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Article
Objective assessment tool of pharmacist skills

Journal: Muthanna Medical Journal مجلة المثنى الطبية ISSN: 2226146x Year: 2015 Volume: 2 Issue: 1 Pages: 39-45
Publisher: Al-Muthanna University جامعة المثنى

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Abstract

The objective of this study is to assess the pharmacist skills and focus on the certain important defects in pharmacist work up and possible causes for these defects and suitable resolution ways. A cross sectional study was involved fourteen pharmacists in two government hospitals in al-Muthana, Iraq. Ten pharmacist in hospital A and Four in hospital B and include collection of data over one week of April 2015. In this study we concentrate on following vital activities (VA.s) with high importance in production of sufficient health services: pharmacist daily tour with the specialist doctors and active participation in patient's management; observation of patient's records including prescribed treatment; with determination of any mistake e.g. (doses, interactions, presence of contraindications or cautions); regulation of drugs administration in proper way; helping of specialist doctors to find suitable substitution for unavailable drug; presentation or attending at the scientific lectures about medical treatments and new sorts of drugs. The assessment of these Vital activities (VAs) is presented as value from hundred percent. Regarding the hospitals A and B the study show poor (< 50 %) average results of the pharmacists five vital activities, that was mentioned in the methods above. There is significant defect in the pharmacist’s performance that is multifactorial in origin and assessment activities should be sequenced throughout effective program to produce most applicable resolutions


Article
Role of the Clinical Pharmacist in Reducing Preventable Adverse Drug Events

Author: Bahir A.Mshiemish
Journal: Iraqi Journal of Pharmaceutical Sciences المجلة العراقية للعلوم الصيدلانية ISSN: 16833597 Year: 2011 Volume: 20 Issue: 2 Pages: 85-90
Publisher: Baghdad University جامعة بغداد

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Abstract

According to so many previous studies, lack of sufficient information during prescribing steps may lead to medication errors. Thus, the presence of the clinical pharmacist during routine rounding process in the ward with intervention of patient care plan may reduce the probability of adverse drug events (ADEs).This study evaluate role of the clinical pharmacists, as a member of medical team with the physician, on ADEs and report their interventions in the internal medicine unit. This study was designed to compare between two groups of patients, those receiving care from a rounding team (physician, nurse, and clinical pharmacist) (study or intervention group with 51 patient); and those receiving care from a rounding team (physician and nurse, but without any pharmacist) (control group with 49 patient). The primary outcome measure was preventable ADEs and secondary one involves the time of staying in the hospital and onset of response to therapy. Patients were randomly selected, followed a single-blind design, and evaluated by a senior physicians and clinical pharmacists who document their medical interventions.Specialist physicians accepted (60) of (77) recommendations (i.e. do modifications in drug therapy depending on clinical pharmacist interventions). The most common intervention was recommending dosage or frequency of medication (32.4%), followed by addition of medication (19.5%).The rate of preventable ordering ADEs in the study unit was 77% lower than in the control unit (P<0.05). There was no significant difference (p>0.05) in the cost of drug therapy between patient groups. Patients with ADEs in the control group had an average of 1.5 day longer staying period at the hospital; which was not differ significantly (p>0.05) from the study group.In summary, presence of clinical pharmacist during tour as a full member of the patient care team in internal medicine ward was associated with a substantially lowered rate of ADEs which caused by prescribing errors. Types of errors indicate the need for activation of the clinical pharmacist's interventions.

