ABSTRACT
Engaru-Kosei General Hospital expanded its pharmacist duties in hospital wards in April 2018 following the nationwide switch to out-of-hospital prescriptions. The purpose of this study was to examine the effect of pharmacists’ ward duties on nursing duties. Pharmacists expanded their duties to cover drug distribution management, infusions of total parenteral nutrition (TPN) mixed with drugs, and aseptic preparation of 24-h infusions (including peripheral parenteral nutrition). The effects were compared between April 2018 before the expansion of duties and May-September 2018 after the expansion, and we compared the number of meetings set up to discuss nurses’ overtime hours and patient problems. In addition, interviews were conducted about the changes experienced on site. Drug distribution management averaged 3,150 cases/month. The number of TPN mixed infusions was 25 cases/month before expansion and this increased to 88 cases/month after expansion. The number of mixed injections of 24-h infusions was 296/month. Nurses' overtime hours did not decrease significantly, but the number of meetings increased from 47/month to 79.4/month. In the interviews, positive responses were obtained about, for example, the increased number of meetings held and more time for patient care. The pharmacist and the nurse collaborated to improve work by using their expertise, we think that the results obtained from work improvement contributed to the improvement of medical quality and medical safety.
ABSTRACT
A questionnaire was administered to identify differences between the information that ward nurses think should be provided on a discharge summary and the information that outpatient nurses consider is necessary for providing continuing nursing care. Respondents were asked to select from multiple choice answers which information they believe is necessary to provide on a discharge summary and their perceptions about continuing nursing care, and they were also asked to record the reasons for their selections. Multiple choice responses were aggregated by simple tabulation and reasons were aggregated by similarity. The results showed that ward nurses and outpatient nurses had the same perceptions of what information is needed on a discharge summary. However, whereas the outpatient nurses wanted to see specific information about what care should be continued on the discharge summary, the ward nurses considered continuing nursing care to mean sharing summarized information about the patient's hospital course. This difference can be attributed to the unique characteristics of ward nurses and outpatient nurses. To provide continuing nursing care, ward nurses and outpatient nurses should each understand the other's thinking and learn what information the other considers necessary.