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Pharmacy on wheels: bringing pharmaceutical care to the childs bedside
  1. Q Naeem,
  2. S Tomlin,
  3. W Thornhill,
  4. P Hayes
  1. Pharmacy Department, Evelina Children's Hospital, Guy's & St. Thomas' NHS Foundation Trust, London, UK

Abstract

Objectives The ward based satellite pharmacies at the Evelina Children's hospital, based in the main drug room on the ward, were designed to supply one-stop-medicines on a daily basis to children's electronically controlled bedside lockers. Utilisation of this room caused interruptions to nurses preparing medicines, removal of drug charts from the child's bedside and a service that was time limited for interaction with children and their carers. The aim was to put a mobile dispensing station,1 equipped with a fully networked live dispensing computer and medicines storage cupboard on each ward to provide bed to bed dispensing. The objective was to reduce nurse interruptions,2 increase pharmacy time at the child's bed and make the dispensing process interactive with the child/carers in terms of the information provided about them.3

Method A time-motion method was used to make observations of ward based activities of the pharmacy team in a preintervention (running the static satellite pharmacy system) and post intervention (pharmacy on wheels service) in order to make comparisons. Satisfaction questionnaires were used to identify the perceptions of key stakeholders of the new service.

Results Interruptions of nurses by pharmacy staff, decreased by 65%. The dedicated time at the bedside meant that the time to take a drug history decreased by 16%, but the patient contact time increased by 30%. Time that the pharmacy team spent walking round the ward was reduced by 44%. 86% of children/carers thought the service was ‘good or excellent’, with 100% saying it was a ‘better service’. 85% of nurses ‘agreed’ that the new service was a safer way of providing medicines at ward level.

Conclusion The introduction of this new bedside service has shown many benefits. The relocation of pharmacy to the bedside has meant a more visual patient focused service has been established. With nurse interruptions being reduced and drug charts kept by the bedside, the new service shows good promise for the future. The pilot showed that the pharmacy team could make better use of their time at ward level, with less walking to and from the satellite pharmacy and more time spent with the individual children and their carers. More work is required on the interruptions of the pharmacy team during the dispensing process at the bedside; although the visual focus of the trolley seems to help avoid this and interruptions are medicine and patient specific.

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