Date of Award

12-2024

Degree Type

Thesis

Degree Name

Master of Health Policy and Management

First Advisor

Dr. ALi Faisal Saleem

Second Advisor

Mr. Iqbal Azam

Third Advisor

Dr. Shiyam Sunder

Department

Community Health Sciences

Abstract

Background: Inpatient drug dispensing practices in paediatric and neonatal intensive care units is not well studied. Difference among these practices between public and private hospitals can lead to undesirable outcomes and can impact patient quality of care. This study has used the American Society of Health-System Pharmacists Paediatric Pharmacy Advocacy Group guidelines for Providing Paediatric Pharmacy Services in Hospitals and Health Systems as a guide to understand the level of pharmacy services provided in these units.
Keywords: Inpatient Drug Dispensing, Intensive Care Units, American Society of Health-system Pharmacists Paediatric Pharmacy Guidelines, Tertiary Care Hospitals, Karachi, Pakistan.
Methods: The study utilized a mixed method convergent parallel study design collecting and analysing both qualitative and quantitative simultaneously, with triangulation of results at the end. A facility checklist and a survey questionnaire for clinical pharmacists working in neonatal and paediatric intensive care units were employed in the quantitative arm of this study. The qualitative component comprised of in-depth interviews with clinical pharmacists involved in the drug dispensing in the tertiary care hospitals across Karachi. The tertiary care hospitals were scored out of a total of 43 points covering the nine elements of care outlined in the ASHP paediatric pharmacy guidelines. The clinical pharmacists were scored out of a total of 15 points, and the results were compared by the type of hospital they worked in. The in-depth interviews focused pharmacists’ own understanding of inpatient drug dispensing in paediatric and neonatal intensive care units and the specific challenges that they face.
Results: The findings indicated that the hospitals have their own in-house standard operating procedures for inpatient drug dispensing in paediatric and neonatal intensive care units, and the processes vary in terms of standardized procedures, specialized training, and use of technology to minimize errors in drug dispensing. The data from the pharmacists showed that their expertise vary in different areas of drug dispensing such as paediatric dosing protocols and use of technology to reduce medication errors and improve patient care outcomes. The key themes in the qualitative analysis showed that the pharmacists face several challenges which impacts the drug dispensing in these units.
Conclusion: This study has identified some gaps in the inpatient drug dispensing practices across the neonatal and paediatric intensive care units in public and private tertiary care hospitals, which underscores the need for a standardized and national standardized framework aligning with the national guidelines and international standards.

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1

Last Page

102

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