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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. januar 2017 oppdatert av: 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

Studieoversikt

Detaljert beskrivelse

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

Intervensjonell

Registrering (Faktiske)

129

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

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

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Forebygging
  • Tildeling: Ikke-randomisert
  • Intervensjonsmodell: Crossover-oppdrag
  • Masking: Ingen (Open Label)

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Aktiv komparator: 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.
Eksperimentell: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
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
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Number of patients with at least one medication error / total number of hospitalized patients included in the service
Tidsramme: 5 days
5 days
For each medication error: the name of the drug
Tidsramme: 5 days
5 days
For each medication error: the type of error
Tidsramme: 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
Tidsramme: 5 days
5 days
For each medication error: when (which step) the error occurred during the drug pathway
Tidsramme: 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
Tidsramme: 5 days
5 days
For each medication error: the criticality of the error
Tidsramme: 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
Tidsramme: 5 days
5 days
The average number of interruptions per hour during preparation or administration of drug doses by nurses
Tidsramme: 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
Tidsramme: 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
Tidsramme: 5 days
5 days
Nursing staff time dedicated to: the preparation of individual doses
Tidsramme: 5 days
5 days
Nursing staff time dedicated to: ordering health products
Tidsramme: 5 days
5 days
Nursing staff time dedicated to: stock management and exceptional orders
Tidsramme: 5 days
5 days
Nursing staff time dedicated to: the delivery, receipt and storage of health products
Tidsramme: 5 days
5 days
Nursing staff time dedicated to: cabinet inventories
Tidsramme: 5 days
5 days
Nursing staff time dedicated to: the management of expired drugs
Tidsramme: 5 days
5 days
The number of calls made to the central pharmacy
Tidsramme: 5 days
5 days
Staff time dedicated to managing exceptional requests
Tidsramme: 5 days
5 days
The number of drugs consumed
Tidsramme: 5 days
5 days
The number of medical devices consumed
Tidsramme: 5 days
5 days
The number of immobilized drugs
Tidsramme: 5 days
5 days
The number of immobilized medical devices
Tidsramme: 5 days
5 days
The cost of adverse drug events care
Tidsramme: 5 days
5 days
Care staff satisfaction questionnaire
Tidsramme: 5 days
5 days
Pharmacy technician satisfaction questionnaire
Tidsramme: 5 days
5 days

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Etterforskere

  • Studieleder: Géraldine Leguelinel-Blache, PharmD, PhD, Centre Hospitalier Universitaire de Nîmes

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. september 2016

Primær fullføring (Faktiske)

16. desember 2016

Studiet fullført (Faktiske)

16. desember 2016

Datoer for studieregistrering

Først innsendt

19. november 2015

Først innsendt som oppfylte QC-kriteriene

23. november 2015

Først lagt ut (Anslag)

25. november 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

1. februar 2017

Siste oppdatering sendt inn som oppfylte QC-kriteriene

31. januar 2017

Sist bekreftet

1. januar 2017

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • LOCAL/2015/GL-01
  • 2015-A01309-40 (Annen identifikator: RCB number)

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