A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists.

Background: Non-technical skills refer to the social and cognitive factors that may influence efficient and safe job performance. Non-technical skills are an important element of patient safety in a variety of health care disciplines, including surgery, anesthesia and nursing. However, the use of non-technical skills in pharmacy practice has not yet been fully assessed. Objective: To examine attitudes toward, and use of, non-technical skills by pharmacy personnel. Methods: A mixed methods approach was used: An attitude survey explored pharmacy personnel attitudes towards non-technical skills and inter-professional collaboration, with community and hospital pharmacy staff (. n = 62). Qualitative interviews were then conducted using the critical incident technique, with community pharmacists (. n = 11). Results: The survey results demonstrated differences in the opinions of community and hospital pharmacists on three non-technical skill constructs: team structure, mutual support, and situation monitoring, with community pharmacists reporting significantly more positive attitudes about all three constructs. Both groups reported low levels of collaboration with primary care physicians. The interviews identified five non-technical skills as key elements of successful pharmacist performance from the interview transcripts: teamwork; leadership; task management; situation awareness; decision-making. Conclusion: The survey and interviews identified the non-technical skills that are important to pharmacists. This represents the first step towards the development of a behavioral rating system for training purposes that could potentially improve the non-technical skills of pharmacists and enhance patient safety

Self-reported clinical pharmacy service provision in Austria: an analysis of both the community and hospital pharmacy sector: a national study.

Background: With expansion of more advanced clinical roles for pharmacists we need to be mindful that the extent to which clinical pharmacy services (CPS) are implemented varies from one country to another. To date no comprehensive assessment of number and types of CPS provided by either community or hospital pharmacies in Austria exists. Objective: To analyse and describe the number and types of CPS provided in both community and hospital pharmacies, as well as the level of clinical pharmacy education of pharmacists across Austria. Setting: Austrian community and hospital pharmacies. Method: An electronic questionnaire to determine number and types of CPS provided was issued to all chief pharmacists at all community (n=1365) and hospital pharmacies (n=40) across Austria. Besides current and future CPS provision, education and training provision were determined. Main outcome measure: Extent of and attitude towards CPS in Austria. Results: Response rates to the surveys were 19.1% (n=261/1365) in community and 92.5% (n=37/40) in hospital pharmacies. 59.0% and 89.2% of community and hospital pharmacies, respectively, indicated that CPS provision has increased substantially in the past 10 years. 51.0% of community pharmacies reported to provide a medication review service, while 97.3% of hospitals provide a range of CPS. Only 18.0% of community pharmacies offer services other than medication review services at dispensing. Binary regressions show that provision of already established medication management is a predictor for the willingness of community pharmacists to extend the range of CPS (p [less than] 0.01), while completed training in the area of clinical pharmacy is not (p [greater than] 0.05). More hospital than community pharmacists have postgraduate education in clinical pharmacy (17.4% vs 6.5%). A desire to complete postgraduate education was shown by 28.3% of community and 14.7% of hospital pharmacists. Lack of time, inadequate remuneration, lack of resources and poor relationship between pharmacists and physicians were highlighted as barriers. Conclusion: Both community and hospital pharmacists show strong willingness to expand their CPS provision and will need continued support, such as improved legislative structures, more supportive resources and practice focused training opportunities, to further these services

A qualitative study of determinants of patient behaviour leading to an infection related hospital admission.

Objective: To describe and understand the determinants of patients' behaviours surrounding admission to hospital for an acute infective episode. Method: Patients admitted to the infection or acute medicine admission units of a major Scottish teaching hospital and commenced on antibiotic therapy after admission were included. Semi-structured face-to-face interviews were conducted using a pre-piloted interview schedule guide that focused on gathering information about patient behaviours and experiences prior to admission to hospital with an acute infection. Interviews were audio-recorded, transcribed verbatim and analysed using the Framework Approach. Emerging themes were matched to the Theoretical Domains Framework of behavioural determinants. Results: Twenty-one patients consented to participate and 18 transcripts were suitable for analysis. The most common infections were those of the skin, soft tissue and respiratory tract. From the patients' perspectives, behavioural determinants that appeared to impact their admission to hospital were principally their knowledge, beliefs of consequences, the environmental context and resources (mainly out-of-hours services), social influences and their own emotions. Determinants such as knowledge of the signs and symptoms, beliefs of consequences and environmental context were facilitators of health seeking behaviours. The main barriers were a lack of awareness of consequences of infection potentially leading to delayed admission impacting infection severity, stay in secondary care and resource utilisation. Conclusions: This study has shown that any initial patient-centred intervention that is proposed to change patient behaviour needs to be based on behavioural determinants emerging in this research. The intervention may include aspects such as patient education on resources available out-of-hours and ways to access the healthcare system, education on recognising signs of infection leading to prompter treatment and positive reinforcement for patients who present with recurrences of infection

Track D Social Science, Human Rights and Political Science

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138414/1/jia218442.pd