Does a high workload decrease ward pharmacists' clinical monitoring?

Abstract

Abstract In Britain prescriptions are written on proforma charts kept by the patient's bed. Pharmacists generally visit wards daily to initiate supply of drugs and monitor prescription charts. We wished to compare this service across all acute hospitals in a British regional health authority. Pharmacists (n=210) at 31 hospitals monitored 10,337 beds in 489 wards. The median beds/pharmacist ratio was 57 (first quartile 33, third quartile 68). The median time to check 100 prescription charts was 2 hours 49 minutes (first quartile 2 hours 21 minutes, third quartile 3 hours 27 minutes) and related to the ward specialty (Spearman's rs=0.78, P=0.013). Analysis of the 19 district general hospitals showed a positive correlation between time to monitor 100 beds and prescription monitoring incidents (PMIs)/100 beds/week (P=0.002) and a negative correlation between beds/pharmacist and PMIs/100 beds/week (P=0.003). Increasing a ward pharmacist's workload may lead to a decrease in their monitoring of appropriate prescribing. It is suggested that these measures may have some value as indicators of workload, clinical effectiveness and efficiency.