중환자 팀 의료 구성원의 니즈 기반 외과계 중환자실 약료서비스 개선 연구
Improvement of the Multidisciplinary Team-based Critical Care Service for Patient in the Surgical Intensive Care Unit: A Qualitative Exploration of Healthcare Professional Needs
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Background : As a member of the multidisciplinary team, the pharmacist can play an essential role in patient care in the intensive care unit (ICU). Although the number of critical care pharmacists has gradually increased and their role has expanded, there continues to be a need for improving the quality of care for critically ill patients. The aim of this study was to evaluate the status of clinical pharmacy practices in the surgical ICU (SICU) and suggest improvements in pharmaceutical care service reflecting the needs of the multidisciplinary team members. Methods : We identified the activities of pharmacists in the SICU and compared them to those previously reported in US hospitals for fundamental, desirable, and optimal activities. Based on these results, in-depth semi-structured interviews were conducted with key stakeholders to evaluate their needs for collaborative team care services improvement. The data from transcribed interviews were analyzed using thematic analysis techniques and the themes were clustered to derive the concept of service. Results : When the pharmacists’activities were compared to those of US hospitals the need for improvements in education, research, and administration were identified. Six physicians, and seven nurses were included in in-depth interviews. Most of them were satisfied with the current service of the pharmacist in the SICU and considered it necessary. However, needs for a better multidisciplinary team care service, including enhancement of pharmacists’participation, improvement of the communication system, etc., were identified. Based on the thematic analysis results, service concepts were developed, which were“ patient-centered collaborative team care”,“ persistent and longitudinal care”, and“ professional and evidence-based care”. Conclusions : An improvement service for critical care patients was derived from this qualitative analysis process. This concept can be used to guide the improvement of the overall quality of patient care in the SICU and to inform healthcare policy decisions.
Abstract
Background : As a member of the multidisciplinary team, the pharmacist can play an essential role in patient care in the intensive care unit (ICU). Although the number of critical care pharmacists has gradually increased and their role has expanded, there continues to be a need for improving the quality of care for critically ill patients. The aim of this study was to evaluate the status of clinical pharmacy practices in the surgical ICU (SICU) and suggest improvements in pharmaceutical care service reflecting the needs of the multidisciplinary team members. Methods : We identified the activities of pharmacists in the SICU and compared them to those previously reported in US hospitals for fundamental, desirable, and optimal activities. Based on these results, in-depth semi-structured interviews were conducted with key stakeholders to evaluate their needs for collaborative team care services improvement. The data from transcribed interviews were analyzed using thematic analysis techniques and the themes were clustered to derive the concept of service. Results : When the pharmacists’activities were compared to those of US hospitals the need for improvements in education, research, and administration were identified. Six physicians, and seven nurses were included in in-depth interviews. Most of them were satisfied with the current service of the pharmacist in the SICU and considered it necessary. However, needs for a better multidisciplinary team care service, including enhancement of pharmacists’participation, improvement of the communication system, etc., were identified. Based on the thematic analysis results, service concepts were developed, which were“ patient-centered collaborative team care”,“ persistent and longitudinal care”, and“ professional and evidence-based care”. Conclusions : An improvement service for critical care patients was derived from this qualitative analysis process. This concept can be used to guide the improvement of the overall quality of patient care in the SICU and to inform healthcare policy decisions.
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