ABSTRACT
Background: Rural hospitals in sub-Saharan Africa suffer from numerous disparities in resources and practices, and subsequently patient care is affected.Methods: In order to assess current practices and opportunities for improvement in pulse oximetry use and patient-care handoffs, a cross-sectional survey was administered to clinicians at a referral level hospital serving a large rural area in Shinyanga, Tanzania.Results: Respondents (n=46) included nurses (50%), medical doctors (48%), and clinical officers (2%). A response rate of 92% was achieved, and 81% of clinicians acknowledged routine difficulties in the use of current devices when obtaining pulse oximetry. Although 83% of respondents reported using a written handoff at shift change, information reporting was inconsistent and rarely included specific management guidance.Conclusions: Further research is needed to elucidate handoff practices in developing settings, but there is a large opportunity for novel point-of-care devices and tools to improve both pulse oximetry use and patient care handoffs in rural Africa.
ABSTRACT
Transitions of care occur each time a patient moves from one healthcare provider or care setting to another. Challenges that have been identified include: failure of the patient to keep appointments for outpatient chronic care; inability for smooth transfer of information between various healthcare providers; and failure to find appropriate placement for patients who can no longer manage independent living. As pharmacists representing an array of practice settings, these authors here present the models of contributions made by pharmacy services within such multifaceted approaches. An initial literature search was conducted using the National Library of Medicine via PubMed. Studies conducted in the United States that included at least one pharmacy service within the methods of intervention were selected for review. Where there are published findings from each setting, we include the measured impact, if reported. Although pharmacists represent the most skilled healthcare professionals in medication reconciliation and management, the best processes for tapping that expertise have yet to be fully elucidated. We present this review of current practices with the continued hope that the pharmacy profession will, not only continue to be the quiet patient advocate for best medication use, but also to open our minds to the need to measure, adjust, and measure again, the systems and processes we use to best integrate our knowledge for the overall benefit of the patient.
ABSTRACT
Transitions of care occur each time a patient moves from one healthcare provider or care setting to another. Challenges that have been identified include: failure of the patient to keep appointments for outpatient chronic care; inability for smooth transfer of information between various healthcare providers; and failure to find appropriate placement for patients who can no longer manage independent living. As pharmacists representing an array of practice settings, these authors here present the models of contributions made by pharmacy services within such multifaceted approaches. An initial literature search was conducted using the National Library of Medicine via PubMed. Studies conducted in the United States that included at least one pharmacy service within the methods of intervention were selected for review. Where there are published findings from each setting, we include the measured impact, if reported. Although pharmacists represent the most skilled healthcare professionals in medication reconciliation and management, the best processes for tapping that expertise have yet to be fully elucidated. We present this review of current practices with the continued hope that the pharmacy profession will, not only continue to be the quiet patient advocate for best medication use, but also to open our minds to the need to measure, adjust, and measure again, the systems and processes we use to best integrate our knowledge for the overall benefit of the patient.