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Results from Part I of ISMP Survey on Pharmacy Interventions


From the June 26, 2002 issue

Factors that facilitate the pharmacist's ability to perform interventions

1 = NOT Present in facility 5 = Present in facility

All Responses   N=608
Percentage of Respondents

Factors                                  

1

2

3

4

5

a) Easy access to patient information

2

3

13

25

55

b) Easy access to drug information

1

2

7

18

70

c)  Proper technological support

9

14

22

26

27

d)  Sufficient clinical skill

1

5

23

40

30

e)  Adequate staffing levels

8

17

28

29

16

f)  Positive staff motivation

3

9

22

35

31

g) Availability of drug appropriateness criteria

3

11

28

37

20

h) Leadership commitment, facilitative organizational culture

4

7

19

36

32

i) Efficient process to document interventions

11

12

23

25

27

Hospitals with (W) Pharmacy Residency Programs                 N=119;                   Hospitals without (WO) N=489   Percentage of Respondents

Factors

1

2

3

4

5

 

W WO W WO W WO W WO W WO

a) Easy access to patient information

3

2

4

3

12

14

24

25

57

55

b) Easy access to drug information

1

1

1

3

3

8

21

18

74

69

c)  Proper technological support

8

9

10

15

24

21

31

25

25

28

d) Sufficient clinical skill

1

1

4

5

15

25

39

40

40

28

e) Adequate staffing levels

8

8

20

17

24

29

32

28

15

16

f) Positive staff motivation

3

3

10

8

29

20

33

35

25

32

g) Availability of drug appropriateness criteria

3

3

3

13

27

29

39

36

28

18

h) Leadership commitment, facilitative organizational culture

5

4

8

7

17

20

34

36

35

32

i) Efficient process to document interventions

14

10

11

13

20

24

25

25

29

27

 

Hospitals with (W) Physician Residency Programs                 N=236;                   Hospitals without (WO) N=372   Percentage of Respondents

Factors

1

2

3

4

5

 

W WO W WO W WO W WO W WO

a) Easy access to patient information

3

2

3

4

13

13

26

24

56

55

b) Easy access to drug information

1

1

1

3

5

8

17

20

76

66

c)  Proper technological support

9

8

14

14

23

21

24

27

28

27

d) Sufficient clinical skill

2

0

6

5

24

23

40

40

29

31

e) Adequate staffing levels

8

8

18

17

28

28

31

28

14

17

f) Positive staff motivation

3

3

9

8

26

19

35

34

27

33

g) Availability of drug appropriateness criteria

3

3

8

12

25

31

44

32

19

20

h) Leadership commitment, facilitative organizational culture

4

4

9

6

18

20

36

35

32

33

i) Efficient process to document interventions

14

9

9

15

21

24

28

23

28

26

 

Hospital Type   General Hospital (G) N=461; Specialty Hospital (S) N=68                                                       Percentage of Respondents

Factors

1

2

3

4

5

 

G S G S G S G S G S

a) Easy access to patient information

2

1

2

7

13

15

26

19

57

57

b) Easy access to drug information

1

0

2

1

7

13

20

15

70

71

c)  Proper technological support

9

10

15

16

22

25

27

21

26

28

d) Sufficient clinical skill

1

0

6

4

24

26

44

31

26

38

e) Adequate staffing levels

8

6

17

19

30

22

30

25

14

26

f) Positive staff motivation

3

1

9

7

23

24

37

22

28

46

g) Availability of drug appropriateness criteria

2

1

12

12

31

19

37

40

17

28

h) Leadership commitment, facilitative organizational culture

4

3

7

10

19

19

38

31

31

37

i) Efficient process to document interventions

10

10

12

7

25

25

25

29

27

28

Effectiveness of factors related to pharmacist's ability to perform interventions

Factors that facilitate the pharmacist's ability to perform interventions

1 = NOT Present in facility        5 = Present in facility

Bed Size  Hospitals under 100 beds (A) N =166; Hospitals 100-299 beds (B) N=223;  Hospitals 300-499 beds (C) N=99; Hospitals over 500 beds (D) N=77

Percentage of Respondents

Factors

1

2

3

4

5

 

