Transcript
Page 1: Mapping clinical pharmacy practice in Swiss hospitals 2013

sportives (5,2 � 1,6) ont ete juges les plus utiles. Les informa-tions sur les interactions avec l’alcool etaient jugees plusutiles que celles avec les traitements contre l’acne ou la pilulecontraceptive.Conclusion.– Certaines des informations souhaitees par lesparents ou les patients ne figurent pas dans la notice officielledes medicaments. Des fiches explicatives sur les medicamentscontenant les informations particulieres mises en evidencedans cette etude vont etre developpees afin d’ameliorer lacontinuite des soins pharmaceutiques au sortir des urgencespediatriques.http://dx.doi.org/10.1016/j.phclin.2014.04.051

P51Mapping clinical pharmacy practice inSwiss hospitals 2013M. Messerlia,b,*, K. Maesa,b, K.E. Hersbergera,M.L. Lamperta,b

a Pharmaceutical Care Research Group, University of Basel, Switzerlandb Clinical Pharmacy Division, Kantonsspital Baselland, Bruderholz,Switzerland* Corresponding author.

Introduction.– In 2011 the Swiss Society of Public HealthAdministration and Hospital pharmacists (GSASA) approveda national definition for clinical pharmacy. A structured post-graduate education program was approved by Swiss Phar-macy Federation in 2008.Objective.– Our objectives were to map the clinical pharmacyservices (CPS) provided in Swiss hospitals and to discuss thedevelopment focusing on different culture areas and varioushealthcare systems.Methods.– In a cross-sectional study we enrolled all GSASAaffiliated chief hospital pharmacists (n = 47) for a 58-itemonline survey. We asked them to describe in a structuredway the nature and extent of CPS (patient-, therapy-, orprocess-oriented perspectives), structural organisation(extent of ward contact), and available human resources.Results.– The survey took place from 21st March to 25th April2013 and the index day was set on 1st January 2013. The surveywas completed by 44 chief hospital pharmacists (94%) from 6institutions affiliated to a university, 21 general hospitals, 7specialised hospitals and 10 hospital networks. Number ofbeds varied from < 200 to 2000+. Thirty-three hospitals offerregular CPS (75%) and 7 planned it (16%). In 4 institutions(12%), pharmacists worked > 50% of their time on the ward.Twenty-six hospitals mentioned part time activities in contactwith the patient, while 3 institutions declined presence on thewards. In the French part of Switzerland (11 hospitals), 23.2% ofthe pharmacists provided clinical pharmacy activities (19.10 of82.40 fulltime equivalent (FTE)), in the German part (31 hos-pitals), 9.9% (14.50 of 146.15 FTE) and in the Italian part (2hospitals) 27.4% (2.90 of 10.60 FTE). Institution in regions withno drug dispensing by physicians (n = 20) rather employed

pharmacists assigned with clinical activities (22.0% of 135.25FTE) than in regions with partial (n = 8, 6.7% of 35.8 FTE) orunrestricted drug dispensing by physicians (n = 16, 6.3% of68.1 FTE). In 73% of all hospitals with implemented CPS,interdisciplinary ward rounds with pharmacists and physi-cians take place weekly, whereas in 18.2% pharmacists assessmedication histories at admission at least weekly and in 9.1%medicines are reconciled at discharge daily.Discussion–Conclusion.– To our knowledge this is the firstcomprehensive national survey of clinical pharmacy practicein Switzerland. Our data show significant regional differencesin the implementation and pattern of CPS and striking corre-lation to drug dispensing by physicians and other culturaldifferences. While interdisciplinary ward rounds are perfor-med at least periodically, seamless care activities by clinicalpharmacists remain insufficiently established.http://dx.doi.org/10.1016/j.phclin.2014.04.052

P52Pre-analyse pharmaceutique : unnouveau concept de collaborationpreparateurs–pharmaciensH. Do Thi Chalamette*, F. Cabrera, M. Rossignol,M. Lefebvre, C. Niepceron, P. HildService pharmacie, centre hospitalier de Roanne, 28, rue de Charlieu,42328 Roanne, France* Auteur correspondant.

Introduction.– Dans notre etablissement, la prescription infor-matisee a debute en 1989 avec la saisie d’ordonnances cen-tralisee a la pharmacie. Cette organisation a permis auxpreparateurs d’obtenir une expertise sur la « lecture » voirel’analyse d’ordonnances. La generalisation de la prescriptionconnectee dans les services (94 % sur 1315 lits dont 447 lits MCOa fin 2012), en liberant du temps de travail des preparateurs,nous a offert l’opportunite de construire un projet integrant lapre-analyse des ordonnances par les preparateurs.Objectif.– La pre-analyse a pour objectif de fournir une aide ala prescription et de securiser l’administration, avec unemeilleure gestion des armoires. Cette activite doit egalementpermettre de developper le niveau 2 « analyse documentee »de l’analyse pharmaceutique effectuee par les pharmaciens.Methode.– La pre-analyse envisagee correspond au niveau 1« revue de la prescription » et sous-entend egalement uneintervention directe sur la prescription afin de corriger cer-taines erreurs inherentes a la prescription informatisee. Legroupe de travail compose de pharmaciens et preparateursa redige en particulier le tableau recensant les situationsrencontrees, les interventions autorisees et les opinions phar-maceutiques types. Ce tableau a ete valide par les prescrip-teurs concernes. Apres une formation theorique, chaquepreparateur est accompagne par le pharmacien dans l’analyseeffective des prescriptions par service. Cette etape permet aupreparateur d’acquerir les competences definies. Ensuite,

Le Pharmacien Hospitalier et Clinicien 2014;49:204-241

232

Recommended