Drug related problems and pharmacist interventions in a geriatric unit employing electronic prescribing

Background Computerised physician order entry (CPOE) and the integration of a pharmacist in clinical wards have been shown to prevent drug related problems (DRPs). Objectives The primary objective was to make an inventory of the DRPs and resident pharmacist on-ward interventions (PIs) identified in a geriatric acute care unit using CPOE system. The secondary objective was to evaluate the physicians\u27 acceptance of the proposed interventions. Setting A 26-bed geriatric ward of a 1,300-bed teaching hospital. Method A 6-month descriptive study with prescription analysis and recommendations to physicians by a resident pharmacist during five half days a week. Main outcome measures Patients\u27 characteristics, number of prescribed drugs per patient, nature and frequency of DRPs and PIs, physicians\u27 acceptance and drugs questioned. Results Resident pharmacist reviewed 311 patients and identified 241 DRPs. One hundred and fifty-two patients (49 %) had at least one DRP (mean +/- A SD age 87 +/- A 6 years, mean +/- A SD number of prescribed drugs 10.7 +/- A 3.4). Most frequent DRPs were: untreated indication (n = 58, 24.1 %), dose too high (n = 46, 19.1 %), improper administration (n = 31, 12.9 %) and drug interactions (n = 23, 9.5 %). The rate of physicians\u27 acceptance was 90.0 % (7.5 % refusals, 2.5 % not assessable). DRPs related to CPOE system misuse (n = 35, 14.5 %) appeared as a worrying phenomenon (e.g., errors in selecting dosage or unit, or duplication of therapy). Conclusion A resident pharmacist detected various DRPs. Most PIs were accepted. DRPs related to the misuse of the CPOE system appeared potentially dangerous and need particular attention by healthcare professionals. The description of the DRPs is an essential step for implementation of targeted clinical pharmacy services in order to optimize pharmacists\u27 job time

Understanding Breastfeeding Women's Behaviors Toward Medication: Healthcare Professionals' Viewpoint

BACKGROUND:: Taking medication during breastfeeding is often a major concern for mothers. Knowledge, representations, and attitudes condition a mother\u27s behavior in this situation. Healthcare professionals, whose medication advice for breastfeeding women is often described in scientific literature as inappropriate, play a major role in counseling mothers. Healthcare professionals\u27 perceptions of mothers\u27 behaviors regarding medication use during breastfeeding may influence mothers\u27 behaviors. RESEARCH AIM:: The aim of this study was to identify healthcare professionals\u27 perceptions of breastfeeding women\u27s knowledge, representations, and attitudes and behaviors about medication use. METHOD:: A cross-sectional, prospective qualitative design was used. Semistructured interviews were conducted with a broad array of healthcare professionals ( N = 20) in different practice settings in the Angers area (France). Thematic analysis of the interview transcripts was carried out using the planned behavior theory of Ajzen. RESULTS:: Seventy themes concerning medication use while breastfeeding were identified and then combined into 8 categories. Healthcare professionals perceived that maternal behaviors regarding medication were mostly focused on the child\u27s safety and were linked to poor knowledge and negative representations, attitudes, and feelings toward medication. Healthcare professionals also perceived significant negative influences from the mother\u27s friends and family in regard to breastfeeding. Relationships between healthcare professionals and women were problematic when it came to drug use during breastfeeding. CONCLUSION:: Taking into account healthcare professionals\u27 perceptions of maternal behavior will help improve education for these professionals. Indeed, knowing precisely what difficulties are met by healthcare professionals when they encounter medication use during breastfeeding can help educators improve training for these professionals

Jamais la première fois sur le patient ! Quand la simulation en santé s'invite dans une formation en éducation thérapeutique

International audienc

Jamais la première fois sur le patient ! Quand la simulation en santé s'invite dans une formation en éducation thérapeutique

International audienc