Perspectives on the attributes and characteristics of pharmacy executives.
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Attitude to Health↗
Biomedical subjects
Craig A Pedersen
Publications and source records attributed to Craig A Pedersen.
Evaluation of board certification in nutrition support pharmacy.
BACKGROUND: Credentialing of healthcare professionals is a topic that has received increasing attention. The Board of Pharmaceutical Specialties (BPS) has recognized nutrition support pharmacy as a specialty for more than 10 years. There has recently been concern about the decline in the number of pharmacists seeking board certification or recertification as specialists in nutrition support and changes in the job responsibilities of nutrition support pharmacists. These factors have resulted in a need to evaluate the current system of certification of nutrition support pharmacists. METHODS: A national survey was developed and sent to pharmacist members of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) and members of the Home Care Section of the American Society of Health-System Pharmacists (ASHP). The objectives of this study were to describe the activities of nutrition support pharmacists, determine the benefits and barriers to board certification, and assess the current system of certification. RESULTS: Two hundred and fifty-eight of 486 surveys were returned for an overall response rate of 53%. There has been a decrease in the amount of professional time devoted to nutrition support activities. The most highly ranked benefit to certification was peer recognition. The most highly ranked barrier to certification was the examination cost. CONCLUSIONS: There is satisfaction with the current system; however, alternative methods were supported if the current method cannot sustain itself There is a need to evaluate the cost of the examination and increase marketing efforts to candidates for whom the examination is intended.
Adult↗
Parenteral nutrition safe practices: results of the 2003 American Society for Parenteral and Enteral Nutrition survey.
BACKGROUND: The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) recently published a revision of its "Safe Practices for Parenteral Nutrition" guidelines. Because there is a paucity of published scientific evidence to support good practices related to ordering, compounding, and administering parenteral nutrition (PN), a survey was performed in the process of the revision to gain insight into the discrepancies between reported practices and previous guidelines. METHODS: A web-based survey consisting of 45 questions was conducted (n = 651) June 1-30, 2003. Respondents were queried about primary practice setting, professional background, processes for writing PN orders, computer order entry of PN orders, problems with PN orders, and adverse events related to PN. RESULTS: There were 651 survey responses, 90% of which were from hospital-based practitioners. Almost 75% of responders processed between 0 and 20 PN orders per day. Overall, physicians (78%) were responsible for writing PN orders, but dietitians and pharmacists had significant involvement. PN base components were most often ordered as percentage final concentration after admixture (eg, 20% dextrose), which is inconsistent with safe practice guidelines of ordering by total amount per day (eg, 200 g/day). There was no consistent method for ordering PN electrolytes. Approximately 45% of responders reported adverse events directly related to PN that required intervention. Of these events, 25% caused temporary or permanent harm, and 4.8% resulted in a near-death event or death. CONCLUSIONS: Although the survey found consistency in PN practices for many areas queried, significant variation exists in the manner by which PN is ordered and labeled.
Dietetics↗
Community pharmacists' work activities in the United States during 2000.
OBJECTIVES: To describe community pharmacists' work activities in the United States during 2000 and to investigate the effects of position, pharmacy type, and prescription volume on work activities. DESIGN: Cross-sectional descriptive survey of a systematic sample of 4,895 U.S. pharmacists, of which 2,250 responded. SETTING: United States. PARTICIPANTS: A sample of 832 community pharmacists working full-time (at least 30 hours per week) out of the total of 2,250 who responded to the survey. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Workload (hours worked and proportion of prescriptions dispensed at the site with which the pharmacist was personally involved) and professional responsibilities (proportion of time spent in medication dispensing, consultation, business management, and drug use management). RESULTS: As of 2000, the typical community pharmacist in the United States devoted 56% of his or her time to medication dispensing responsibilities, 19% to consultation responsibilities, 16% to business management responsibilities, and 9% to drug use management responsibilities. These results were consistent for pharmacists regardless of pharmacy type or prescription volume; however, position did significantly affect the proportion of time spent in the various activities. CONCLUSION: Pharmacists are still devoting the majority of their time to medication dispensing responsibilities. However, our findings also show that pharmacists would prefer to devote more of their time to professional responsibilities, such as consultation and drug use management, and less time to medication dispensing and business management.
Adult↗
Pharmacists' opinions regarding level of involvement in emergency preparedness and response.
