Assessing the Impact of a Clinical Pharmacist in a Postsurgical Inpatient Population

Abstract

Objective: To quantify the number and type of clinical pharmacist interventions with an impact on patient care in a postsurgical nonintensive care patient population. Background: Studies have shown that pharmacists are able to improve the quality of patient care; however, the pharmacist role in postsurgical nonintensive care areas is not well defined. Methods: A clinical pharmacist provided care for 2 postsurgical floors for 2 weeks and collected information about the number and type of interventions made and adverse events avoided. In addition, the study team conducted an anonymous survey amongst the multidisciplinary team who collaborated with the pharmacist at the end of the trial period to understand the perception of having access to a clinical pharmacist who was designated to their floor. Results: In a 2-week time period, the clinical pharmacist was able to make 218 interventions, including 38 recommendations for optimization of antimicrobials, 26 recommendations for anticoagulation optimization, and providing education for 20 patients planned for discharge on high-risk medications. Interventions made by the clinical pharmacist helped decrease adverse events, improve patient safety and knowledge, and potentially avoid readmissions and reduce hospital length of stay. The survey results revealed that 100% strongly agreed that a clinical pharmacist should be a member of the multidisciplinary team for the postsurgical floors. Conclusion: This data signifies that having a clinical pharmacist dedicated to the postsurgical patient population allows for optimization of antimicrobial and anticoagulant use, improves outcomes for patients through medication education, and enhances provider satisfaction.

Perceptions and expectations of health professionals regarding hospital pharmacy services and the roles of hospital pharmacists: A qualitative systematic review and meta-synthesis

“… Emergency department Doctors/physicians: 4 Nurses: 4 8 Interviews Thematic analysis Minor concern Salgado et al 2013 45 Australia and Portugal To explore the opinions of Australian and Portuguese nephrologists toward the current and future provision of clinical pharmacy services in outpatient dialysis centres Outpatient dialysis Doctors/physicians: 21 21 (14 Portuguese and 7 Australian) Interviews Thematic analysis Minor concern Salgado et al 2014 46 Australia and Portugal To explore the differences in the views of Australian and Portuguese renal nurses on the provision of clinical pharmacy services in outpatient dialysis centres Outpatient dialysis Nurses: 18 18 (13 Portuguese and 5 Australian) Interviews Thematic analysis Minor concern Sjölander, Gustafsson and Gallego 2017 47 Sweden To explore doctors' and nurses'perceptions and expectations of having a ward-based pharmacist providing clinical pharmacy services in a rural hospital in northern Sweden. Medical Doctors/physicians: 9 Nurses: 9 18 Interviews Thematic analysis No or very minor concern Tavakoli et al 2022 48 Unknown To identify evidence-based clinical pharmacy services with an impact on patient care in the postsurgical inpatient population. Surgical Doctors/physicians: 5 Nurses: 2 Physician assistants: 2 9 (total = 12) Surveys Mixed-methods Moderate concern Tegegn et al 2018 49 Ethiopia To explore the challenges and opportunities of clinical pharmacy services offered in University of Gondar hospital through health practitioners' perspectives Various Doctors/physician: 5 Nurses: 5 10 (total = 15) Interviews Thematic analysis No or very minor concern Tran et al 2019 50 Australia To evaluate the effect of an integrated pharmacy service provi...…”

“… Australia 20 , 40 , 45 , 46 , 50 Canada 53 Indonesia 6 Ireland 44 South Korea 39 USA 5 Malta 21 Portugal 45 Unknown 48 Medication reviews and/or prescribing feedback Activities that involved reviewing the medications prescribed during admission, aimed at identifying any potential medication-related problems and promoting the quality use of medicines. Australia 26 , 45 , 50 Canada 27 Ethiopia 43 , 49 Indonesia 6 Ireland 44 Malta 21 Mexico 29 Pakistan 23 , 37 Qatar 35 Sweden 31 , 33 , 52 Switzerland 25 UK 41 USA 5 , 28 , 34 , 42 Unknown 24 , 48 Proactive roles in medication-related therapy decisions Collaborative activities or discussions between pharmacists and other members of the multidisciplinary team that occurred before prescribing any medications or making therapeutic decisions. Australia 20 , 38 , 45 , …”

“… Australia 26 , 45 , 50 Canada 27 Ethiopia 43 , 49 Indonesia 6 Ireland 44 Malta 21 Mexico 29 Pakistan 23 , 37 Qatar 35 Sweden 31 , 33 , 52 Switzerland 25 UK 41 USA 5 , 28 , 34 , 42 Unknown 24 , 48 Proactive roles in medication-related therapy decisions Collaborative activities or discussions between pharmacists and other members of the multidisciplinary team that occurred before prescribing any medications or making therapeutic decisions. Australia 20 , 38 , 45 , 50 , 51 Ethiopia 49 India 32 Indonesia 6 Malaysia 19 Malta 21 Pakistan 22 South Korea 39 Qatar 35 Sweden 31 , 33 Switzerland 25 USA 28 , 34 , 42 Unknown 48 Drug information and...…”

“… Australia 20 , 38 , 45 , 50 , 51 Ethiopia 49 India 32 Indonesia 6 Malaysia 19 Malta 21 Pakistan 22 South Korea 39 Qatar 35 Sweden 31 , 33 Switzerland 25 USA 28 , 34 , 42 Unknown 48 Drug information and education for other health professionals Activities that were designed to assist health professionals in obtaining information regarding medications in general or to aid in prescribing e.g., continuing education sessions. Australia 20 , 38 , 45 , 46 Brazil 30 Canada 27 Ethiopia 49 France 36 India 32 Indonesia 6 Malaysia 19 Malta 21 Mexico 29 Pakistan 23 , 37 Portugal 45 , 46 South Korea 39 Qatar 35 Sweden 31 , 33 Switzerland 25 UK 41 USA 28 , ...…”

“… Communication at discharges and transitions of care: activities that facilitated efficient hospital discharges and transitions by involving communication with community caregivers and health professionals. Australia 40 , 45 , 46 Brazil 30 Canada 27 Ethiopia 49 Indonesia 6 Malaysia 19 Malta 21 Pakistan 23 , 37 Sweden 31 , 33 , 47 USA 5 , 34 Unknown 48 Independent prescribing and diagnosis Activities that involved prescribing directly by pharmacists with no or little involvement by other health professionals. Australia 45 , 51 Canada 27 Ethiopia 49 Indonesia 6 Pakistan 22 Research and medication governance Research: activities that involved research and the dissemination of findings to wider communities.…”