Snapshot versus continuous documentation of pharmacists’ interventions: are snapshots worthwhile?

Abstract

Background:The documentation of pharmacists' interventions is important but there are limited studies evaluating the different methods of documentation.Aim: To compare the nature of pharmacists' interventions documented during snapshots versus direct observation in a paediatric hospital and to gather pharmacists' opinions on the utility of the different documentation methods. Method:The pattern and rates of pharmacists' interventions from the snapshot reports and direct observation were compared across five study wards. The snapshots represented pharmacists' self-reported interventions over a period of 5 days. The researcher observed and documented pharmacists' interventions for 35-37 non-consecutive days. A focus group discussion was conducted to gather pharmacists' opinions on the documentation methods. Results:A total of 398 interventions were documented by pharmacists during three snapshots with 'clarification of medication orders' being the commonest type of intervention. A total of 982 pharmacists' interventions were documented during direct observation. The overall rate of pharmacists' interventions documented during observation was not significantly different compared to that of the snapshots (p = 0.054). However, the rate of active interventions (i.e. interventions leading to a change in drug therapy) was significantly higher (p = 0.002) during direct observation, and the pattern of interventions was significantly different. From the focus group discussion, participants felt that the snapshot reports were an inadequate representation of pharmacists' clinical activities.Conclusion: Documentation of pharmacists' active interventions during snapshots was not representative of those documented during observation. This suggests that snapshot data may underestimate the impact of pharmacists' interventions in minimising medication misadventure amongst paediatric inpatients.

Analysis of clinical intervention records by pharmacists in an Australian principal referral and specialist women's and newborns' hospital

“…the ward type, time allocation and pharmacist's experience . Furthermore, as discussed earlier, pharmacist interventions are often under‐documented …”

“…Selected studies conducted in Australia and overseas have focused on analysing pharmacists’ intervention records and reported that pharmacists prevented MRPs, including potentially serious prescribing errors . Although these studies highlighted the clinical significance of medication errors and the important role of hospital pharmacists in identifying and preventing medication errors, many of the reports evaluated short‐term data collected over periods of <12 months .…”

Evaluation of the clinical pharmacist services at a gynaecological oncology preadmission clinic

“…Pharmacist interventions are often reported to be under-documented. 11 Furthermore, the number of surveys received from patients is relatively small and does not represent all at PAC. During the evaluation, several PAC appointments were moved to telephone consults due to the COVID-19 pandemic.…”

An evaluation of the utilisation of the Medication Action Plan form in a tertiary hospital: what is the impact of the pharmacist?

“…Irrespective of whether this was due to pharmacists’ time restrictions or whether it is influenced by the nature of the interventions and their clinical significance, relying on evaluating the impact of clinical interventions using the data from iPharmacy ™ alone vastly underestimates the contribution that pharmacists make to optimising patient care. Alternative, less labour intensive ways of collecting and collating data relating to pharmacists’ interventions has been described elsewhere but requires future exploration …”