Construction and empirical study of competency model for perioperative medication management by clinical pharmacists...

Drug-related problems (DRPs) remain a critical concern in perioperative management. Improper perioperative medication decision-making will significantly increase patients' perioperative medical risks, increase medical expenses, and cause a great waste of medical resources.

To enhance clinical pharmacists' perioperative medication management abilities and improve patient adherence, this study analyzes the current status of competency research to propose appropriate indicators. Using expert consultation, a suitable indicator system was selected. Based on survey data, a competency model for clinical pharmacists in perioperative medication management was constructed. The model was empirically tested to evaluate its effectiveness and aims to contribute to the development of a training and accreditation system for clinical pharmacists in China.

Through literature review and expert consultation, a national survey was developed on perioperative medication management practices via a national-level working committee focused on perioperative medication (organization name blinded). A competency theoretical model was constructed using Delphi method and validated through confirmatory factor analysis. A six-month empirical study was conducted in the spinal surgery department of a tertiary hospital in Eastern China (institution name blinded) to evaluate model effectiveness.

The finalized model comprised four dimensions: pharmacist qualification, perioperative medication therapy management, teamwork, and academic involvement. The most influential factor was perioperative medication therapy management (path coefficient: 0.904), followed by qualification (0.857), teamwork (0.797), and teaching and research (0.669). Model-guided pharmacist training significantly improved clinical outcomes, including a 55.6% reduction in postoperative infection rate, a 0.61-day decrease in antimicrobial therapy duration (p = 0.007), a 51.4% reduction in respiratory symptoms, a 0.8-point reduction in pain scores (p < 0.05), and a 2-day reduction in incision healing time for diabetic patients (p = 0.01). Economic benefits included a 25.8% decrease in total treatment cost and a 97.5% reduction in proton pump inhibitor expenditure.

This study preliminarily developed a competency indicator system for Chinese clinical pharmacists in perioperative medication management, thereby enhancing the overall standard of clinical pharmacist practice in this domain.