472 / Clinical pharmacy services

AUSTRIA
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Medication / IV Fluids
There is no specified text here There is no specified text here
Topic of the reported practice
Clinical risk management
Aim and the benefit of the Patient Safety Practice
 
To analyse drug-related problems (DRPs) and describe clinical pharmacists’ interventions in an Austrian tertiary care hospital.
Description of the Patient Safety Practice
 
Method: A prospective 22-week observational descriptive clinical pharmacists’ intervention study on six different wards of an Austrian tertiary care university hospital. In-depth analysis of DRPs, performed interventions and inter-rater and intra-rater variability analysis of interventions’ significance assessment was conducted. Type and frequency of DRPs, clinical pharmacists’ interventions and the physicians’ acceptance rate were recorded. Further outcome parameters were the clinical significance of the interventions and the proportion of those with a cost-reducing potential. Results: A total of 478 DRPs were detected during 138 ward rounds. The most common DRPs related to specific therapy discussions (30.1%), organisational advice (14.2%), medical chart errors (7.7%), untreated indications (7.5%) and drug use without indication (6.9%). Clinical pharmacists provided information (42.9%), suggested the addition of new drugs (13.4%) and the adaptation of drug dosages (12.6%). Antibacterials for systemic use, anti-thrombotics and drugs for acid-related disorders were commonly implicated. The mean acceptance rate of interventions was 54.7%. Three out of four clinical pharmacists’ interventions were rated to be significant. The inter-rater reliability analysis of clinical significance immediately and 2 weeks after study completion showed a fair to moderate agreement (Fleiss’s 0.35, pairwise Spearman correlation coefficients between 0.5 and 0.74, all p<0.0001). One out of 20 interventions showed a cost-reducing potential. Conclusions: The results highlight a positive impact of clinical pharmacy services in a continually developing environment. Although, on average, every second intervention was immediately accepted, the proportion of significant interventions was high. Clinical pharmacy services are one method of addressing evident DRPs in hospitalised patients in Austria. This is a well documented practice, but results for patients were not evaluated.
Attachment of relevant written information and/or photos, as appropriate
565_WP4_ejhpharm-2012-000131.full.pdf
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Unit or ward level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Not relevant
A measurement after full implementation of the reported practice was obtained
Not relevant
Evaluation of a "positive" effect of the reported practice on Patient Safety
Not relevant
Type of before-and after evaluation
There is no specified text here
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
565_WP4_ejhpharm-2012-000131.full.pdf
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Not known
Specification of implementation in another health care setting(s)
Primary care
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Not known
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
No
List of sources where public information is accessible
There is no specified text here
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Involvement of service users did not happen
Lack of knowledge on implementation strategies
Not sufficient human resources available
Specially trained staff not available
Staff or management did not recognise the need for change
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Mag. Dr. Gunar Stemer, aHPh
Country: AUSTRIA
Organisation: Vienna General Hospital - Pharmacy Department
E-mail: gunar.stemer@akhwien.at
Phone: There is no specified text here
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