnicos (p=0.0002 para tipo e duração da dispensa); e
para os profissionais com mais de 10 anos de experiência na respetiva trust em comparação
com aqueles com menos anos (p=0.002 e p=0.001, respetivamente, para tipo e duração da
dispensa).
Discussão e conclusão: Este estudo elucida os fatores envolvidos na tomada de decisão e a sua
importância relativa para diferentes grupos de profissionais de farmácia. Limitações incluem
poder estatístico insuficiente e a incapacidade de compreender a influência dos fatores nas
decisões tomadas, a qual será investigada através de entrevistas individuais.
Introduction: In the United Kingdom, pharmacy staff must decide on medication supply type, between “one-stop” dispensing or inpatient supply, and on its duration, when ordering inpatient-specific medicines. Currently, official guidance in this regard is limited, and little is known about the factors at play. The aim of this study was to explore pharmacy staff decisions on the type and duration of inpatient medication supply in an English hospital trust. Methods: The study was exempt from ethical approval as it was approved as a service evaluation in the organisation concerned. Nineteen factors, identified through a focus group, were evaluated quantitatively regarding decisions on supply type and duration. This assessment was conducted via an online survey by pharmacy staff members, using 5-point Likert scales ranging from 1 (“not at all”) to 5 (“a great deal”). Responses were subjected to descriptive analysis in Microsoft Excel, and a subset of factors compared between staff groups using Mann-Whitney U tests, with the Bonferroni correction applied for multiple comparisons. Results: The survey yielded 57 responses out of 180 eligible professionals, reflecting a 32% response rate. For decisions on both supply type and duration, fourteen factors were considered very important (median scores of 4 or 5), with “patient on a multi-compartment compliance aid” and “duration of treatment” rated 5. The factor “nurse skill set on the ward” was considered least important (median score of 2). Data analysis suggested that the factor “medication screened by a pharmacist” was less important to pharmacists than to medicines management pharmacy technicians (p=0.0002 for both supply type and duration); and to staff employed at the trust for over 10 years compared to those with fewer years (p=0.002 and p=0.001, respectively, for supply type and duration). Discussion and conclusion: This study offers valuable insights into the diversity of factors that play a role in decision-making and their relative importance for different pharmacy staff groups. Limitations include insufficient statistical power and inability to understand how factors influence decisions, which will be addressed through individual interviews.
Introduction: In the United Kingdom, pharmacy staff must decide on medication supply type, between “one-stop” dispensing or inpatient supply, and on its duration, when ordering inpatient-specific medicines. Currently, official guidance in this regard is limited, and little is known about the factors at play. The aim of this study was to explore pharmacy staff decisions on the type and duration of inpatient medication supply in an English hospital trust. Methods: The study was exempt from ethical approval as it was approved as a service evaluation in the organisation concerned. Nineteen factors, identified through a focus group, were evaluated quantitatively regarding decisions on supply type and duration. This assessment was conducted via an online survey by pharmacy staff members, using 5-point Likert scales ranging from 1 (“not at all”) to 5 (“a great deal”). Responses were subjected to descriptive analysis in Microsoft Excel, and a subset of factors compared between staff groups using Mann-Whitney U tests, with the Bonferroni correction applied for multiple comparisons. Results: The survey yielded 57 responses out of 180 eligible professionals, reflecting a 32% response rate. For decisions on both supply type and duration, fourteen factors were considered very important (median scores of 4 or 5), with “patient on a multi-compartment compliance aid” and “duration of treatment” rated 5. The factor “nurse skill set on the ward” was considered least important (median score of 2). Data analysis suggested that the factor “medication screened by a pharmacist” was less important to pharmacists than to medicines management pharmacy technicians (p=0.0002 for both supply type and duration); and to staff employed at the trust for over 10 years compared to those with fewer years (p=0.002 and p=0.001, respectively, for supply type and duration). Discussion and conclusion: This study offers valuable insights into the diversity of factors that play a role in decision-making and their relative importance for different pharmacy staff groups. Limitations include insufficient statistical power and inability to understand how factors influence decisions, which will be addressed through individual interviews.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
Pharmacy staff Medication supply type Medication supply duration Hospital inpatients Decisions Mestrado Integrado - 2023