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BEA-004 Taking a Lead in Ward Patient Safety
  1. EGM Ulgey
  1. Konya Numune State Hospital, Pharmacy, Konya

Abstract

Background The pharmacist workforce is limited in terms of patient safety due to the ‘one pharmacist to every one hundred beds’ rule in Turkish state hospitals. Our hospital is being rebuilt, and having fewer patients in wards has resulted in all departments working under capacity for a certain period.

Purpose To take advantage of this unique situation that allowed pharmacists to raise the standards of patient safety by using the extra time and workforce granted; and also to prove that good leadership in pharmacy care can result in better patient health.

Materials and Methods Pharmacists were encouraged to appraise the clinical skills of their department, determine the level of the need of ward patients for better patient safety and judge the resources currently available for implementation, before considering the potential sources of collaboration with other health professionals. ‘Rx Media Pharma’ software was used for gaining detailed results on patient chart evaluations. All documentation was performed online with ‘Google Docs’, allowing participants to share and make changes online directly with selected health professionals.

Results For 23 working days, 200 patient charts were reviewed. The average number of drugs used was 7.6 and the drug-drug interactions identified were 2.02 per patient. The importance of the interactions was evaluated in 3 levels; major (42.82%), moderate (51.23%) and minor (5.94%). The numbers of recommendations regarding the drug-drug interactions spotted were: 31 therapeutic exchange (7.67%), 88 dosage recommendation (21.78%), 4 adding drug to the treatment (0.99%), 99 proposal to withdraw a particular drug (24.50%), 182 monitoring (45.04%). Total number of food-drug interactions was 286 (1.43 per patient), with 118 instances of intravenous incompatibility warnings made to the ward nurses (0.59 per patient). 62 inappropriate drug dosages (0.31 per patient) and 3 drugs containing the same active substances in different formulations (0.015 per patient) were reported to the prescribing physicians. In 124 cases (0.62 per patient), pharmacists requested information about the use of the drugs prescribed for treatment.

Upon discussion of the results, the physicians provided feedback and acted according to three options: (9.14%) the physician didn’t agree (they believed the situation didn’t require an intervention), (58.53%) the physician felt it was sufficient to monitor the patient’s status, considering the suggested change in treatment, (32.31%) the physician agreed to a change in the patient’s treatment, applying the recommendation pharmacists made.

Conclusions Our pharmacy department discovered that continuous service at this level of quality is needed for ward patients. Similar studies should be encouraged by health care leaders in Turkey to improve hospital care.

No conflict of interest.

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