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01-12-2020 | Original Article

Impact of a Unit-Based Clinical Pharmacist on Communication of Medication Information in an Orthopedic Hospital

Authors: Kelly Guerin, PharmD, BCPS, Patricia Quinlan, PhD, MPA, RN, CPHQ, Robert Wessolock, PharmD, MS, RPH, Stephanie Goldberg, MSN, RN, NEA- BC, Joseph T. Nguyen, MPH, Patricia W. Stone, PhD, RN, FAAN

Published in: HSS Journal ® | Special Issue 2/2020

Abstract

Background

Medication management, a complex yet essential part of patient care, requires that clinicians and patients understand indication, dosage, frequency, and adverse effects in order to maximize benefits and minimize errors, as well as to transition patients from hospital to home. Clinical pharmacists improve care transitions and safety by interacting with patients, prescribers, and nurses on medication management and self-care. However, little is known on the use of clinical pharmacists on interdisciplinary teams at the unit level within orthopedics.

Questions/Purposes

This study sought to measure the impact of unit-based clinical pharmacists on patient perceptions of communication specific to medication during hospitalization at an orthopedic specialty hospital and on the frequency of medication errors.

Methods

A retrospective, quasi-experimental, two-group evaluative design with nonequivalent controls was used. Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data on six inpatient units was analyzed 6 months before and 6 months after assignment of clinical pharmacists to half these units. Data specific to questions that measure quality of communication as well as medication understanding were analyzed. Additionally, data on medication error frequency were collected and compared between units with and without clinical pharmacists.

Results

A total of 2022 surveys were analyzed. The percentage of patients who reported receipt of medication information and medication understanding increased significantly after the implementation of unit-based clinical pharmacists. Comparison of intervention and non-intervention groups showed no statistically significant difference in the frequency of medication errors.

Conclusion

Results suggest that a clinical pharmacist assigned to an inpatient unit in orthopedics significantly influences patient perceptions of communication about and understanding of their medications.

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Boulding W, Glickman SW, Manary MP, Schulman KA, Staelin R. Relationship between patient satisfaction with inpatient care and hospital readmission within 30 days. Am J Manag Care. 2011;17(1):41–48.

Brantley AF, Rossi DM, Barnes-Warren S, Francisco JC, Schatten I, Dave V.Bridging gaps in care: implementation of a pharmacist-led transitions-of-care program. Am J Health Syst Pharm. 75(5 Supplement 1):S1–S5. https://doi.org/10.2146/ajhp160652.

Kaboli PJ1, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166(9):955–964.

Kennedy JM, van Rij AM, Spears GF, Pettigrew RA, Tucker IG. Polypharmacy in a general surgical unit and consequences of drug withdrawal. Br J Clin Pharmacol. 2000;49:353–362.CrossRef

Kripalani S, Roumie CL, Dalal AK, et al. Effect of a pharmacist intervention on clinically important medication errors after hospital discharge: a randomized trial. Ann Intern Med. 2012;157(1):1–10:https://doi.org/10.7326/0003-4819-157-1-201207030-00003

Leape LL, Cullen DJ, Clapp MD, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999; 282(3):267–270.

Levine RE, Fowler FJ Jr, Brown JA. Role of cognitive testing in the development of the CAHPS Hospital Survey. Health Serv Res. 2005;40(6 Pt 2):2037–2056:https://doi.org/10.1111/j.1475-6773.2005.00472.x

National Coordinating Council for Medication Error Reporting and Prevention. Types of medication errors. February 20, 2001. Available from http://www.nccmerp.org/types-medication-errors

Phatak, A, Prusi R, Ward B, et al. Impact of pharmacist involvement in the transitional care of high-risk patients through medication education, and post discharge call-backs (IPITCH study). J Hosp Med. 2016;11(1):39–44.

10.

Reichard, JS, Savage, S, Eckel SE. Pharmacy-initiated transition of care services: an opportunity to impact patient satisfaction. Hosp Pharm. 2015;50 (10):911-917:https://doi.org/10.1310/hpj5010-911

11.

Renaudin P, Coste A, Audurier Y, et al. Clinical, economic and organizational impact of the clinical pharmacist in an orthopedic and trauma surgery department. J Patient Saf. 2018: 1–7. doi: https://doi.org/10.1097/PTS.0000000000000539

12.

Schnipper JL, Kirwin JL, Cotugno MC, et al. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006;166(5):565–571. doi: https://doi.org/10.1001/archinte.166.5.565CrossRefPubMed

13.

Smythe MA, Shah PP, Spiteri TL, Lucarotti RL, Begle RL. Pharmaceutical care in medical progressive care patients. Ann Pharmacother. 1998;32(3):294–299.CrossRef

14.

Tran T, Taylor SE, Hardidge A, Mitri E, George J, Elliott RA. The prevalence and nature of medication errors and adverse events related to preadmission medications when patients are admitted to an orthopedic inpatient unit: an observational study. Ann Pharmacother. 2019;53(3):252–260. https://doi.org/10.1177/1060028018802472

15.

Weiner BK, Venarske J, Yu M, Mathis K. Towards the reduction of medication errors in orthopedics and spinal surgery: outcomes using a pharmacist-led approach. Spine (Phila Pa 1976). 2008;33:104–107. https://doi.org/10.1097/BRS.0b013e31815e3a5d.

16.

Ziaeian B, Araujo KL, Van Ness PH, Horwitz LI. Medication reconciliation accuracy and patient understanding of intended medication changes on hospital discharge. J Gen Intern Med. 2012;27(11):1513–1520. doi:https://doi.org/10.1007/s11606-012-2168-4

Title: Impact of a Unit-Based Clinical Pharmacist on Communication of Medication Information in an Orthopedic Hospital
Authors: Kelly Guerin, PharmD, BCPS
Patricia Quinlan, PhD, MPA, RN, CPHQ
Robert Wessolock, PharmD, MS, RPH
Stephanie Goldberg, MSN, RN, NEA- BC
Joseph T. Nguyen, MPH
Patricia W. Stone, PhD, RN, FAAN
Publication date: 01-12-2020
Publisher: Springer US
Published in: HSS Journal ® / Issue Special Issue 2/2020
Print ISSN: 1556-3316
Electronic ISSN: 1556-3324
DOI: https://doi.org/10.1007/s11420-019-09739-2

At a glance: The STEP trials

Springer Medicine

Impact of a Unit-Based Clinical Pharmacist on Communication of Medication Information in an Orthopedic Hospital

Abstract

Background

Questions/Purposes

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Questions/Purposes

Methods

Results

Conclusion

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