Aim To determine the impact of replacing a nurse with a ward-based pharmacy technician as the second checker, in the process of administering medicines to children in hospital by exploring the views and experiences of parents and staff involved in the change in practice.
Method Having undertaken additional in-house training, a pharmacy technician replaced the second nurse on medication ward rounds (second checker) for 10 months over two wards. This took place on a neuro-medical ward and a medical specialty ward. The pharmacy technician undertook roles relating to medicines administration, including: attending day time medicine administration rounds; checking accuracy and appropriateness of prescriptions; preparing/administering prescribed medicines; independently undertaking dosage calculations; recording the administration of medicines. Using their specialist knowledge and skills, the role aimed to improve medicines optimisation for patients and their families during their inpatient stay.
Research staff conducted semi-structured qualitative interviews with parents of patients who were administered medicines during the study period (n=12) and with staff involved with the change in practice, as well as an interview with the pharmacy technician themselves after leaving each ward. Families were recruited from the two wards. Semi-structured interviews with staff (n=14) gathered data on the perspectives and experiences of the contribution of the ward-based pharmacy technician across two wards. An exploratory approach was taken using Thematic Analysis.1 Interviews were transcribed verbatim and anonymised. The research team familiarised themselves with transcripts by reading in full and generating initial codes using text from the data. Themes were generated and discussed between the team to produce an overall story of the analysis. Interviews were conducted over a 4 month period.
Results Parents discussed the importance of communication about their child’s medicines in hospital. Some parents were aware of the pharmacy technician’s role as second checker. Parents recognised the benefits of the technician’s background and expertise, and their contribution to the ward team.
Fourteen staff interviews were conducted including the ward based pharmacy technician (after leaving each ward), the Chief Pharmacist, the Director of Nursing, a Ward Manager, Nursing and Pharmacy staff. Staff commented how the pharmacy technician provided a link between the Pharmacy and Nursing teams, alleviating nurses of administration duties and allowing them to spend more time with patients. The role was also seen as educational allowing for nurses to refresh their knowledge on medication storage procedures and alternative methods of administration.
Conclusion To the research team’s knowledge, this is the first study of its kind to assess the potential benefits of introducing a ward-based pharmacy technician as a second checker. This novel role extension releases nursing staff time to undertake more patient-centred nursing duties. In addition, the specialist knowledge of the pharmacy technician at the point of medicine administration had a positive impact on medicines optimisation for children in hospital, providing more effective administration of medicines and contributing to wider patient safety in paediatric settings. Although further evaluation is required, our findings indicate that parental and staff support the future development of this service.
Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2):77–101.
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