A

B

C

D

A

B

C

D

A

B

C

D

A

B

C

D

A

B

C

D

a) easy access to patient information

2

0

2

5

4

3

3

1

12

12

14

21

28

25

20

25

54

60

60

48

b) easy access to drug information

2

0

1

0

1

3

1

4

4

11

5

6

19

20

15

18

74

66

77

71

c) proper technological support

10

9

9

8

18

13

12

17

15

26

26

22

27

25

26

27

30

27

25

26

d) sufficient clinical skill

0

0

0

5

2

8

4

5

23

23

21

26

43

41

49

34

31

28

24

30

e) adequate staffing levels

7

7

9

12

14

19

15

17

28

32

19

31

25

28

42

29

23

13

12

12

f) positive staff motivation

1

3

9

5

5

9

15

13

22

23

19

23

30

35

42

35

41

30

12

23

g)availability of drug appropriateness criteria

4

2

3

3

14

13

8

6

30

28

29

25

30

39

44

44

22

18

14

22

h)leadership commitment, facilitative organizational culture

2

4

3

6

6

9

7

6

23

22

12

13

36

31

41

45

31

34

33

29

i) efficient process to document interventions

14

7

7

18

13

11

10

13

28

24

26

12

20

26

29

27

23

32

25

29

Part II - Types of Pharmacy Intervention Services Provided by Hospitals


From the July 10, 2002 issue

All Responses N=608 Percentage of Respondents

Intervention Categories Not Performed Routine Activities Targeted Activities
a) antimicrobial therapy

16

50

31

b) anticoagulation therapy

40

30

28

c) narcotics/pain management

42

30

26

d) drug dose verification

4

86

9

e)appropriateness of drug selection

15

66

15

f) renal dosing

15

53

30

g) monitor special populations (pediatrics, oncology, elderly)

20

48

29

h) detect patient allergies related to prescribed therapy

2

87

9

i) verify order completeness

2

89

7

j) identify dangerous abbreviations, dose expressions

13

69

16

 

Hospitals with (W) Pharmacy Residency Programs N=119; Hospitals without (WO) N= 489 Percentage of Respondents

Intervention Categories

Not Performed

Routine Activities

Targeted Activities

W WO W WO W WO

a) antimicrobial therapy

12

17

41

53

45

28

b) anticoagulation therapy

20

45

34

29

45

24

c) narcotics/pain management

28

46

31

30

40

22

d) drug dose verification

1

4

83

86

15

7

e)appropriateness of drug selection

8

17

69

66

22

14

f) renal dosing

13

15

44

55

42

27

g) monitor special populations (pediatrics, oncology, elderly)

12

22

45

49

43

25

h) detect patient allergies related to prescribed therapy

2

3

86

87

13

8

i) verify order completeness

3

1

86

90

10

6

j) identify dangerous abbreviations, dose expressions

12

13

73

68

15

16

 

Hospitals with (W) Physician Residency Programs N=236; Hospitals without (WO) N=372 Percentage of Respondents

Intervention Categories

Not Performed

Routine Activities

Targeted Activities

W WO W WO W WO

a) antimicrobial therapy

15

17

44

54

40

26

b) anticoagulation therapy

33

44

30

30

36

23

c) narcotics/pain management

43

42

31

29

25

26

d) drug dose verification

3

4

87

85

9

8

e)appropriateness of drug selection

12

17

71

64

15

16

f) renal dosing

14

15

51

54

35

27

g) monitor special populations (pediatrics, oncology, elderly)

17

23

48

48

34

25

h) detect patient allergies related to prescribed therapy

3

2

87

86

10

9

i) verify order completeness

1

2

90

88

8

6

j) identify dangerous abbreviations, dose expressions

11

15

74

66

15

17

 

Hospital Type General Hospital (G) N=461; Specialty Hospital (S) N=68 Percentage of Respondents

Intervention Categories

Not Performed

Routine Activities

Targeted Activities

G S G S G S

a) antimicrobial therapy

12

21

52

50

35

26

b) anticoagulation therapy

39

41

30

34

30

21

c) narcotics/pain management

44

40

28

34

26

24

d) drug dose verification

3

4

88

81

8

12

e)appropriateness of drug selection

15

16

67

71

16

12

f) renal dosing

8

25

57

49

34

24

g) monitor special populations (pediatrics, oncology, elderly)

19

16

48

62

31

21

h) detect patient allergies related to prescribed therapy

2

0

88

88

9

10

i) verify order completeness

2

0

91

87

7

10

j) identify dangerous abbreviations, dose expressions

13

6

68

81

18

12

 

