Khawla Abu Hammour

Effect of educational intervention on healthcare providers knowledge and perception towards pharmacovigilance: A tertiary teaching hospital experience

Objective Based on the theory on planned behavior, perception or attitude is found to be a well-established predictor of healthcare providers’ intentions to perform different behaviors. Also, improving knowledge was proposed to affect their practice as well. In Jordan, many studies have been conducted to evaluate healthcare providers’ knowledge and perception towards pharmacovigilance but no intervention or training was provided. Thus, the aim of this study was to evaluate the impact of an educational workshop on the knowledge and perception of healthcare providers towards pharmacovigilance in a Jordanian tertiary teaching hospital. Methods An interventional study conducted in Jordan University Hospital on various healthcare providers to assess their pre- and post-knowledge and perception towards pharmacovigilance and adverse drug reactions (ADRs) reporting via questionnaire before and after an educational workshop. Results Among the 200 invited healthcare providers, 150 attended the educational workshop (response rate 75.0%). Pre-workshop, healthcare providers showed an overall low knowledge score (7.8/19), where only 8.7% could define pharmacovigilance correctly. On the other hand, they showed a favorable perception score (33.6/39). Following educational workshop, knowledge scores significantly improved by 67.9% (P-value <0.05). A similar finding was obtained for perception scores, where perception scores significantly improved by 10.1% following workshop (P-value <0.05). Conclusion Continuous efforts are needed to implement different strategies including education modules and the provision of appropriate training programs to increase awareness and improve perception towards pharmacovigilance among healthcare providers. Future study is needed to evaluate the impact of improving knowledge and perception on ADRs reporting practice.

Noncompliance with surgical antimicrobial prophylaxis guidelines: A Jordanian experience in cesarean deliveries.

HighlightsCompliance with antibiotic prophylaxis guidelines prior cesareans was evaluated.Overall compliance and compliance with the duration of prophylaxis were poor.Compliance with indication and choice of antibiotic was high.Emergent cesareans reduced noncompliance risk with dose/time of administration.Emergent operations increased the risk of prolonging prophylaxis following surgery. Background: Surgical site infections are common, especially in developing countries. Nevertheless, up to 60% of surgical site infections can be prevented with appropriate perioperative care, which includes among other measures using suitable surgical antimicrobial prophylaxis (SAP). Methods: After a short interview with patients and retrospective review of medical charts, compliance with 6 SAP parameters was assessed for appropriateness; those parameters are indication, choice, dose, time of administration, intraoperative redosing interval, and duration of prophylaxis in 1,173 operations. Results: Overall compliance was poor; nevertheless, certain components showed high compliance rates, such as indication and choice of antibiotics. The most frequent error noted was extended administration of prophylactic antibiotics, which was observed in 88.2% of the study population. Emergency operations were associated with a lower risk of noncompliance in administering the correct dose at the correct time (odds ratio, 0.63; 95% confidence interval, 0.47‐0.83 and odds ratio, 0.21; 95% confidence interval, 0.14‐0.3, respectively). On the other hand, women who underwent an emergency operation were associated with a 6‐fold higher risk of receiving prophylactic therapy following surgery. Conclusions: The present study demonstrated the existence of a surprisingly low level of overall compliance with the hospital‐adapted SAP guidelines. Factors implicated in noncompliance were investigated, and the present results create a starting point to improve the current practice.

Drive-thru pharmacy service: Assessments of awareness, perception and barriers among pharmacists in Jordan