وفقا لدراسات سابقة فان افتقار المعلومات الدوائیة اثناء عملیة الوصف الدوائي یسبب الوقوع في اخطاء طبیة, لذلك فانتواجد الصیدلاني السریري اثناء الجولة المعتادة للفریق الطبي قد یساھم في التقلیل من احتمالیة وقوع مثل ھذه الاخطاء والمتمثلةبالتاثیرات الجانبیة للدواء. كان الھدف من ھذه الدراسة تقییم دور الصیدلاني السریري في مساعدة الفریق الطبي للتقلیل من التاثیراتالدوائیة الممكن تجنبھا وتسجیل ھذه التداخلات الصیدلانیة في ردھات الباطنیة .صممت ھذه الدراسة لمقارنة دور الصیدلاني السریريفي التاثیرعلى علاج مرضى ردھات الباطنیة(مجموعة التداخل , 51 مریض) مع اولئك الذین لم یكن للصیدلاني السریري دور فيتغییر ادویتھم الموصوفة من قبل الطبیب(مجموعة السیطرة , 49 مریض) .كان المعیار الاساسي في ھذه الدراسة ھو معدل حصولالتاثیرات الدوائیة والممكن تجنبھا , اما المعیار الثانوي فكان الفترة الزمنیة لمكوث المریض في الردھة ومدى الاستجابة للعلاجالموصوف. تم اختیار المرضى عشوائیا وقیمت حالتھم المرضیة من قبل اطباء باطنیة اختصاص وتم تسجیل التداخلات الدوائیة التياوصى بھا الصیادلة السریریون .بینت النتائج انخفاض في احتمالیة حصول التاثیرات الدوائیة الممكن تجنبھا بنسبة 77 % وتم تسجیل(% 77 ) تداخل صیدلاني قبل منھا ( 60 ) من قبل الفریق الطبي وكان اكثر ھذه التداخلات مرتبط بتغییر الجرع الدوائیة ( 32.4 )واضافة ادویة لم تكن موصوفة مسبقا ( 19.5 %). لم یكن ھنالك فرق معنوي في الكلفة العلاجیة بین الردھتین ,اما الفترة الزمنیةلمكوث مرضى مجموعة السیطرة في ردھة الباطنیة فكانت اطول وبمعدل یوم ونصف. في ضوء ھذه النتائج یمكننا تاكید الدور الفاعلللصیدلاني السریري في مساعدة الكادر الطبي لاتخاذ القرارات المتعلقة بالادویة الموصوفة والتقلیل من مضاعفاتھا المستقبلیةواضرارھا الجانبیة.


Article
Medical Mistakes Amongst the Negligence of Both Physician’s Diagnosis and the pharmacist’s Prescription Comparative study in Jurisprudence and Iraqi law
الأخطاء الطبية بين إهمال الطبيب في التشخيص والصيدلي في صرف الدواء دراسة مقارنة في الفقه والقانون العراقي

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Abstract

The research discusses the problem of medical mistakes amongst the negligence of the physician’s diagnosis and pharmacist’s prescription. As it follows up closely the responsibility arisen from such mistakes in terms of law and jurisprudence and detects the responsible person by means of determining the cases of mistakes’ incidence and the causes such as negligence. Consequently, there will be a liability of compensation upon the person who is in charge. In addition to indicate the aspects of responsibility such as the eligibility of the pharmacist or the physician including a study that involves the discussion over various opinions according to law and jurisprudence. Research Key:Medical mistake is a mistake that occurs throughout the practice of medical professions due to the lack of experience or efficiency of the physician or of his co-workers as a result of exercising modern methods of treatment, an emergency which requires speed at the expense of accuracy or due to the nature of a complex treatment.

إن البحث يناقش المشكلة الأخطاء الطبية بين إهمال الطبيب في التشخيص والصيدلي في صرف الدواء ليتابع بدقة ومن ناحية قانونية وفقهية المسؤولية المترتبة عن الأخطاء الطبية ومن المسؤول عنها من خلال تشخيص حالات حدوث الخطأ وأسباب حدوثه كالإهمال الذي قد يقع فتترتب على اثره مسؤولية توجب التعويض وبيان حالات التي توجب المسؤولية والمتعلقة بالقائم بالفعل كالأهلية للصيدلي أو الطبيب بدراسة تشمل طرح ومناقشة الآراء الفقه قانوناً وفقهاً.مفتاح البحث :الخطأ الطبي هو خطأ يحدث في مجال ممارسة المهن الطبية نتيجة لانعدام الخبرة والكفاءة من قبل الطبيب الممارس أو الفئات المساعدة أو نتيجة ممارسة عملية أو طرق حديثة وتجريبه في العلاج أو نتيجة لحالة طارئة تتطلب السرعة على حساب الدقة أو نتيجة لطبيعة العلاج المعقد.


