ASSESSMENT OF PHARMACY STUDENTS’ KNOWLEDGE OF HANDLING HIGH ALERT MEDICATIONS

Öz

Objective: High alert medications (HAM) are medications commonly used in health care settings that are associated with significant harm when used in error. Improvement in the knowledge and practice of pharmacists is crucial to prevent and solve medication errors associated with HAM. This study aimed to assess the knowledge of pharmacy students about HAM. Material and Method: A cross-sectional study was conducted among pharmacy students (3rd, 4th and 5th-year students) through an online survey in Ankara, Türkiye between 1 May 2021 and 31 October 2021. A Turkish translated and validated version of the High Alert Medications Knowledge Questionnaire was used. Only a correct answer was given score of 1 among the knowledge questions. The common resources for HAM use in the practice were assessed. Result and Discussion: Among 124 students, 80.6% were female. The mean age (standard derivation ± SD) of the students was 23.3 ± 1.37 years. The percentages of the 3rd, 4th and 5th-year students were 51.6%, 16.1% and 32.3%, respectively. The mean ± SD score of the students was 6.8 ± 3.28 out of 20. The 5th-year students (8.00 ± 2.90) were more likely to get higher scores compared to 3rd-years (5.89 ± 3.15) (p = 0.003). RxMediaPharma® (local online drug information database) was the most (75.0%) commonly used resource by pharmacy students. The pharmacy students’ knowledge about HAM was poor. Educational interventions are necessary early in the clinical pharmacy curriculum to improve pharmacy students' knowledge and preparedness to handle HAM.

Anahtar Kelimeler

• High alert medication
• clinical pharmacy education
• knowledge
• questionnaire

ECZACILIK ÖĞRENCİLERİNİN YÜKSEK RİSKLİ İLAÇLARIN KULLANIMI HAKKINDA BİLGİSİNİN DEĞERLENDİRİLMESİ

Öz

Amaç: Yüksek riskli ilaçlar (HAM), sağlık hizmeti sunulan ortamlarında yaygın olarak kullanılan ve yanlışlıkla kullanıldığında önemli zararlarla ilişkilendirilen ilaçlardır. Eczacıların bilgi ve uygulamalarındaki gelişme, HAM ile ilişkili ilaç hatalarını önlemek ve çözmek için çok önemlidir. Bu çalışma, eczacılık öğrencilerinin HAM hakkındaki bilgilerini değerlendirmeyi amaçlamıştır. Gereç ve Yöntem: Eczacılık öğrencileri (3., 4. ve 5. sınıf öğrencileri) arasında çevrimiçi anket yoluyla kesitsel bir çalışma Ankara, Türkiye’de yapılmıştır. Türkçe validasyonu yapılan Yüksek Riskli İlaçlar Hakkında Bilgi Anketi kullanılmıştır. Bilgi sorularından sadece doğru cevaba 1 puan verildi. Uygulamaları sırasında HAM kullanımı için kullandıkları yaygın kaynaklar değerlendirildi. Sonuç ve Tartışma: Ankete katılan 124 öğrencinin %80.6’sı kızdır. Öğrencilerin yaş ortalaması [standart sapma (SSD)] 23.3 ± 1.37 olarak bulunumuştur. Eczacılık 3., 4. ve 5. sınıf öğrencilerinin oranı sırasıyla %51.6, %16.1 ve %32.3’tür. Öğrencilerin ortalama ± SD puanı 20 üzerinden 6.8 ± 3.28’dir. 5. sınıf öğrencilerinin (8.00 ± 2.90) 3. sınıf öğrencilerine göre (5.89 ± 3.15) daha yüksek puan alma olasılığı daha fazla bulunumuştur (p = 0.003). RxMediaPharma® (yerel çevrimiçi ilaç bilgi veritabanı), eczacılık öğrencileri tarafından en çok (%75,0) kullanılan kaynaktı. Eczacılık öğrencilerinin HAM hakkındaki bilgileri yeterli bulunamamıştır. Eczacılık öğrencilerinin HAM’ı yönetme konusundaki bilgilerini ve hazırlıklarını geliştirmek için klinik eczacılık müfredatının başlarında eğitimsel müdahaleler gereklidir.

