Implications of involving pharmacy technicians in obtaining a best possible medication history from the perspectives of pharmaceutical, medical and nursing staff: a qualitative study

Abstract

ObjectivesIn recent years, the involvement of pharmacy technicians in medication reconciliation has increasingly been investigated. The aim of this study was to assess the implications on professional roles and collaboration when a best possible medication history (BPMH) at admission is obtained by pharmacy technicians.DesignQualitative study with semistructured interviews. Data were analysed using a qualitative content analysis approach.SettingInternal medicine units in two mid-sized Swiss hospitals.Participants21 staff members working at the two sites (6 pharmacy technicians, 2 pharmacists, 6 nurses, 5 physician residents and 2 senior physicians).ResultsPharmacy technicians generally appreciated their new tasks in obtaining a BPMH. However, they also experienced challenges associated with their new role. Interviewees reported unease with direct patient interaction and challenges with integrating the new BPMH tasks into their regular daily duties. We found that pharmacists played a key role in the BPMH process, since they act as coaches for pharmacy technicians, transmit information to the physicians and reconcile preadmission medication lists with admission orders. Physicians stated that they benefitted from the delegation of administrative tasks to pharmacy technicians. Regarding the interprofessional collaboration, we found that pharmacy technicians in the study acted on a preliminary administrative level and did not become part of the larger treatment team. There was no direct interaction between pharmacy technicians and physicians, but rather, the supervising pharmacists acted as intermediaries.ConclusionThe tasks assumed by pharmacy technicians need to be clearly defined and fully integrated into existing processes. Engaging pharmacy technicians may generate new patient safety risks and inefficiencies due to process fragmentation. Communication and information flow at the interfaces between professional groups therefore need to be well organised. More research is needed to understand if and under which circumstances such a model can be efficient and contribute to improving medication safety.

PRN Medicines Optimization and Nurse Education

“…While the prescription and administration of PRN medications is the result of close nurse–patient collaboration and decision-making, the participation of other healthcare professionals involved in the medication process, such as physicians and pharmacists, is required for making the best decisions on the selection of PRN medications. Therefore, nursing students should receive training on accessing communication tools and contributing proactively to the decision-making process alongside other healthcare providers [ 105 , 106 , 107 ]. They should be educated to value the skills and responsibilities of other team members and respect their unique contributions in making decisions on medication safety [ 108 ].…”