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The utility of the decision support tool FIRSTLight in a paediatric hospital dispensary
  1. P Patel,
  2. D Terry
  1. Aston University

Abstract

Aims To determine if FIRSTLight is suitable to support pharmacists when clinically checking prescriptions in a paediatric hospital dispensary.

Methods Stage 1: Pre-piloted, structured, direct observation of dispensary clinical pharmacists resolving clinical concerns on hospital prescriptions, prior to dispensing, over an 11 day period (25 h observation). Setting was a single UK paediatric hospital providing both secondary and tertiary care that at the time of the study did not use FIRSTLight. Data set included: drug, route, dose, patient details, pharmacist, resources consulted, time taken, and if the query was resolved. Stage 2: Retrospective use of the decision support tool FIRSTLight to identify if relevant information was available from this source, and time taken to obtain.

Results Fifty-one clinical queries were observed during the study period that required reference to (drug) information sources for resolution. These were managed by eight different pharmacists and involved 41 different drugs (chemical entities). Seven different information sources were consulted a total of 61 times. Most frequently used resource was BNFc (n=34, 56%). FIRSTLight was shown retrospectively to provide the relevant information required to resolve the query on 33 occasions (65%). In comparison the BNFc was able to provide the required information alone on 27 (44%) of occasions. Time taken to resolve the queries, excluding those with delays (n=4) without using FIRSTLight ranged from 16 s to 18 min 53 s (mean 4 min 21 s). Time taken to identify relevant information using FIRSTLight ranged from 20 s to 5 min 21 s (mean 2 min 43 s). Overall FIRSTLight was both quicker and provided the necessary information on 19 occasions (37%).

Conclusions FIRSTLight may be a useful resource to provide clinical information to pharmacists when clinically checking paediatric prescriptions in a hospital dispensary. Further work will be required to determine the most time effective pathway for obtaining or confirming necessary clinical information in this setting. FIRSTLight may also be considered by community pharmacists who are known to have difficulties managing hospital prescriptions.1

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