Medication errors are becoming problematic in both hospital and outpatient settings worldwide. Inappropriate use of medication can cause harm to the patient and maintaining high levels of quality patient care is essential to protect all patients. Clinical pharmacy practice contributes to improved patient care by optimising medication therapy; and promoting health, wellness and disease prevention. The involvement of a pharmacist at a ward level has been shown to improve patient care; reduce mortality and morbidity rates; decrease healthcare costs; minimise medication errors; and improve outcomes of drug therapy. However, clinical pharmacy is a fairly new practice in South Africa and there are limited studies available. This study aimed to evaluate the perceived benefits of a ward-based pharmacist on the provision of pharmaceutical care to patients in a hospital setting and to consequently implement a ward-based pharmacy service. The objectives of the study were: (1) to assess, via a questionnaire, the perceptions and attitudes of medical practitioners and nurses to ward-based pharmacy prior to and after implementation of a ward-based pharmacy service, (2) to implement a ward-based pharmacy service in a selected hospital ward; (3) to document and analyse the nature of the work and activities that a ward pharmacist undertakes, and (4) to document and analyse the frequency and nature of ward pharmacist interventions. The study was conducted in a surgical ward of a private hospital in the Eastern Cape. The study design was an intervention study, using a mixed-methods design, with a convergent approach. A convenience sample of 106 patients was obtained over the eight week study period. Participation was voluntary and confidentiality was maintained at all times. Four data collection tools were used during the study and a pilot study was conducted to ensure their validity and reliability. The quantitative data was analysed statistically while the qualitative questions were analysed through coding the various responses. The results of the study showed that medical practitioners and nurses of a surgical ward had a positive attitude towards ward pharmacy both prior to and after the implementation of a ward pharmacy service. There were ward pharmacist interventions made in 50% (n=106) of the patients who participated in the study. A large percentage (57%; 50; n=87) of the ward pharmacist interventions were pharmacist-initiated interventions to optimise patient care while prescribing errors (51%; 19; n=37) were the most commonly occurring medication error. The majority of the medication items involved in the interventions (34%; 34; n=101) were related to the anti-microbial medication class. Overall, there was a 73% (36; n=49) acceptance rate of the ward pharmacist interventions that were made to both the medical practitioners and nurses. There were a number of factors that had a significant relationship with a ward pharmacist intervention being required which included: (1) number of medication items (p=0.001; Chi² test; p<0.0005 Student’s t-test), (2) length of hospital stay (p<0.0005; Chi² test), (3) presence of one or more chronic disease states (p=0.003; Chi² test) and (4) presence of one or more allergies (p=0.028; Chi² test). The ward pharmacist interventions were shown to be of clinical significance and to have a positive impact on the patients concerned. It can be concluded that the ward pharmacy service was beneficial to the patients, medical practitioners and nursing staff.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nmmu/vital:21012 |
| Date | January 2015 |
| Creators | Stone, Leanne Nicole, Burton, S F |
| Publisher | Nelson Mandela Metropolitan University, Faculty of Health Sciences |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis, Masters, MPharm |
| Format | xi, 179 leaves, pdf |
| Rights | Nelson Mandela Metropolitan University |
Page generated in 0.0022 seconds