A qualitative exploration of the impact of a hospital electronic prescribing and medicines administration (HEPMA) protocol on junior doctor confidence and competence to prescribe end-of-life care medicines.

IF 2.6 4区 医学 Q2 PHARMACOLOGY & PHARMACY
Ewan McLean, Amanda McLean, Marion Bennie
{"title":"A qualitative exploration of the impact of a hospital electronic prescribing and medicines administration (HEPMA) protocol on junior doctor confidence and competence to prescribe end-of-life care medicines.","authors":"Ewan McLean, Amanda McLean, Marion Bennie","doi":"10.1007/s11096-024-01789-9","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>With hospital electronic prescribing and medicines administration (HEPMA) systems now in widespread use across hospital inpatient clinical services, work is underway to measure the benefits of HEPMA on healthcare systems and patient care. HEPMA functionality enables users to prescribe medicines by 'bundle' or 'protocol'. Although it is assumed that this is a significant system benefit, there are few qualitative studies supporting this conclusion.</p><p><strong>Aim: </strong>To explore the impact of an electronic anticipatory care medicines protocol on junior doctor perceptions of their confidence and competence to prescribe opioids and midazolam for patients at the end of life.</p><p><strong>Method: </strong>Between May and August 2022, one-to-one semi-structured interviews were conducted at a 570-bed District General Hospital with junior doctors who had experience of prescribing on both HEPMA and paper-based systems. Audio recordings of the interviews were transcribed verbatim and underwent thematic analysis.</p><p><strong>Results: </strong>Ten junior doctors participated (median age 23 years). Analysis generated five main themes that described perceptions and attitudes towards confidence and competence. These were prescribing safety benefits; information technology infrastructure, interoperability and system design concerns; clinical knowledge and training needs; cultural and social factors and risks of automation in prescribing.</p><p><strong>Conclusion: </strong>This study suggests that junior doctors experienced an overall increase in their confidence and perceived competence to prescribe anticipatory medicines post-implementation of a HEPMA protocol. Further studies are required to detail the impact of HEPMA/CPOE protocols on clinical practice.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"1445-1452"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576621/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Pharmacy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11096-024-01789-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/7 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: With hospital electronic prescribing and medicines administration (HEPMA) systems now in widespread use across hospital inpatient clinical services, work is underway to measure the benefits of HEPMA on healthcare systems and patient care. HEPMA functionality enables users to prescribe medicines by 'bundle' or 'protocol'. Although it is assumed that this is a significant system benefit, there are few qualitative studies supporting this conclusion.

Aim: To explore the impact of an electronic anticipatory care medicines protocol on junior doctor perceptions of their confidence and competence to prescribe opioids and midazolam for patients at the end of life.

Method: Between May and August 2022, one-to-one semi-structured interviews were conducted at a 570-bed District General Hospital with junior doctors who had experience of prescribing on both HEPMA and paper-based systems. Audio recordings of the interviews were transcribed verbatim and underwent thematic analysis.

Results: Ten junior doctors participated (median age 23 years). Analysis generated five main themes that described perceptions and attitudes towards confidence and competence. These were prescribing safety benefits; information technology infrastructure, interoperability and system design concerns; clinical knowledge and training needs; cultural and social factors and risks of automation in prescribing.

Conclusion: This study suggests that junior doctors experienced an overall increase in their confidence and perceived competence to prescribe anticipatory medicines post-implementation of a HEPMA protocol. Further studies are required to detail the impact of HEPMA/CPOE protocols on clinical practice.

医院电子处方和药物管理(HEPMA)协议对初级医生开具临终关怀药物处方的信心和能力的影响的定性研究。
背景:随着医院电子处方和药品管理(HEPMA)系统在医院住院临床服务中的广泛使用,目前正在开展工作以衡量 HEPMA 对医疗系统和患者护理的益处。HEPMA 的功能使用户能够按 "捆绑 "或 "协议 "开具药品处方。目的:探讨电子预知护理药物协议对初级医生为生命末期患者开具阿片类药物和咪达唑仑处方的信心和能力的影响:方法:2022 年 5 月至 8 月期间,在一家拥有 570 张病床的地区综合医院,对曾使用 HEPMA 和纸质系统开处方的初级医生进行了一对一半结构化访谈。访谈录音被逐字转录,并进行了主题分析:10 名初级医生参加了访谈(中位年龄为 23 岁)。分析产生了五大主题,描述了对信心和能力的看法和态度。这些主题是:处方安全的益处;信息技术基础设施、互操作性和系统设计问题;临床知识和培训需求;文化和社会因素以及处方自动化的风险:本研究表明,在实施 HEPMA 协议后,初级医生开具预期药物处方的信心和能力总体上有所提高。需要进一步研究 HEPMA/CPOE 协议对临床实践的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
4.10
自引率
8.30%
发文量
131
审稿时长
4-8 weeks
期刊介绍: The International Journal of Clinical Pharmacy (IJCP) offers a platform for articles on research in Clinical Pharmacy, Pharmaceutical Care and related practice-oriented subjects in the pharmaceutical sciences. IJCP is a bi-monthly, international, peer-reviewed journal that publishes original research data, new ideas and discussions on pharmacotherapy and outcome research, clinical pharmacy, pharmacoepidemiology, pharmacoeconomics, the clinical use of medicines, medical devices and laboratory tests, information on medicines and medical devices information, pharmacy services research, medication management, other clinical aspects of pharmacy. IJCP publishes original Research articles, Review articles , Short research reports, Commentaries, book reviews, and Letters to the Editor. International Journal of Clinical Pharmacy is affiliated with the European Society of Clinical Pharmacy (ESCP). ESCP promotes practice and research in Clinical Pharmacy, especially in Europe. The general aim of the society is to advance education, practice and research in Clinical Pharmacy . Until 2010 the journal was called Pharmacy World & Science.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信