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Objective: To determine the perception of patients and practitioners regarding the role of the hospital pharmacist along the care  continuum., Method: This was a multicenter cross-sectional observational analytical study, carried out in two phases between 15 October and 31  December 2020. In the first phase, a literature search was carried out to  identify specific questionnaires that measured the overall satisfaction of  patients in relation to the work of hospital pharmacists. Subsequently, a  specific consensus-based questionnaire was developed, structured into  three areas: care, relationships, and capacity-building and training. The  study included patients treated in the participating centers and served by  patient associations. They had to be older than 18 years, present with a  chronic condition, and be treated with medication for hospital use. In the  second phase, a qualitative study was carried out using focus group  discussions to analyze how hospital pharmacists are perceived and how  they would like to be recognized by patients. Four meetings were held in  different territories of Spain. Previously, the research team agreed on the  questions to be asked, which were grouped into four sections: healthcare,  relational, training and information., Results: A total of 482 surveys were obtained. The percentage of patients  who expressed a positive view of the role of the hospital  pharmacist was 88.0% (n = 424). In the multivariate analysis, the most  positive  opinions about these professionals were expressed by women and by patients who had received previous care in the hospital, those who had  a high opinion of the coordination of these professionals with the rest of  the care team, and those who had received the greatest amount of  emotional support. Integration of the pharmacist with the healthcare team  was found to vary across different hospitals and the hospitals' public image  we seen to be related to the way they were pharmacoeconomically  managed. In the sections related to capacity-building and training and  challenges for the future, respondents emphasized the need to promote  the introduction of new patient monitoring technologies., Conclusions: Patients have a good opinion of the service provided by hospital pharmacists, although many are unaware of the significance of  their role., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Clinical Decision Support Systems (CDSS) are computerized tools designed to help healthcare professionals to make clinical and therapeutic decisions, with the objective of improving patient care. Prescription-targeted CDSS have the highest impact in improving patient safety. Although there are different designs and functionalities, all these systems will combine clinical knowledge and patient information in a smart manner, in order to improve the prescription process. With the emergence of new technologies and advances in smart decision systems, the implementation of said systems can achieve an important improvement in terms of the prescription process and patient safety. The design and implementation of these systems should be performed by a multidisciplinary team of professionals, where Pharmacists will play an important role due to their technical knowledge about medications and the technologies associated to their use. This article aims to provide basic guidelines for the design and adequate implementation, monitoring and follow-up of Clinical Decision Support Systems within the setting of pharmacological prescription., (Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.)

Background The introduction of new technologies in the prescribing process has seen the emergence of new types of medication errors. Objective To determine the prevalence and consequences of technology-induced prescription errors associated with a computerized provider order entry (CPOE) system in hospitalized older patients. Setting Patients 65 years or older admitted to the Departments of Internal Medicine, General Surgery, and Vascular Surgery of a tertiary hospital. Method Prospective observational 6-month study. Technology-induced errors were classified according to various taxonomies. Interrater reliability was measured. Consequences were assessed by interviewing patients and healthcare providers and classified according to their severity. Main outcome measure Prevalence of technology-induced errors. Results A total of 117 patients were included and 107 technology-induced errors were recorded. The prevalence of these errors was 3.65%. Half of the errors were clinical errors (n = 54) and the majority of these were classified as wrong dose, wrong strength, or wrong formulation. Clinical errors were 9 times more likely to be more severe than procedural errors (14.8 vs 1.9%; OR 9.04, 95% CI 1.09-75.07). Most of the errors did not reach the patient. Almost all errors were related to human-machine interactions due to wrong (n = 61) or partial (n = 41) entries. Conclusion Technology-induced errors are common and intrinsic to the implementation of new technologies such as CPOE. The majority of errors appear to be related to human-machine interactions and are of low severity. Prospective trials should be conducted to analyse in detail the way these errors occur and to establish strategies to solve them and increase patient safety. [ABSTRACT FROM AUTHOR]

Rationale, aims, and objectives To evaluate the effect of an electronic medication administration record (eMAR) application on the rate of medication errors in medication administration recording (ME-MAR). Methods A before-and-after, quasiexperimental study was conducted in a university hospital that implemented the eMAR application in March 2014. Data collection was conducted in April 2012 (pre-) and June 2014 (post-) by two pharmacists. The ME-MARs were analysed by the staff involved to identify their cause. The two pharmacists independently classified the ME-MARs. In the case of disagreement, a research team examined the ME-MARs and categorized them by consensus. Three classifications were used: A classic medication error taxonomy and 2 technology-induced error taxonomies. Results The pharmacists analysed 2835 (pre-) and 2621 (post-) medication administration records (MAR), respectively. Overall, the ME-MAR rate decreased from 48.0% (pre-) to 36.9% (post-) ( P < .05). The same types of ME-MAR were observed in both phases except for 'MAR with incomplete information,' which was not observed in the postimplementation phase. In both phases, the most frequent ME-MAR was 'MAR at the wrong time' (MAR before or after medication administration) (31.6% vs 30.2%). The main cause of ME-MARs in both phases was the failure to follow work procedures. The potential future risk of ME-MARs significantly decreased after the eMAR implementation ( P < .05). All ME-MARs were 'use errors' because of human factors. New ME-MARs (1.24%; n = 12) were observed in the postimplementation phase. Conclusion Use of the eMAR application significantly reduces the rate of ME-MAR and their potential risk. The main cause of ME-MAR was the failure to follow work procedures . [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives The aim of this study is to adapt and assess the interrater reliability of a potential future risk matrix for medication errors in medication administration recording (ME-MAR). Methods The study was carried out in a teaching hospital. It was conducted in two phases. In the first phase, a consensus method was used in order to adapt the potential future risk matrix published by the National Patient Safety and Otero et al. to the ME-MAR. The consensus method consisted in a nominal group formed by four pharmacists. In the second phase, a multidisciplinary group of experts in patient safety assessed the reliability of the adapted matrix. Five raters evaluated 100 ME-MAR. Its reliability was evaluated using the kappa statistic. Results In the first phase, two meetings were necessary until consensus was reached to adapt the potential future risk matrix to the ME-MAR. For this purpose, the two following categories were defined: likelihood of ME-MAR's recurrence and most likely consequences of ME-MAR. The definition of each grade of likelihood of recurrence was based on the incidence of ME-MAR from an unpublished study carried out in our hospital. In order to determine the most likely consequences of ME-MAR, a two-dimensional matrix was designed, with severity per type of ME-MAR on one axis and the class of medication on the other. In the second phase, the reliability of the matrix was tested. The overall interrater agreement for the five raters was substantial at 0.68 (Confidence interval 95% 0.60-0.76). Conclusion The adapted matrix of potential future risk to ME-MAR is reliable and can serve as a guide for future studies. [ABSTRACT FROM AUTHOR]