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Master Thesis

Présence pharmaceutique et mise en place d'activités de pharmacie clinique dans un service de chirurgie orthopédique

Abstract : Medication reconciliation (MR), combined with the abalysis of prescriptions, is a clinical pharmacy practice to be implemented to fight against iatrogenism. In a desire to develop clinical pharmacy activities within Libourne hospital, pharmacists has prioritized its actions in the surgical departments, which are more at risk of medication errors. Several activities have been evaluated in orthopedics. First, a prospective study on medication reconciliation at hospital admission was conducted over 9 months. The patients included are patients who went through the emergency before being transferred to the surgical department. Another study was done on the MR at discharge. The patients included are those for whom an anticoagulant relay is necessary, over a period of 6 months. The other patients are patients treated for bone and joint infection, over a period of 9 months. Out of 684 patients included, 71% of patients are reconciled within 24 hours: 168 patients benefited from a proactive MR and 382 patients benefited from a retroactive MR. Of these, 2.12 unintentional discrepancies were detected per patient, the omission accounts for 70.9% of the discrepancies. A proportion of 39.13% of patients on oral anticoagulants were reconciled on discharge. Discrepancies are found in 10 patients: that represents 36.11% of patients. Similarly, 46.67% of patients on antibiotics are reconciled on discharge. Discrepancies are found in 3 patients: 21.43% of patients have medication errors. The relevance of this work is demonstrated by the significant number of discrepancies found during the MR. This experience at Libourne hospital center is encouraging, but improvements are needed on hospital discharge, in particular better coordination with the physicians team. Pharmacists wish to strengthen this activity within the surgery department, and see the development in other departments.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-02970010
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  • HAL Id : dumas-02970010, version 1

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Chloé Biasolo. Présence pharmaceutique et mise en place d'activités de pharmacie clinique dans un service de chirurgie orthopédique. Sciences du Vivant [q-bio]. 2020. ⟨dumas-02970010⟩

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