Australian hospital pharmacists stepping up to the Global Patient Safety Challenge
Hospital pharmacists leading education on digital prescribing, improving communication and information-sharing at transitions of care and leading stewardship programs for high-risk medicines have been highlighted as key activities in line with the WHO Global Patient Safety Challenge in the latest issue of the Society of Hospital Pharmacists of Australia (SHPA)’s flagship journal.
In the August 2021 issue of the Journal of Pharmacy Practice and Research (JPPR), focused on initiatives to reduce medication-related harm, Editor-in-Chief Professor Michael Dooley says the impact of hospital pharmacists leading education on digital prescribing is increasingly important.
‘Over one-third of Australian public hospitals now have an inpatient electronic medication record.
‘Evaluated by McCleary et al. a hospital pharmacist-led education intervention was delivered to intern medical officers (IMOs) at orientation, including hands-on experience to prescribe safely within the electronic medication management (EMM) system.
‘Results from 56 IMOs saw reported improvement in self-confidence in all scenarios examined, with the authors concluding appropriately that the program resulted in improved prescribing skills. However some regular activities – such as the prescribing of warfarin, assessing venous thromboembolism risk and the prescribing of insulin – still showed much room for improvement.’
Professor Dooley says hospital pharmacists have great potential to improve communication and information-sharing at all-important transitions of care in hospital outpatient clinics, as indicated by a preliminary scoping study.
‘Snoswell et al. evaluated the activities of pharmacists in a range of ambulatory clinics after the implementation of a major investment in clinical pharmacy services. As expected, the primary role was the taking of medication histories and documentation of adverse drug reactions, along with the documentation of recommendations for dose adjustments and the withholding of medications prior to surgery.
‘More importantly, however, this study challenges others to be as innovative and seek funding and resources for implementation of these roles in ambulatory clinics.’
A third example in the issue details the experience of two innovative stewardship programs now in their fifth year, as Bui et al.* conclude key governance and quality improvement models for existing antimicrobial stewardship (AMS) programs can be successfully applied to anticoagulants and analgesics.
By describing the adaptation of the AMS framework to other therapeutic areas, the authors seek to ‘potentially motivate wider adoption of stewardship principles for high-risk medicines in healthcare settings’, as ‘the national adoption of anticoagulation stewardship (ACS) and analgesic stewardship (AGS) programs would ensure patient safety improvements and optimal clinical outcomes for patients.’
Professor Dooley says these three papers provide examples of innovation and evaluation of approaches to reducing medication-related harm.
‘The challenge is to translate these findings into other hospitals and settings, building on their key elements, as we continue to design and implement improvements in the systems in which we provide care.’
JPPR is available free to SHPA members.