Background and Importance In a multidisciplinary hospital with 426 beds, roles of hospital pharmacist are varied and drug circuit presents many risks of medication error. According to the WHO, the roles of pharmacists are ‘the Seven star Pharmacist’: care giver, decision maker, communicator, leader, manager, lifelong learner and teacher.
Aim and Objectives Objective of this study is to measure effectiveness of actions taken by pharmacists to reduce medication errors: from prescription to administration.
Material and Methods Between 2019 and 2022, a compilation of audits have been made. Various stages of drug circuit were audited using previously validated audit grids. Each audit have been made during 15 days for all new prescriptions. A statistical analysis of proportion comparing the error rate before and after the implementation of improvement actions was carried out. Prescription of all injectable drugs has been formalised, new doctors arriving at the hospital are made aware. Concerning medication reconciliation: in the event of a discrepancy observed, doctor is systematically informed, a pharmacy student has been assigned to the surgery unit. Errors not detected during pharmaceutical validation were presented to all pharmacists. Measures to reduce risk of task interruption were implemented during dispensing (dedicated emergency telephone line, redefining tasks). Concerning administration of medication: training workshop days for nurses have been created by pharmacists.
Results Results showed a statistically significant improvement in certain criteria (statistical analysis of proportion : comparing error rate before and after actions ; alpha = 5%) : medication reconciliation rate increased from 64% in 2019 to 73% in 2021 (64% VS 73%); errors not detected during pharmaceutical validation (2% VS 1%); dispensing error (3% VS 2%); lack of knowledge of the establishment's drug administration procedure (58% in 2019 VS 33% in 2022). On the other hand, certain criteria have deteriorated: prescription compliant in 70% in 2019 and 65% in 2022.
Conclusion and Relevance This study has made it possible to objectify that actions of pharmacists have been beneficial in management of patients. However, we find that actions taken to improve prescription of drugs have not been effective. It would be interesting to set up continuous training for doctors on the use of the prescription software in our establishment.
Conflict of Interest No conflict of interest
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