Background Few elements in the literature detail the organisation and impact of pharmaceutical work in care units. Pharmacists perform pharmaceutical interventions (PIs) when they detect a possible medicines error (ME). Another duty of pharmacists is reconciliation, i.e. correct alignment of outpatient and inpatient prescriptions.
Purpose To compare the work of two pharmaceutical teams: before and after the creation of senior pharmacist posts. Does the recruitment of more senior pharmacists improve patient care?
Materials and methods PIs were recorded during two successive six-month periods in a 15-bed unit. During the first period, prescriptions were mainly checked by the resident at the patient bedside. During the second period, prescriptions were checked either by senior pharmacists or by the resident. We compared the number, the type, and the acceptance of PIs during these two periods including reconciliation activity. Data were compared using Fisher’s exact test or chi-2 analysis, tests are performed by R software (*p < 0.05).
Results The involvement of senior pharmacists significantly increased the number of PIs: the first and second team recorded respectively 104 PIs for 1408 prescriptions analysed (7.4%) and 317 PIs for 1391 (22.8%) (p = 0.002). The PI acceptance rate was not significantly different. Concerning types of PI, only ‘untreated indication’ increased significantly after more senior staff were recruited (13.5% vs. 26.5%) (p = 0.006). The number of PIs from reconciliation also increased significantly after senior pharmacists started checking prescriptions (0.96% vs. 8.83% p = 0.018).
Conclusions In our study we show that senior pharmacists improve PIs. When they are in the care unit, near residents and prescribers, activity and reconciliation are increased compared with only one resident pharmacist at bedside. We reorganised the way we worked, specifying the work of each pharmacist, modifying the time spent in care unit and on reconciliation. This has improved patient care and prevented some MEs.
No conflict of interest.
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