The implementation of a Technician Enhanced Administration of Medications [TEAM] model: An evaluative study of impact on working practices in a children's hospital

LOUISE COPE, AXEL KAEHNE, Sergio Silverio, Louise Bracken, Jennifer Bellis, Matthew Peak

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Abstract

Background: Children are frequently prescribed unlicensed and off-label medicines meaning dosing and administration
of medicines to children is often based on poor quality guidance. In UK hospitals, nursing staff are
often responsible for administering medications. Medication Errors [MEs] are problematic for health services,
though are poorly reported and therefore difficult to quantify with confidence. In the UK, children's medicines
require administration by at least two members of ward staff, known as a ‘second check’ system, thought to
reduce Medication Administration Errors [MAEs].
Objectives: To assess the impact on working practices of the introduction of a new way of working, using
Technician Enhanced Administration of Medications [TEAM] on two specialist wards within a children's’ hospital.
To evidence any potential impact of a TEAM ward-based pharmacy technician [PhT] on the reporting of
MEs.
Methods: A TEAM PhT was employed on two wards within the children's hospital and trained in medicines
administration. Firstly, an observational pre-and-post cohort design was used to identify the effect of TEAM on
MEs. We analysed the hospital's official reporting system for incidents and ‘near misses’, as well as the personal
incident log of the TEAM PhT. Secondly, after implementation, we interviewed staff about their perceptions of
TEAM and its impact on working practices.
Results: We affirm MEs are considerably under-reported in hospital settings, but TEAM PhTs can readily identify
them. Further, placing TEAM PhTs on wards may create opportunities for inter-professional knowledge exchange
and increase nurses’ awareness of potential MAEs, although this requires facilitation.
Conclusions: TEAM PhT roles may be beneficial for pharmacy technicians’ motivation, job satisfaction, and
career development. Hospitals will need to consider the balance between resources invested in TEAM PhTs and
the level of impact on reporting MEs. Health economic analyses could provide evidence to fully endorse integration
of TEAM PhTs for all hospital settings.
Original languageEnglish
JournalResearch in Social and Administrative Pharmacy
Early online date6 Feb 2020
DOIs
Publication statusE-pub ahead of print - 6 Feb 2020

Keywords

  • Children's medicines
  • Hospital pharmacy
  • Medication administration errors
  • Medication errors
  • Paediatric medicines
  • Pharmacy technician

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