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Clinical pharmacy and clinical trials (including case series)
Prescription and administration of medicine in a surgical department. Clinical pharmacists increase the safety of medical treatment of surgical patients
  1. T. Birkeskov Axelsen,
  2. K. Thygesen Nielsen,
  3. H. Jepsen,
  4. C. Arp Sørensen,
  5. A. Kyhn Brejnholt
  1. 1Regionshospitalet Randers, Hospital Pharmacy, Randers NØ, Denmark
  2. 2Regionshospitalet Randers, Department of Surgery, Randers NØ, Denmark

Abstract

Background General surgeons do not focus on the medical treatment of their patients. This conclusion can be drawn following an internal survey on the way prescription and administrations of medicine were handled on Department of Surgery, Randers Regional Hospital. The surgeons faced a big challenge in order to pass the standards set by the Danish Healthcare quality Programme (DDKM). The requisites for medication set by DDKM, involved requirements for preparation and registration of the medical history, medication reconciliation and allergy-registration. Therefore, a collaboration between the clinical pharmacists and the surgical department was initiated.

Purpose To ensure accreditation by the DDKM by performing medication related interventions. -To gather information and experience from the concept of having a clinical pharmacist at the ward.

Materials and methods The clinical pharmacist worked at the surgical ward 2 h a day (mon-fri) for a 5 months period. Using the patients' electronic health records, the clinical pharmacist reviewed the prescribed medicine of the admitted patients and made comments about the results of the medication review. The interventions were implemented by: -Teaching the staff about the elements of the accreditation process. -Weekly presentation of interim results from the individual accreditations elements. -Presentation of the final results at staff-meetings.

Results In the intervention period 672 patients (82%) had their medication evaluated. This resulted in 1297 interventions in 413 patients (3,2/patient). The Department of Surgery passed the standards set by the DDKM. Safe medication of the patients was observed during the period, and the pharmacists gave several recommendations for future collaboration and for further increasing safety.

Conclusions The clinical pharmacist can, through education of the staff, various tools, intense focus and dialogue, guide surgeons to better focus on medicine prescription and thereby ensure accreditation according to DDKM. By a proactive attitude the clinical pharmacist can contribute to increased patient safety.

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