Impacting Nurses

1
Impacting Nurses Attitudes and Designing an IV
Drip Reorder Form as Initial Steps of Pharmacy
Decentralization at Loyola University Medical
Center

• Denisa Olarescu, Suman R Saini, Sandy Tiao,
  Charlene Yang, Maria Yu
• Preceptors Richard Ricker, RPh, MBA and Cheryl
  Gallagher, PharmD, MJ, CGP

Results
Projected Outcomes
Methods

• Pilot project conducted is the primary step in
  the decentralization process
• More efficient IV drip delivery time should
• Improve patient outcomes
• Decrease medication errors
• Be cost-effective
• Global Goal
• A decentralized pharmacy will improve patient
  outcomes
• Specific Study Objectives
• Creation of an IV drip form will improve
  medication delivery time
• Improving nurse attitudes towards pharmacists
  will lead to successful interprofessional
  relationships

• IV drip delivery system
• In the current IV delivery system, there was a
  decrease (50 to 20) in rating 1-3 and an
  increase (20 to 50) in rating 7-10
• Timely delivery of medications
• 20 agreed in post-survey about timely delivery
  of medications
• 20 strongly disagreed and 50 disagreed in
  pre-survey while 10 strongly disagreed and 40
  disagreed in timely delivery of medications
• For IV medication delivery wait time, there was a
  20 increase in 16-30 minutes, 30 increase in 46
  minutes 1 hour, and a 50 decrease for gt 1
  hour.
• Communication level between nurses and
  pharmacists
• 40 increase in nurse rating of communication
  level 4.
• No nurses rated the current communication level
  as 5 (no changes needed)
• Decentralized system implementation
• In pre-survey, 10 stated MAYBE but in
  post-survey, 100 agreed on benefits of
  implementing the decentralized system

• Most of my IVs come to the unit on time.
• 10 nurses/nurse managers surveyed

Background Information
Sources http//root.main.uab.edu

• How is the communication level between
  yourselves (nurses) and pharmacists?
• 10 nurses/nurse managers surveyed
• 1 needs improvement
• 5 no changes needed

Sources www.bnn-online.co.uk

• Literature Review 3 Comparison of Medication
  Distribution Systems
• In Sophia Childrens Hospital in the
  Netherlands, a three
• month study was conducted comparing the
  efficiency of
• drug distribution between a ward stock
  system and a
• decentralized pharmacy.
• The average time was measured for the
  distribution
• process such as preparing IVs and
  administering the
• medications.
• Study outcomes reported by authors
• Nurses spend more time (average 4 minutes)
  than
• pharmacy technicians (average 2.42
  minutes) preparing
• medications.
• Authors Conclusions
• With the satellite pharmacy, pharmacists
  spend more time
• as therapeutic consultants. Therefore
  more attention is
• given to patient care.
• (Poley MJ, Bouwmans CA, Hanff LM, Roos PJ, van
  Ineveld BM. Efficiency of different systems for
  medication distribution in an academic childrens
  hospital in The Netherlands. Pharm World Sci.
  2004 Apr26(2)83-9.)

Study Implications
Future Research Avenues

• After reviewing the existing literature available
  and conducting the pilot project, a decentralized
  system should in long-term
• Benefit patients
• Benefit health care providers (HCPs)
• Improve working relationships between HCPs
• Provide higher quality patient care

• Follow-up on the
• Nurses attitudes toward the pharmacists
• Interpersonal relationships between nurses and
  pharmacists
• Effectiveness of the IV drip order form (Figure
  1) in terms of medication delivery created in
  this project
• Process of decentralization
• Future challenges with the new decentralized
  system once implemented

Figure 1