Bridging Care- Insights from a Pharmacist on Interprofessional Collaboration

Bridging Care- Insights from a Pharmacist on Interprofessional Collaboration

Prescribing Errors and Interprofessional Collaboration between Pharmacists and Prescribers

Today, much research has established that the primary issue negatively impacting patient outcomes in the United States stems from prescribing errors, which often result in poor medication adherence due to lack of instruction clarity and accuracy, as well as lack of adequate patient knowledge about drug treatment. This problem is caused by a lack of interprofessional collaboration and communication between prescribers and pharmacists. In this case, prescribers refer to all those healthcare professionals licensed to make drug and treatment prescriptions, including physicians, physician assistants, clinical pharmacists, as well as pharmacists. The FDA estimates that nearly 1.3 million medication errors occur in the U.S. yearly (Hayes, 2017), costing taxpayers billions of dollars in terms of extended hospitalizations, disability, as well as death. Therefore, this paper’s primary objective is to summarize the outcomes of the interview with a pharmacist that was primarily intended to shed more light on the importance of interprofessional collaboration between pharmacists and prescribers.

Firstly, according to the interviewee, errors encountered in the pharmacy spread across the drug-use system and are made during prescription, when entering information into an electronic health record system, upon dispensation (especially when preparing the details), and when administering medication to the patient via the IV root or when the drug is being taken orally. Overall, this includes failing to warn patients about the complications (especially the harmful drug interactions) and side effects and failing to follow the 5R prescribing rule, missing out on the right dose, right time, right drug, right route, and right patient. According to Alabdulhafith & Sampalli (2018), these five requirements constitute a proper prescription. In truth, several studies seem to back up the claims by pharmacists, especially regarding the common sources and types of medication errors often encountered by pharmacists. For example, a 2020 research by Gogazeh identifies dispensing errors, transcription errors, prescription errors, prescribing errors, and administration errors as some of the common medication blunders encountered by pharmacists.

On the other hand, in terms of omissions, the interviewee identified labeling exclusions as some of the common sources of mistypes that usually lead to prescribing and transcription errors encountered by most pharmacists. Besides the absence of key information, such as dosage, quantity, timeframe, drug, and name of the patient, the respondent pointed out things like incorrect pharmacy address, the omission of extra warnings, incorrect expiry date, inaccurate drug strength, and many other labeling mistakes as some of the common omissions that build up to prescribing and prescription errors. These omissions can be from the prescriber (by failing to indicate the right patient and drug needs), the drug labeling company (failing to provide the correct information about the drug on the packaging material), as well as from the pharmacists (failing to dispense the right drug based on the instructions received, personal knowledge, and information provided on the drug labels).

In addition, the respondent (pharmacist) identified five key steps as forming the basis of filling a prescription – a process that entails translating a prescription (medication) order into a personalized medication remedy to the patient in a legally accepted, appropriate, and safe manner. The first step is to conduct an initial and input check. This initial phase requires the patient to fill in the general demographic data that the pharmacist uses to create a profile. The second step is the therapeutic check and verification, which involves confirming the prescriber’s (physician’s) information, including the drug type, quantity, dosage, route, and so on. This is the step where the pharmacists confirm the legality and validity of the drugs prescribed and whether there are any allergic reactions, side effects, or contraindications. This is the step where pharmacists often call or contact doctors to check that their information is legal, accurate, and matches the patient demographics. Sometimes, this phone call is necessary to avoid medication errors (in case the physicians have omitted something or made any prescription blunder) or clarify some information.

The third step is preparation. Upon verifying the drug details, which sometimes involves calling the physician, the pharmacists then prepare to make a prescription by communicating the cost to the patient and other related information. The interviewee noted that the pharmacist also uses this opportunity to confirm if the patient has any insurance plans for the prescribed medications and any accompanying conditions. Upon consenting, the pharmacist then prepares the medication for the patient based on his/her insurance guidance. Most importantly, the pharmacist must check for the expiry date and labeling information before scanning and packing the drugs. The fourth step is to conduct a technical check. After packing the drugs, the pharmacist is required to hand them to a separate individual within the pharmacy to confirm the accuracy and relevance of the information, including whether the drug is currently used to treat the patient’s condition, the quantity, dosage, route, and so on.

The final step is to supply and educate the patient. After checking and verifying the information on the drug and matching it with the patient data, the pharmacist then hands the drug to the patient after payment has been completed. The pharmacist might also take this opportunity to provide counseling on any potential side effects and what should be done. However, it is important to note that sometimes Prior Authorization is taken by some insurers to confirm with the prescribers whether or not and why they should cover certain medications. The prescriber must take the initiative of contacting the insurers and give details as to what reasons necessitate the particular medication to be provided to patients. Some of the drugs that are subject to prior authorization include drugs used for non-life-threatening (or for cosmetic) reasons, mediations with age limits, expensive drugs, and the physician or patient is requesting a specific brand name while a generic drug with equivalent use is available on the market (Jones et al., 2018).

Finally, the interviewee revealed that interprofessional collaboration between pharmacists and prescribers is very important because it serves to lower medication errors, such as the common omission mistakes prescribers often make (Axon et al., 2018). By calling the physician, pharmacists can clear any misunderstanding and get further clarification. This can address any personal errors due to mistypes or lack of current knowledge from the physician’s end. Overall, the information gathered in this interview will help my prescription writing in the hospital by reducing medication errors. I am now more aware of the sources of these errors, such as problems in labeling, which puts me in a better position to avoid them. I will insist on communicating and consulting prescribers (physicians) in the field to ascertain all information presented.

References

Alabdulhafith, M., & Sampalli, S. (2018). NFC-based framework for checking the rights of medication administration. Procedia Computer Science, 37, 434-438. https://doi.org/10.1016/j.procs.2014.08.065

Axon, D. R., et al. (2018). Junior doctors’ communication with hospital pharmacist about prescribing: findings from a qualitative interview study. European Journal of Hospital Pharmacy: Science and Practice, 25(5), 257-261. DOI: 10.1136/ejhpharm-2017-001449

Gogazeh, E. (2020). Dispensing errors and self-medication practice observed by community pharmacists in Jordan. Saudi Pharmaceutical Journal, 28(3), 233-237. https://doi.org/10.1016/j.jsps.2020.01.001

Hayes, K. (2017). Medication errors are more than double. AARP. Retrieved from https://www.aarp.org/health/drugs-supplements/info-2017/medication-errors-rise-fd.html

Jones, L. K., et al. (2019). Understanding the medication prior –authorization process: A case study of patients and clinical staff from a large rural integrated health delivery system. American Journal of Health-System Pharmacy, 76(7), 453-459. https://doi.org/10.1093/ajhp/zxy083

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Interview Summary

The purpose of this assignment is to interview a pharmacist to learn more about interprofessional collaboration between prescribers and pharmacists. If possible, volunteer to shadow the pharmacist. Discuss the following in your interview:

• The process of filling a prescription.
  

  Interview Summary

• Common reasons pharmacists call providers to clarify orders.
• What is on a proper prescription?
• Common omissions on prescriptions they receive.
• Medication errors pharmacists encounter.
• The prior authorization (par) process and common par medications.

Write a 500-1,000 word paper summarizing your experience and what you learned from the pharmacist you interviewed. Reflect on how this information will help your prescription writing. Discuss intercollaboration between pharmacists and prescribers.

You are required to cite three to five sources related to inter-collaboration to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this paper according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required