An evaluation of physicians' and nurses' perspectives regarding pharmacy services at St. Luke's Hospital.

Abstract

The study attempted to obtain a comprehensive picture of physicians' and nursing officers' perspectives regarding several aspects of the pharmacy services currently provided at St. Luke's Hospital - Malta's main public general hospital. This study sought to determine which of the current pharmacy services are used most often by physicians and Nursing Officers and whether these services are useful to them and their patients. The health professionals' relationships with pharmacists were also investigated. An attempt was made to elicit health professionals' recommendations for improvement of the current pharmacy services at St. Luke's Hospital and their proposals for the pharmacy services to be available at Mater Dei Hospital. A self-administered structured questionnaire was distributed to all physicians, nursing officers and deputy nursing officers working at St. Luke's Hospital. Further insight into health professionals' opinions was gained through a focus group. An overall response rate of 51.3% (n=270) was obtained to the questionnaire. Analysis of responses revealed that Nursing Officers were more frequent users of the pharmacy services than physicians, together with professionals from the Ophthalmic Department, Accident and Emergency Department and Department of Medicine. The services for Ordering of Medicines and Medicines Information were those most frequently used, while that of Extemporaneous Preparation of Medicines was the service least frequently utilized. A high proportion of respondents felt the pharmacy staff take an active interest in the care of their patients and use their knowledge and product base to support patient care. Around half the respondents had a strong professional relationship with pharmacists. Participants stated that the current pharmacy services are useful both to themselves and to their patients and they said they were able to obtain useful and timely drug information whenever needed. Although improvements have recently been seen in the pharmacy services, respondents stated there was still room for further improvement. About half the respondents did not have access to the hospital formulary while almost three-fourths were not adequately informed of alterations to the formulary and to drug entitlement criteria. Over two-thirds of respondents felt the drug entitlement system is not "fair and reasonable". Participants agreed that a radical overhaul of the drug entitlement system and a reduction in the level of bureaucracy within the Pharmacy Department are urgently needed. There was consensus that the new features which will be available at Mater Dei Pharmacy will all contribute to an improvement in the pharmacy services. Physicians and Nursing Officers felt there was an urgent need for an increase in communication between pharmacists and other health care professionals. Participants proposed the introduction of educational spots on the media in an attempt to decrease drug wastage and hoarding by patients. Implications for management include that the results of this study be considered when planning pharmacy services at Mater Dei Hospital. Analysis of these results will enable management to determine which pharmacy services to expand and which to consider outsourcing. It shall highlight those aspects of the pharmacy service that particularly require to be improved upon. The results shall also confirm that certain plans for Mater Dei Hospital shall meet professionals' and patients' needs. Recommendations for further research include repeating this study after the migration to Mater Dei Hospital and in a different setting, such as Zammit Clapp Hospital. The reactions of the senior management of the Pharmacy Department, to the results could also be elicited.