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Evaluation of the Impact of the Presence of a Pharmacy Technician on the Quality and Cost of Drug Therapy (OPTI-PP)

31 januari 2017 bijgewerkt door: Centre Hospitalier Universitaire de Nīmes

Evaluation of the Impact of the Presence of a Pharmacy Technician on the Quality and Cost of Drug Therapy in the Hepato-Gastroenterology Department of the Nîmes University Hospital

The main objective of this study is to evaluate the impact of the presence of a pharmacy technician in a care unit (Hepato-Gastroenterology Department) on detected medication errors.

This is a before-after study consisting of three sequential phases:

Month 1: one month of observation of what is happening in the department Month 2: one month wash out period Month 3: active participation of a pharmacy technician in the department

Studie Overzicht

Gedetailleerde beschrijving

The secondary objectives of this study are:

A- To assess the impact of the presence of a pharmacy technician on the ratio of the number of patients with at least one medication error / number of included patients hospitalized in the service.

B- To characterize detected medication errors.

C- To identify and evaluate the potential causes of medication errors.

D- To evaluate whether the presence of a pharmacy technician reduces nursing time spent on medication management.

E- To evaluate the economic impact of the presence of a pharmacy technician.

F- To evaluate the acceptability of the intervention by the nursing staff and pharmacy technicians using questionnaires.

Studietype

Ingrijpend

Inschrijving (Werkelijk)

129

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studie Locaties

      • Nîmes Cedex 09, Frankrijk, 30029
        • CHRU de Nîmes - Hôpital Universitaire Carémeau

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  • The patient must be insured or beneficiary of a health insurance plan
  • The patient is hospitalized in the Hepato-Gastroenterology Department of the Nîmes University Hospital

Exclusion Criteria:

  • The patient is under judicial protection
  • The patient, or his/her legal guardian, expresses opposition to participation in the study
  • It is impossible to correctly inform the patient

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Niet-gerandomiseerd
  • Interventioneel model: Crossover-opdracht
  • Masker: Geen (open label)

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: 1st observational period (before experimental intervention)

Patients in this arm are included during a first month of observation before the intervention is implemented.

Intervention: One month of department-wide observation

A pharmacy technician will be present full time in the care unit from Monday to Friday between 8:30 and 17h for 1 month for observational purposes only. During this phase, the pharmacy technician observes the current practices of preparation and administration of medication by nurses. He / she will collect medication errors and other observational data.
Experimenteel: 2nd obs. period (during experimental intervention)

Following a one-month wash-out period, patients in this arm are included during a second month of observation during which the intervention is implemented.

Intervention: Pharm Tech participates in department

Following a 1 month wash-out period, a pharmacy technician will again be present full time (in practice, two technicians will relay each other) in the care unit from Monday to Friday between 8:30 and 17h for 1 month. He/she will actively take part in drug care activities in the department: management of product pathways, verification of injectable preparation, advice, etc. Medication errors and other observational data will be collected.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
The following ratio (relative units): Number of medication errors / number of medications administered and omitted from among all those listed on the prescription for admission
Tijdsspanne: 5 days
Primary Outcome Measure as given in protocol: Number of medication errors / number of medications administered and omitted from among all those listed on the prescription for admission (during month 1 versus during month 3).
5 days

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Number of patients with at least one medication error / total number of hospitalized patients included in the service
Tijdsspanne: 5 days
5 days
For each medication error: the name of the drug
Tijdsspanne: 5 days
5 days
For each medication error: the type of error
Tijdsspanne: 5 days

Errors are classifies as one of the following types:

Omission; Drug; Dosage form; Expired or damaged drug; Dose; Concentration; Frequency of administration; Administration technique; Route of Administration; Rate of administration; Duration of administration; Administration Time; Patient; Drug interaction.

5 days
For each medication error: the severity index
Tijdsspanne: 5 days
5 days
For each medication error: when (which step) the error occurred during the drug pathway
Tijdsspanne: 5 days

The considered steps are:

Writing the prescription Medical decision for the prescription Transcription Pharmaceutical analysis Deliverance Preparation / reconstitution Pillbox Administration Procurement Storage Compliance Therapeutic and clinical follow-up

5 days
For each medication error: the evolution of the adverse drug event, if occurred
Tijdsspanne: 5 days
5 days
For each medication error: the criticality of the error
Tijdsspanne: 5 days

Criticality is graded according to the following classes:

  1. C: no potential harm to the patient;
  2. D: treatment or increased monitoring without harm to the patient
  3. (E to I): potential harm to the patient

3E: treatment or surgery with temporary harm 3F: longer duration of hospitalization with temporary harm 3G: permanent harm 3H: involving a life-threatening harm 3I: death

Criticality is determined by the concordance of two, independent expert opinions; or, in case of discordance, the concordance of 2 out 3 expert opinions.

5 days
The potential causes of medication errors
Tijdsspanne: 5 days
5 days
The average number of interruptions per hour during preparation or administration of drug doses by nurses
Tijdsspanne: 5 days
5 days
The number of patients for whom personal treatments were managed by the nursing staff on admission / number of patients who brought their personal treatments to the care unit
Tijdsspanne: 5 days
5 days
The number of patients for whom personal treatments were returned by the nursing staff at hospital discharge / number of patients who brought their personal treatments to the care unit
Tijdsspanne: 5 days
5 days
Nursing staff time dedicated to: the preparation of individual doses
Tijdsspanne: 5 days
5 days
Nursing staff time dedicated to: ordering health products
Tijdsspanne: 5 days
5 days
Nursing staff time dedicated to: stock management and exceptional orders
Tijdsspanne: 5 days
5 days
Nursing staff time dedicated to: the delivery, receipt and storage of health products
Tijdsspanne: 5 days
5 days
Nursing staff time dedicated to: cabinet inventories
Tijdsspanne: 5 days
5 days
Nursing staff time dedicated to: the management of expired drugs
Tijdsspanne: 5 days
5 days
The number of calls made to the central pharmacy
Tijdsspanne: 5 days
5 days
Staff time dedicated to managing exceptional requests
Tijdsspanne: 5 days
5 days
The number of drugs consumed
Tijdsspanne: 5 days
5 days
The number of medical devices consumed
Tijdsspanne: 5 days
5 days
The number of immobilized drugs
Tijdsspanne: 5 days
5 days
The number of immobilized medical devices
Tijdsspanne: 5 days
5 days
The cost of adverse drug events care
Tijdsspanne: 5 days
5 days
Care staff satisfaction questionnaire
Tijdsspanne: 5 days
5 days
Pharmacy technician satisfaction questionnaire
Tijdsspanne: 5 days
5 days

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Onderzoekers

  • Studie directeur: Géraldine Leguelinel-Blache, PharmD, PhD, Centre Hospitalier Universitaire de Nīmes

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start

1 september 2016

Primaire voltooiing (Werkelijk)

16 december 2016

Studie voltooiing (Werkelijk)

16 december 2016

Studieregistratiedata

Eerst ingediend

19 november 2015

Eerst ingediend dat voldeed aan de QC-criteria

23 november 2015

Eerst geplaatst (Schatting)

25 november 2015

Updates van studierecords

Laatste update geplaatst (Schatting)

1 februari 2017

Laatste update ingediend die voldeed aan QC-criteria

31 januari 2017

Laatst geverifieerd

1 januari 2017

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • LOCAL/2015/GL-01
  • 2015-A01309-40 (Andere identificatie: RCB number)

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