The Critical Role of Ward-Based and Satellite Pharmacists in Improving Pharmaceutical Care in Hospital

Abstract

Objective: Medical errors are the third leading cause of death in the U. S., with medication mistakes being a common issue. Medication reconciliation (MR) involves comparing patients’ orders with their existing medications to prevent errors. Pharmacists are ideally suited for MR tasks. Effective MR can reduce drug-related rehospitalizations. This study aimed to investigate medication errors among hospitalized patients and to evaluate the impact of ward-based and satellite pharmacists on the quality of drug administration services. Methods: A descriptive cross-sectional study was conducted at Nikan General Hospitals in Tehran, Iran, over 6 months. We assessed the performance of ward-based and satellite pharmacists in various wards. All patient medication activities were meticulously monitored and recorded. Adjusted drug-related problem (DRP) codes were then used to identify medication errors and the corresponding interventions. Findings: The study included 1682 patients, each experiencing at least one DRP. The data revealed a DRP prevalence of 6.44% (95% confidence interval: 6.15%–6.75%). A total of 2173 DRPs were identified, with 650 originating from intensive care units and the remaining 1523 from other wards. Notably, DRPs attributed to nurses (labeled as S2) constituted 18.36%, and those due to drug interactions (classified as D7) accounted for 13.48%. Following intervention, the most common pharmacist recommendations were initiating a medication (14.04%), discontinuing a medication (13.12%), changing a medication (11.38%), and reducing doses (11.09%). Conclusion: Effective MR, supported by comprehensive training of medical staff such as physicians and nurses, can significantly reduce DRPs in hospitalized patients. Clinical pharmacists play a vital role in this context.

Keywords

• drug-related problem
• medication errors
• medication reconciliation
• pharmaceutical care
• satellite pharmacist