Objective Drive-thru pharmacy services have become widely recognized service worldwide. Despite its proven success, there were doubts in its ability to maintain safe practice. Thus, the aim of the current study was to investigate the awareness, perception and barriers of drive-thru pharmacy services among pharmacists in Jordan. Methods A cross-sectional study was conducted in Amman-Jordan between February-May 2017. During the study period, 226 pharmacists were approached. Pharmacists were interviewed to assess their perception toward drive-thru services, and to assess their opinions regarding the advantages and disadvantages of this system using validated questionnaire. Results Although the majority of pharmacists reported that they were aware about the concept of drive-thru pharmacy service (n = 194, 85.5%), but only 27.9% (n = 63) reported that they are willing to register with this service. The most important advantage of drive-thru pharmacy service was serving sick patients, elderly, disabled people or women with child in the car (n = 166, 88.0%). Most of pharmacists agreed that drive-thru pharmacy service may negatively affect the image of pharmacy profession (n = 168, 74.6%), and it makes pharmacists feel more like a fast food worker than a pharmacist (n = 147, 65.9%). Pharmacists working in chain community pharmacies showed better perception to drive-thru pharmacy service compared to pharmacists who are working in independent community pharmacies (p-value = 0.004). Conclusion Most of the study pharmacists showed relatively poor perception toward drive-thru pharmacy service and were unwilling to use this service. More effort is needed to better introduce the concept of drive-thru pharmacy service among pharmacists in Jordan since the benefit of this service is well established across the world.

Impact of pharmacist's directed medication reconciliation on reducing medication discrepancies during transition of care in hospital setting

To evaluate the effect of pharmacists directed services (reconciliation plus counselling) on reducing medication discrepancies and improving patients outcomes at discharge from hospital.

Surgical site infections following caesarean operations at a Jordanian teaching hospital: Frequency and implicated factors

Surgical site infections (SSIs) following caesarean surgeries are common. The present study aimed to evaluate the frequency of SSIs following caesareans at Jordan University Hospital during the 30 postoperative days and to identify factors associated with increased SSIs risk. Data regarding the occurrence of SSIs were collected both prospectively via follow-up phone calls and retrospectively via reviewing wound culture results and clinical notes. SSI cases were subsequently determined utilizing predefined criteria. Data relating to possible risk factors of SSIs were collected from patient interviews and hospital records. Risk factors for SSIs were identified via logistic regression. A high rate of SSIs (14.4%) was detected; implicated factors included body mass index ≥36 kg/m2 prior to pregnancy odds ratio (OR) 3.8, 95% confidence interval (95% CI) 1.6–9.4, hospital stay longer than 3.5 days OR 2.3, 95% CI 1.4-3.6, having the operation at a gestational age greater than 40 weeks OR 2.2, 95% CI 1.3-3.9. Receiving a higher weight-adjusted dose of the prophylactic antibiotic cefazolin was associated with lower SSIs risk OR 0.967, 95% CI 0.94-0.99.In conclusion, a high rate of SSIs following caesareans was detected, and modifiable risk factors of SSIs should be incorporated into targeted policies aiming to reduce the rate of SSIs.

Medication Errors in Voluntary Reported Incidents at a Jordanian Hospital = الأخطاء الدوائية في الحوادث الطوعية في مستشفى أردني

Medication incident reports may help organizations to prevent medication errors and to improve patient outcomes. Aims: To assess the prevalence, origin, type, and severity of reported medication incidents at Jordan University Hospital, utilizing a voluntary non-punitive reporting system. Materials and Methods: The present study is of a retrospective design. All voluntary non-punitive incident reports that occurred between January 2014 to March 2015 at Jordan University Hospital were retrieved from the quality department of the hospital. Detailed content analysis was conducted to obtain all relevant information. Data were coded anonymously and analyzed using SPSS version 20. Results: There was an increase in reporting of medication errors overtime and almost all of the reporters were nurses. A total of 58 medication error reports including 86 medications were related to errors in medication management process starting from prescribing, dispensing to administration of medications. Two-thirds of those reports originated from the internal medicine department and the neonatal intensive care unit. The most common drug classes associated with those reports were anti-infectives, antivirals, antifungals, cardiovascular medications and chemotherapy agents. The majority of errors occurred during the administration phase where missed doses and wrong time accounted for more than 52% of the reported incidents. Around 98.8% of reported incidents did not cause major harm to patients. Conclusion: Results of this study showed low percent of a broad variety of medication errors in multiple hospital departments. Additional research is required to identify possible improvements to optimize reporting and to enhance the response to each report.