Anahtar Kelimeler

• Anket
• bilgi
• klinik eczacılık eğitimi
• yüksek riskli ilaçlar

Kaynakça

1. 1. Food and Drug Administration, US. Working to Reduce Medication Errors, 2019. Available from: https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reduce-medication-errors. Access date: 15 Feb 2022.
2. 2. World Health Organisation. Patient Safety, 2019. Available from: https://www.who.int/news-room/fact-sheets/detail/patient-safety. Access date: 15 Feb 2022.
3. 3. Lu, M.C., Yu, S., Chen, I.J., Wang, K.W., Wu, H.F., Tang, F.I. (2013). Nurses’ knowledge of high-alert medications: a randomized controlled trial. Nurse Education Today, 33(1), 24-30. [CrossRef]
4. 4. Cohen M.R. Medication Errors, 2nd ed. American Pharmaceutical Association, Washington, DC, 2007.
5. 5. Engels, M.J., Ciarkowski, S.L. (2015). Nursing, pharmacy, and prescriber knowledge and perceptions of high-alert medications in a large, academic medical hospital. Hospital Pharmacy, 50(4), 287-295. [CrossRef]
6. 6. World Health Organisation. Medication Without Harm, 2017. Available from: https://www.who.int/initiatives/medication-without-harm. Access date: 15 Feb 2022.
7. 7. Sullivan, K.M., Le, P.L., Ditoro, M.J., Andree, J.T., Charest, D.J., Tuiskula, K.A. (2021). Enhancing high alert medication knowledge among pharmacy, nursing, and medical staff. Journal of Patient Safety, 17(4), 311-315. [CrossRef]
8. 8. Graham, S., Clopp, M.P., Kostek, N.E., Crawford, B. (2008). Implementation of a high-alert medication program. The Permanente Journal, 12(2), 15-22. [CrossRef]

9. 9. Brown, J.N., Britnell, S.R., Stivers, A.P., Cruz, J.L. (2017). Medication safety in clinical trials: Role of the pharmacist in optimizing practice, collaboration, and education to reduce errors. The Yale Journal of Biology and Medicine, 90(1), 125-133.
10. 10. Hsaio, G.Y., Chen, I.J., Yu, S., Wei, I.L., Fang, Y.Y., Tang, F.I. (2010). Nurses' knowledge of high-alert medications: Instrument development and validation. Journal of Advanced Nursing, 66(1), 177-190. [CrossRef]
11. 11. Ozturk, F., Ozkan, O., Torun, B., Bektay, B., Sancar, M., Okuyan, B. (2022). Reliability of high alert medications knowledge questionnaire in Turkish healthcare professionals. Bezmialem Science, 10(1), 15-21.
12. 12. Jaam, M., Naseralallah, L.M., Hussain, T.A., Pawluk, S.A. (2021). Pharmacist-led educational interventions provided to healthcare providers to reduce medication errors: A systematic review and meta-analysis. PloS One, 16(6), e0253588. [CrossRef]
13. 13. Cleary-Holdforth, J., Leufer, T. (2013). The strategic role of education in the prevention of medication errors in nursing: part 2. Nurse Education in Practice, 13(3), 217-220. [CrossRef]
14. 14. Irajpour, A., Farzi, S., Saghaei, M., Ravaghi, H. (2019). Effect of interprofessional education of medication safety program on the medication error of physicians and nurses in the intensive care units. Journal of Education and Health Promotion, 8, 196. [CrossRef]
15. 15. Accreditation Council for Pharmacy Education. Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree, 2011. Available from: https://www.acpe-accredit.org/pdf/S2007Guidelines2.0_ChangesIdentifiedInRed.pdf. Access date: 15 Feb 2022.
16. 16. Gilligan, A.M., Myers, J., Nash, J.D., Lavigne, J.E., Moczygemba, L.R., Plake, K.S., Quiñones-Boex, A. C., Holdford, D., West-Strum, D., Warholak, T.L. (2012). Educating pharmacy students to improve quality (EPIQ) in colleges and schools of pharmacy. American Journal of Pharmaceutical Education, 76(6), 109. [CrossRef]
17. 17. International Pharmaceutical Federation (FIP). Patient safety. Pharmacists’ role in medication without harm. The Hague: International Pharmaceutical Federation (FIP); 2020.
18. 18. Panakkal, L.M., Sam, B.S., Thomas, A.R., Latheef K.V. F., Saheed, F., Karattuthodi, M.S. (2022). The clinical pharmacist governed periodic monitoring of high alert medications in a tertiary care hospital: A drug utilization evaluation study. Le Pharmacien Clinicien, 57(2), 145-155. [CrossRef]
19. 19. Engels, M.J., Ciarkowski, S.L. (2015). Nursing, pharmacy, and prescriber knowledge and perceptions of high-alert medications in a large, academic medical hospital. Hospital Pharmacy, 50(4), 287-300. [CrossRef]
20. 20. Mansur, J.M. (2016). Medication safety systems and the important role of pharmacists. Drugs Aging 33, 213-221. [CrossRef]
21. 21. ASHP Statement on the Role of the Medication Safety Leader. Available from: https://www.ashp.org/-/media/assets/policy-guidelines/docs/statements/role-of-medication-safety-leader.ashx. Access date: 18 Apr 2023.