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Differing clinical pharmacy service models: Quantitative and qualitative analysis of nurse perceptions of support
Robert Bryant1, Betty Chaar1, Carl Schneider1
1Faculty of Pharmacy, University of Sydney, Australia.
Background:
In the last decade interdisciplinary teamwork and collaboration are increasingly favoured as strategies to improve healthcare delivery. The need for collaboration is especially evident in acute care medical-surgical wards of hospitals. Doctors, nurses, pharmacists, doctors and other healthcare professionals work in shifts to provide a multiplicity of services to a rapidly changing caseload of patients. Traditionally, pharmacists have been assigned to a ward or wards for which they provided all clinical services. An alternative clinical pharmacy service model which aligns pharmacists with medical teams is being introduced into Australian hospitals. This newer model, teambased pharmacy, is intended to provide better clinical services overall to patients, but the effect on the working relationship between pharmacists and nurses has not been examined.
Objective:
To compare nurses' perceptions of the pharmacist's role, collaboration with and support for nurses for two models of clinical pharmacy: wardbased pharmacy and teambased pharmacy.
Design:
Quantitative and qualitative analysis of survey data from nurses.
Settings And Participants:
A total of 90 nurses from five acute-care wards located in two tertiary hospitals in Sydney, Australia participated in the survey.
Methods:
Statistical comparison of quantitative data from Likert-type questionnaire, and qualitative thematic analysis of nurses' written responses to an open-ended question.
Results:
The qualitative data analysis indicated that the team-based pharmacy clinical service model, resulted in a perceived increase in nursing workload and a decreased collaboration with pharmacists. These findings were corroborated by the quantitative data analysis findings of statistically significant perceived reductions in collaboration.
Conclusions:
Efforts to align pharmacists with medical teams by replacing the traditional ward-based pharmacy model with an alternative model resulted in a perceived reduction in collaboration with and support for nursing teams. Evaluation of the impact of new pharmacy service models should involve all health professionals contributing to the safe and effective use of medicines. Intervention is recommended to provide resources to satisfy nurses' needs for information and education about medication for hospitals that operate team-based clinical pharmacy services.
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