OBJECTIVE: To assess opinions of pharmacist-members of the American Pharmacists Association Academy of Pharmacy Practice and Management (APhA-APPM) regarding the appropriate level of pharmacists' involvement in emergency preparedness and response activities and to determine whether opinions differed according to demographic characteristics. DESIGN: Cross-sectional, descriptive, Web-based survey. SETTING: United States. PARTICIPANTS: Five hundred eighteen APhA-APPM member-pharmacists. MAIN OUTCOME MEASURES: Responses to survey questions. RESULTS: Respondents to our survey indicated that pharmacists should have a high level of involvement in emergency preparedness and response activities. Traditional pharmacy practice activities (such as medication preparation and dispensing) and patient education were the most highly supported roles for pharmacists. Newer activities such as surveillance, vaccine administration, and mobilization were also strongly supported. Demographic characteristics, such as age, sex, degree, state of residence, practice setting, and employment setting, did not influence respondents' opinions. The only characteristic that influenced pharmacist opinions was previous participation in local and/or state emergency preparedness and response activities. Compared with other respondents, pharmacists who participated in these activities gave higher ratings to these possible roles for pharmacists: surveillance, triage/evaluation, community planning and preparation, mobilization, and training of others. CONCLUSION: Pharmacist-members of APhA-APPM who responded to this survey believe that participating in public health activities related to emergency preparedness and response is important for members of the pharmacy profession.
Attitude of Health Personnel↗
Pharmacists' attitudes toward worklife: results from a national survey of pharmacists.
OBJECTIVES: To provide a current profile of pharmacists' attitudes toward worklife and determine how demographic, family, and practice variables influence work attitudes. DESIGN: Cross-sectional descriptive survey. SETTING: Nationwide sample of licensed pharmacists in the United States. PARTICIPANTS: 1,737 actively practicing pharmacists. INTERVENTIONS: Mailed survey. MAIN OUTCOME MEASURES: Previously validated rating scales were used to measure job satisfaction, job stress, work-home conflict, role overload, role ambiguity, and role conflict. Family variables included the number and age(s) of children and marital status; demographic variables included age, gender, race, years of experience, region, and degree; practice variables included setting, position, work status, and work activities. RESULTS: Although 67.2% of pharmacists were satisfied with their job, more than 68% experienced job stress and role overload, and 48% experienced work-home conflict. The levels of role ambiguity, role conflict, and job stress were significantly higher in chain, mass merchandiser, and hospital settings relative to independent settings. Wanting to spend more time in consultation was most positively associated with role ambiguity, role overload, and role conflict and most negatively associated with job satisfaction. Gender, race, years of experience, marital status, and children also affected work attitudes. CONCLUSION: Those interested in the quality of worklife of pharmacists need to develop and implement realistic methods to decrease the role stress that pharmacists continue to face. Unless role stress of pharmacists is lessened, the profession may be endangering not only the physical and mental health of its current and future practitioners, but possibly compromising patient safety as well.
Adult↗
Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.
OBJECTIVES: To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. DESIGN: Cross-sectional study. SETTING: Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). PARTICIPANTS: Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. INTERVENTION: Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. MAIN OUTCOME MEASURES: Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). RESULTS: Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. CONCLUSION: Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.
Community Pharmacy Services↗
Pharmacist participation in the workforce: 1990, 2000, and 2004.
OBJECTIVE: To examine work variables for licensed pharmacists for 1990, 2000, and 2004. DESIGN: Three cross-sectional, descriptive studies. SETTING: United States. PARTICIPANTS: Licensed pharmacists: 1,623 in 1990; 2,092 in 2000; and 1,564 in 2004. These numbers of usable responses to the three respective surveys represented 54.0%, 42.7%, and 33.8% of those receiving surveys. INTERVENTION: Mailed survey from the 2004 National Pharmacist Workforce Survey; data from the national studies of the pharmacist workforce conducted in 1990 and 2000. MAIN OUTCOME MEASURES: Characteristics of pharmacists; work setting, work position and age distribution of actively practicing pharmacists. Work status of licensed pharmacists; proportion actively practicing pharmacy. Proportion of pharmacists working part-time overall and by age group, weekly hours worked by actively practicing pharmacists, and full-time equivalents (FTEs) by age group. Proportion of pharmacists with secondary pharmacy employment; work setting, hours worked, and weeks worked in secondary pharmacy employment. RESULTS: In each year studied, more than 86% of licensed pharmacists were actively practicing pharmacy. In 2004, the largest proportion of actively practicing women pharmacists was between the ages of 31 and 45, and the largest proportion of actively practicing men pharmacists was between the ages of 46 and 60. Across the survey years, the proportion of all actively practicing pharmacists working part-time increased, and the proportion of women working part-time was at least double that of men except in 2004. In 2004, the FTE contribution for women was 0.81 and 0.91 for men. CONCLUSION: The decrease in FTE contributions by all pharmacists and the aging of the male pharmacist population raise concerns about the adequacy of current and future pharmacist supply. As the demand for pharmacists continues to evolve, pharmacy must continue to monitor the pharmacist workforce to show how pharmacists react to changes to better inform projections of the pharmacist workforce.
Adult↗
Pharmacists' desired and actual times in work activities: evidence of gaps from the 2004 National Pharmacist Workforce Study.