 

Bed Size Up to 299 Beds Percentage of Respondents

Intervention Categories

Not Performed

Routine Activities

Targeted Activities

<100 100-299 <100 100-299 <100 100-299

a) antimicrobial therapy

20

12

58

50

22

36

b) anticoagulation therapy

49

43

28

28

22

28

c) narcotics/pain management

40

47

34

26

25

25

d) drug dose verification

6

2

85

88

8

8

e)appropriateness of drug selection

17

16

67

67

13

16

f) renal dosing

19

11

58

55

22

33

g) monitor special populations (pediatrics, oncology, elderly)

25

17

54

51

20

30

h) detect patient allergies related to prescribed therapy

1

3

92

88

7

9

i) verify order completeness

1

2

94

89

4

8

j) identify dangerous abbreviations, dose expressions

14

13

70

72

15

15

 

 

Bed Size 300 to >500 beds Percentage of Respondents

Intervention Categories

Not Performed

Routine Activities

Targeted Activities

300-499 >=500 300-499 >=500 300-499 >=500

a) antimicrobial therapy

10

17

46

47

40

36

b) anticoagulation therapy

30

26

36

32

31

42

c) narcotics/pain management

30

38

46

39

17

23

d) drug dose verification

0

1

89

88

9

10

e)appropriateness of drug selection

9

14

69

65

20

18

f) renal dosing

7

12

48

55

42

32

g) monitor special populations (pediatrics, oncology, elderly)

20

14

41

43

35

40

h) detect patient allergies related to prescribed therapy

2

4

87

81

9

16

i) verify order completeness

0

1

89

90

7

9

j) identify dangerous abbreviations, dose expressions

9

12

68

69

21

18

 

Part II - Communication of Interventions and Use to Improve the Prescribing Process ns

 

 

All Hospitals and Hospitals by Bed Size

Questions

Percentage of respondents

All Hospitals

Under 100 beds

100-299 beds

300-499 beds

Over 500 beds

Yes

No

Yes

No

Yes

No

Yes

No

Yes

No

a) As a whole, does the medical staff respond well to pharmacists' interventions?

94

6

96

4

94

4

94

6

94

6

b) Are pharmacy interventions included as a measure of performance in evaluating all pharmacists (clinical and dispensing)?

47

53

36

64

56

44

49

51

55

45

c) Are pharmacy interventions routinely documented?

78

22

69

31

85

15

83

17

82

18

d) Are factors related to the prescribing errors identified by pharmacists presented to committees/staff for the purpose of improving the prescribing process?

64

36

51

49

74

26

73

27

68

32

e) Is the documentation of pharmacy interventions detailed enough to guide improvement?

61

39

52

48

70

30

60

40

62

38

f) In the past year, have pharmacy interventions been used to plan and carry out medical staff education?

44

56

35

65

48

52

53

47

53

47

g) Excluding prescriber education, have pharmacy interventions been used in the past year to improve the prescribing process (establish guidelines, protocols, standardized order sets, etc.)?

63 38

52

48

70

30

69

31

68

32

 

 

Hospitals by Physician and Pharmacy Residency Programs

 

Questions

Percentage of respondents

With Pharmacy Residency

Without Pharmacy Residency

With Physician Residency

Without Physician Residency

Yes

No

Yes

No

Yes

No

Yes

No

a) As a whole, does the medical staff respond well to pharmacists' interventions?

97

3

93

7

96

4

93

7

b) Are pharmacy interventions included as a measure of performance in evaluating all pharmacists (clinical and dispensing)?

55

45

45

55

53

47

44

56

c) Are pharmacy interventions routinely documented?

77

23

78

22

80

20

76

24

d) Are factors related to the prescribing errors identified by pharmacists presented to committees/staff for the purpose of improving the prescribing process?

65

35

64

36

69

31

61

39

e) Is the documentation of pharmacy interventions detailed enough to guide improvement?

59

41

61

39

64

36

59

41

f) In the past year, have pharmacy interventions been used to plan and carry out medical staff education?

48

52

44

56

50

50

41

59

g) Excluding prescriber education, have pharmacy interventions been used in the past year to improve the prescribing process (establish guidelines, protocols, standardized order sets, etc.)?

65

35

62

38

69

31

59

41

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