With the ANPD Virtual Symposium just around the corner, Deborah Goodlett, MSN, RN, and her co-presenters are preparing for their on-demand session, where they will discuss how their team developed and implemented a pharmacy-nursing alliance to improve outcomes in patient experience and nurse satisfaction by leveraging interprofessional collaboration.

Program Overview

Health care organizations must find creative staffing models allowing nurses to care for more patients while working at the top of their licenses in response to the nursing shortage. According to the World Health Organization (WHO), nine million more nurses and midwives will be needed by 2030 to care for patients (WHO, 2022). At Ochsner Health, we believe there are extensive opportunities to revamp existing clinical care models on medical-surgical and telemetry in-patent units in order to care for more patients, decrease nurse burnout, and improve nurse retention.

Through a time and motion study, we found that nurses spent nearly 27% of a 12-hour shift in medication administration. On reviewing this data, pharmacist leaders, nurse leaders, and nursing professional development (NPD) practitioners then collaborated to create an interdisciplinary care model using a medication administration pharmacist. Our focus of the pilot was to remove most medication-related tasks from the nurses to expand nurse assignments and allow nurses to perform at the top of their license.

We selected a hybrid approach to onboard the pharmacists selected for the program. Pharmacists are the experts on medication management and medication education, but we realized they had to be comfortable caring for patients at the bedside. Our nurses and pharmacists had to work as a team and build trust for the pilot to be successful. In addition, communication between the care team on the patient’s clinical status and medications was critical.

We used both bedside registered nurse (RN) preceptors and NPD practitioners to onboard the pharmacists. Our bedside preceptors validated competencies of modes of medication administration, vital signs, blood glucose monitoring, and IV smart pump management. Our NPD practitioners developed simulation training consisting of bedside emergencies, IV therapy, and enteral medication management, with debriefing sessions. The use of simulation training was effective in increasing the confidence level of the newly hired pharmacists.

Highlights for Session Attendees

Nurses, NPD practitioners, pharmacists, and leaders will identify strategies we used from viewing our session on the Pharmacy-Nursing Collaborative Care Model. Since most hospitals are experiencing staffing challenges with the current nursing shortage, a pharmacy-nursing collaborative could be explored at your facility. Executive leaders may be interested to learn how our facilities reduced external agency in four of our inpatient units once assignments were expanded after reducing medication administration functions for nurses. Nurses participating in the pilot provided overwhelming support of the model and requested having an expanded assignment with a pharmacist over fewer patents without a pharmacist. NPD practitioners are change agents and collaborated with health care leaders to find innovative staffing models in response to nursing shortages. NPD practitioners created a supportive environment for quality improvement and were vital to planning, implementing, and evaluating the model.

Learners will be able to discuss how pharmacists were included within the patient care model to provide medication administration and education. The audience will identify the positive impact on the quality of care related to medication administration, nurse satisfaction, patient satisfaction, and fiscal impact from this innovative model. NPD practitioners will identify competencies required for the new care model. Learners will self-reflect on their current staffing model and consider the Pharmacy-Nursing Collaborative Model in their areas of practice.

References:

• Nursing and midwifery. Accessed September 5, 2022. www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery
• Andrews, L. B., & Barta, L. (2020). Simulation as a tool to illustrate clinical pharmacology concepts to healthcare program learners. Current Pharmacology Reports, 6(4), 182-191. doi: 10.1007/s40495-020-00221