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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Profession in Brazil does not renovate / it is outdated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