Article
Evaluation the Role of Clinical Pharmacist on Prevents or Reduced the Medication Error in Emergency Department
تقويم دور الصيدلي السريري في منع او تقليل الاخطاء الدوائية في قسم الطوارئ

Authors: Rana Bahaa --- May S. Al_Sabagh --- Hassan M. Abbas
Journal: nursing national Iraqi specility المجلة العراقية الوطنية للعلوم التمريضية ISSN: 18122388 Year: 2013 Volume: 26 Issue: 2 Pages: 129-135
Publisher: Baghdad University جامعة بغداد

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Abstract

Objective: To identify the role and importance of the clinical pharmacist in the Emergency Department on prevent or reduced the medication error.Methodology: We collected the medical file of 3400 patients, 1400 patient's file in (A) hospital, and 1000 patient's file in each of (B and C) hospital, who admitted to the ED, at primary weekdays between 8 am to 2 pm, and recorded all the intervention made by clinical pharmacist through an active search in clinical charts, with analysis of the daily medical prescription. The potential severity of harm of the medication error judged by two reviewers, a permanent emergency physician, and clinical pharmacist based on the National Coordinating Council (NCC) of Medication Error Reporting and Prevention error classification system.Results: Four of intervention that have the greatest incidence which represent the majority of the cases, and they were related to: dosage 500 (38.7%), route of administration 300 (23.2%), frequency 100 (7.7%), and incompatibility 120 (9.3%). The severity of medication errors that was judged as potentially life threatening (67; 5.1%), serious (135; 10.4%), significant (634; 49.1%), and insignificant (454; 35.1%). The acceptance to the presence and intervention of pharmacist was as follow: senior physicians 75%, permanent physicians 20%, resident physicians 77%, and nurses 30%.Recommendation: Hospitals should contemplate assigning well-trained knowledgeable, efficient and skilled ED clinical pharmacists to prospectively review medication orders whenever clinically possible. It is also recommended that each hospital performs acquainted analysis of medication errors occurring in its ED, in order to determine their origin and then establish the necessary ED-based clinical pharmacy services. The sets of actions needed to provide such services, as well as the skills, which their ED pharmacists must possess or acquire in order to be capable of producing desired outcomes

المستخلص: الهدف: معرفة دور واهمية الصيدلي السريري في منع او تقليل الاخطاء الدوائية في قسم الطوارئ .المنهجية : قمنا بجمع ملفات 3400 مريض ،1400 ملف في المستشفى (أ) و 1000 ملف في كل من المستشفيات (ب ، ج)، للمرضى الداخلين في قسم الطوارئ خلال ايام الاسبوع من 8 صباحا الى 2 ظهرا، وسجلت جميع التداخلات الصيدلانيه التي اجراها الصيدلي السريري من خلال البحث الدوءوب في ملفات المرضى وتحليل جميع الوصفات الطبيه.احتمالية شدة الضرر الناتج من الخطأ الطبي وقد تم تقييمها من قبل طبيب (مقيم اقدم/طوارئ) وصيدلانيه سريريه بالاعتماد على نظام مجلس التنسيق القومي لتصنيف الاخطاءالدوائية (NCC)العالمي. النتائج: اربعة من التداخلات الصيدلانيه كان لها اكبر معدل حدوث والتي مثلت النسبه الاكبر من الحالات ،والتي كانت متعلقه بما يأتي : لجرعه 500(38%) ،طريقة اعطاء العلاج 300(23.2%)، اوقات اعطاء العلاج 100(7.7%)، عدم تجانس العلاج الوريدي 120 (9.3%). تصنيف شدة هذه الاخطاء وتاثيرها على المريض كانت كالتالي: شديدة الخطوره على الحياة 67 (5%) ،خطيرة 135 (10.4%)،مؤثره 634 (49.1%)،غير مؤثره 454 (35.1%). مدى التقبل لوجود الصيدلي السريري وتداخلاته الصيدلانيه من قبل الكادر الطبي في قسم الطوارئ كان الطبيب الاخصائي 75%، الطبيب المقيم الاقدم 20%، الطبيب الدوري 78%، الكادر التمريضي30%.التوصيات:- على المستشفى التفكيرمليا في تعيين صيادلةسريرين ذوي تدريب جيد،معرفةواسعة،واصحاب مهارات عاليه في قسم الطوارئ لغرض قيامهم بمراجعة مستقبليةلاوامرصرف الدواء متى ماكان ذلك ممكناسريريا. من التوصيات ايضا أنه على كل مستشفى ان تقوم بتحليل ملم بجميع الاخطاء العلاجيةالتي تحدث في قسم الطوارئ لتحديدسببها وبذلك انشاء الخدمات الصيدلانيه الضروريه والاساسية في قسم الطوارئ


Article
Pharmacist Role in Enhancement of Medication Adherence and Clinical Outcomes in Acute Coronary Syndrome Paitents
دور الصيدلاني في تعزيز الالتزام بالأدوية و النتائج السريرية لمرضى متلازمة الشريان التاجي