OBJECTIVES: To describe pharmacists' work activities in the United States during 2004 in terms of (1) the desired amount of time they would like to spend in each of four work activities (medication dispensing, consultation, business management, drug use management), (2) the amount of time they actually spend in each activity, and (3) the gaps between desired and actual time reported in each activity. DESIGN: Cross-sectional study. SETTING: Pharmacies (community chain, community independent, hospital, and other) in the United States. PARTICIPANTS: 1,564 actively practicing pharmacists. INTERVENTION: Mailed survey from portions of the 2004 National Pharmacist Workforce Survey. MAIN OUTCOME MEASURES: Differences between desired and actual time spent in work activities in medication dispensing, consultation, business management, and drug use management and the associations between practice setting characteristics and demographic variables were explored using linear and logistic regression analyses. Practice variables included position, years in current position, working part time, work with other pharmacists, work with technicians, proportion of staff who are pharmacists, staff size, dispensing level. Demographic variables included age, gender, race, marital status, and year of licensure with respondents' reported work activity amounts and gaps. Linear regression results were interpreted based on standardized beta coefficients and corresponding P values. Logistic regression results were interpreted based on 95% confidence intervals for odds ratios. RESULTS: The proportion of time pharmacists devoted to medication dispensing, consultation, business management, and drug use management did not change between 2000 and 2004. Practice setting was the most consistently influential variable on pharmacists' work activities when controlling for other variables. Pharmacists in all practice settings would like to spend more time in consultation and drug use management and less time in medication dispensing, but compared with community pharmacists, hospital and other patient care pharmacists were less likely to report a gap between desired and actual time spent in dispensing activities. Age was a significant predictor of gaps between desired and actual time spent in various activities, but only the oldest age groups (ages of 60 or 70 years and older) were significantly different from the reference group of pharmacists aged 23 to 30 years. CONCLUSION: Pharmacists would like to devote more of their time to consultation and drug use management activities in community pharmacy settings but have not yet been afforded a full opportunity to engage in these activities to the extent that they desire.
Adult↗
Documentation of patient care services in a community pharmacy setting.
OBJECTIVE: To assess the types of patient care documentation systems currently being used by community pharmacists and determine the preferred characteristics of an ideal patient care documentation system. DESIGN: Mailed survey. SETTING: United States. PARTICIPANTS: One pharmacist from each of 125 targeted community pharmacies. INTERVENTION: Survey mailed in February 2003, followed by a second mailing to nonrespondents in March 2003. MAIN OUTCOME MEASURES: Responses to survey items about (1) patient care services provided at the pharmacy, (2) characteristics of the current documentation system, and (3) characteristics of an ideal documentation system. RESULTS: A total of 48 usable responses were received from 106 pharmacies to which surveys were delivered (45.3%). Independent pharmacies accounted for 50% of survey respondents. More than 80% of respondents were providing patient screening or management services associated with a chronic disease such as diabetes, hypertension, or dyslipidemia. Approximately 54% of the pharmacists were using a paper documentation system. However, challenges identified with a paper system included documentation time, retrieval of patient data, tracking patient outcomes, and storage. Respondents indicated that an ideal documentation system would be comprehensive, easy and efficient to use, and affordable. CONCLUSION: Pharmacists recognize the importance of documenting patient care services. While the majority of respondents are using paper charts to document patient care services, computerized systems appear to offer advantages over paper charts. This information offers community pharmacists a summary of previous experiences and a starting point when trying to identify or modify a documentation system that would better meet the pharmacies' needs.
Community Pharmacy Services↗
Community pharmacists' work environments: evidence from the 2004 National Pharmacist Workforce Study.
OBJECTIVES: To describe characteristics of community pharmacists' current practice environments and pharmacists perceptions' about aspects of their work environments. DESIGN: Cross-sectional study. SETTING: Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies) in the United States. PARTICIPANTS: 1,564 actively practicing pharmacists. INTERVENTION: Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. MAIN OUTCOME MEASURES: Hours the pharmacy was open; staffing; workload, perceptions of workload, and impact of the current workload on them and their work; equipment and technology available and used; and impact of equipment and technology at the practice site. Responses were compared with those from the 2000 National Pharmacist Workforce Survey. RESULTS: Hours of operation varied across practice settings in 2004 and were similar to those reported in 2000. Pharmacist and technician staffing varied somewhat across settings, but overall pharmacists were working with more technicians in 2004 compared with 2000. The number of prescriptions personally dispensed daily (personal workload) increased for pharmacists in all practice settings from 2000 to 2004. When pharmacists reported the impact of their current workload, motivation to work at the pharmacy and job satisfaction were rated most positive, and opportunity to take adequate breaks were rated most negative. Equipment used for facilitating the dispensing process was more common in pharmacies than equipment related to patient care activities. More than one half of pharmacists reported that equipment and technology increased their level of productivity, quality of care, financial performance, and job satisfaction in the pharmacy. CONCLUSION: Pharmacists' work environments tend to be oriented toward traditional dispensing roles and activities. Staff, equipment, and information technology resources are available to facilitate both dispensing and patient care activities, and these resources have increased productivity, quality of care, and pharmacists' satisfaction.
Community Pharmacy Services↗
The state of the pharmacy workforce.
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Employment↗