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Table 2 Perception of pharmacists and managers regarding the implementation of Clinical Pharmacy services in a high-complexity public hospital. Categories of “Perception of the current situation”, “Expectations of clinical pharmacy implementation”, “Barriers to the implementation” and “Facilitators for the implementation”. Aracaju, 2016

From: Perceptions of a group of hospital pharmacists and other professionals of the implementation of clinical pharmacy at a high complexity public hospital in Brazil

Category Registration Unit
Perception of the current situation Pharmacists Managers
  Profession in Brazil does not renovate / it is outdated
Dissatisfaction with work
Exclusively distributive assignments
Job satisfaction when there is interprofessional collaboration
Incipient pharmaceutical education in the clinical area
Hospital without work process focused on patient safety
There is no record of clinical interventions carried out by the pharmacists
Lack of support from pharmacy teams to clinical services
Fragmented view of the medical staff on patients
Lack of clinical pharmacy services in the hospital
Some pharmacists of the team prefer distributive assignments
Management support to activities related to patient safety
Expectations Pharmacists Managers
  Professional practice focusing on clinical services
Researchers’ support and guidance
Positive impact of the services for patients and healthcare team
Services sustainability
The new services will make pharmacists more visible for directors
Improvement in the medication use process
Positive impact for patients
Reducing costs and damage caused by misuse of drugs
Improvement of the communication process among the healthcare team
Appreciation of pharmacist’s clinical performance at the hospital
Pharmacist’s qualification
Recruitment of new pharmacists
Barriers Pharmacists Managers
Subcategory
External factors
Failures of the public health system in Brazil
Resistance of some healthcare professionals to clinical pharmacy services
Lack of proactive attitude and collaboration among pharmacists
Changes in the hospital board of directors may hinder the process of Clinical Pharmacy implementation
Unawareness of pharmacists’ clinical activities by healthcare team and managers
Resistance of some healthcare professionals to clinical pharmacy services
Structure and organization Insufficient pharmacists to distributive and clinical tasks
Lack of adequate working facilities to develop clinical pharmacy
Drug shortage in the hospital
Manager pressure on pharmaceutical distributive tasks
Poor workforce management
Lack of standardization of pharmaceutical work process
Insufficient number of pharmacists and pharmacy assistants to assist the hospital’s patients
Pharmacists have to deal with clinical and distributive tasks
High rotation of physicians in the hospital
Lack of standardization of distributive activities
Lack of standardization of pharmaceutical work process
Lack of integration (collaborative practices) in the healthcare team work processes
Barriers Pharmacists Managers
Subcategory
Structure and organization
Lack of training of pharmacy assistants on distributive assignments
Lack of experience and training of pharmacists on clinical practice
 
Attitudes of pharmacists and relationship with healthcare team Pharmacist’s insecurity by poor qualification and experience on clinical practice
Lack of pharmacist autonomy at work
Difficulties in interacting with the healthcare team
Unawareness of pharmacists’ clinical activities by healthcare team and managers
Uncertainty regarding the sustainability of Clinical Pharmacy services
Absence of communication with the healthcare team
Facilitators Pharmacists Managers
Subcategory
Structure and organization
Lack of training of pharmacy assistants on distributive assignments
Lack of experience and training of pharmacists on clinical practice
 
  Part of the pharmacist’s team has experience in Clinical Pharmacy
Prior knowledge of other healthcare professionals on clinical pharmacy services
Support of medical residents
Existence of a Drug Information Service at the hospital
Part of the pharmacists’ team has clinical experience
Interest of the majority of pharmacists to provide clinical services
Good relationship between pharmacists and some healthcare professionals
Management support to activities related to patient safety program
Support of pharmaceutical and medical residents
Organization of the healthcare team work processes
Support of healthcare team, managers and pharmacy team
Training of pharmacists and pharmacy assistants for clinical practice
Adequacy of the physical structure for service
Pharmacist participation in the multidisciplinary activities of the hospital
Registration of clinical and economic impacts of the Clinical Pharmacy services