Authors: Amina M. Jabri آمنة محسن حمزة --- Hayder Ch. Assad حيدر جاسب عصاد
Journal: Al-Mustansiriyah Journal for Pharmaceutical Sciences مجلة المستنصرية للعلوم الصيدلانية ISSN: 18150993 Year: 2019 Volume: 19 Issue: 2 Pages: 67-78
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Patients who experience acute coronary syndrome (ACS) are at high risk of having further events in the future. One month after the attack, the average readmission rate was estimated to be approximately 20%. As a result, patients must receive secondary preven-tion medications to avoid reoccurrenceof these cardiovascular events. To get the entire benefit, patients must adhere to the prescribed regimen. However, many studies demonstrated that patients do not adhere to the prescribed medications upon the long term, and this leads to substantial deterioration of disease and consequently death, as well as significant financial burden. This study has the objective of assessing the impact of pharmacist intervention on increasing patients' adherence to ACS medications.Method: a prospective interventional study was performed from January to October 2018. A total of 70 patients were selected randomly and were divided into those who received the usual care processes offered by pharmacists at discharge, and those who received well-structured clinical pharmacist intervention about the discharge medications and disease. Heart rate (HR), blood pressure (BP) and lipid profile were measured at baseline and after 3 months. Also, patients' level of adherence to the discharge medications was assessed after 3 months. Furthermore, 30-day hospital readmission rate was evaluated.Results: Regarding patients' medication adherence, 63.3% of the patients in intervention group had high level of adherence compared to only 21.1% of controls. After 3 months of follow up significant reduction in mean scores of outcomes were noticed in intervention group compared to control, where HR (73.6 vs. 80), SBP (129.5 vs. 141), DBP (81.2 vs. 87.5). Also serum cholesterol, triglycerides, and LDL were reduced and HDL increased significantly in the intervention group (P <0.05), while no such changes seen in controls. Moreover, no considerable difference was observed in hospital readmission between the intervention and control group.Conclusion: This study showed that pharmacist intervention caused notable enhancement in patient' medication adherence with subsequent improvement of heart rate, blood pressure, and lipid profile, but with no improvement in hospital readmission.


Article
Utilization of the License to Practice Pharmacy (A Comparative Study)
الانتفاع بإجازة مزاولة مهنة الصيدلة - دراسة مقارنة

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Abstract

The profession of pharmacy, which accompanied the profession of medicine is one of the oldest professions practiced by the human. Despite the importance of this profession, some phenomena which were characterized by ambiguity had emerged. And because of the novelty of these contracts, they were not organized by the legislator. Among these phenomena is the permission that the pharmacist grants for another person to benefit of the license to practice his private profession to open a pharmacy and receive the clients using his own name and license. This calls for finding the suitable adaptation for this case because of the existence of a legislative and doctrinal deficiency for treating such cases. It is likely that the absence of the legal organization can be traced to the non- expectancy of the appearance of such contracts. This requires the legislator's and the legal jurisprudent’s intervention to find appropriate solutions by defining the obligations and the responsibilities of the parties to this contract if they violate the legal rules governing the practice of pharmacy profession.

تعد مهنة الصيدلة من أقدم المهن التي امتهنها الإنسان، هذه المهنة التي رافقت مهنة الطب، وعلى الرغم من أهمية هذه المهنة فقد ظهرت بعض الظواهر التي شابها بعض الغموض وبالنظر لحداثة هذه العقود فأنها لم تنظم من قبل المشرع، ومن هذه الظواهر هي قيام الصيدلاني بالسماح لشخص ثانٍ بالانتفاع بإجازة ممارسة المهنة الخاصة به بفتح صيدلية واستقبال الجمهور باسمه وإجازته الخاصة. وهو مما يدعو إلى إيجاد التكييف القانوني المناسب لهذه الحالة وذلك لوجود قصور تشريعي بل وفقهي في معالجة مثل هذه الحالات، ولعل غياب التنظيم القانوني يعود لعدم توقع ظهور مثل هذا النوع من العقود، مما يستدعي المشرع والفقه القانوني لإيجاد الحلول المناسبة من خلال تحديد التزامات أطراف هذا العقد ومسؤوليتهم إذا ما خالفوا القواعد القانونية الخاصة بمزاولة مهنة الصيدلة.

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