Browsing by Subject "yhteistyö"
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(2011)The Ministry of Social Affairs and Health published a report on development needs of elder care and geriatric pharmacotherapy in 2006. The major concern in this report was related to several challenges in pharmacotherapy of the aged, such as deficiencies in medical knowledge of nurses working with elderly people. One way to improve the medication expertise of those various parties involved in caring elderly people is continuing education (CE). The aim of this study was to explore pharmacotherapy-related training needs of health care professionals involved in the home care services for the elderly in the Social and Health Care Cooperation Region of Lohja, Siuntio, Inkoo and Karjalohja (the LOST Region). This study was started by conducting a survey among nurses working in home care services for the elderly in the LOST Region in 2009 (response rate 47%). To deepen understanding of the key findings of the survey, focus group discussions (FGDs) and face-to-face interviews were conducted among nurses, nursing aids, their managers and physicians (1 FGD among nurses, n=6; 1 FGD among their managers, n=6; and face-to-face interviews with 4 physicians). The survey data were analyzed separately for nurses (n=9), practical nurses (n=53) and home aids (n=9), but results were the same in every group. Of the theoretical training needs, topics related to pharmacokinetics and special characteristics of using medicines in the elderly, effects, adverse effects and interactions of medicines, were most important. In addition, the theoretical training needs covered professional ethics issues, such as accuracy and carefulness of nursing practice. The main training needs related to collaborative practice in pharmacotherapy concerned monitoring medicine user's condition and medication, and dosing medicines (right medicine, dose, strength, dosage) in the right time, and administration routes of medicines. Focus group discussions and face-to-face interviews of the physicians provided a deeper understanding of the results of the survey. One of the main findings of this qualitative part of the study was challenges in cooperation in home care services in the LOST Region. Implementation and monitoring geriatric pharmacotherapy can be improved by improving multiprofessional cooperation and training for nurses and physicians working in home care services. The most important diseases and disorders for which the nurses would like to have shared operational guidelines were diabetes, cardiovascular diseases, pain, memory and psychiatric disorders. Training needs also covered special characteristics of pharmacotherapy for the elderly, and formulations and administration routes of medicines. Finally, a synthesis was made of the results of the survey, focus group discussions and face-to-face interviews. On the basis of the synthesis, a proposal for a multiprofessional training was developed for the LOST Region. The training plan includes topics related to geriatric pharmacotherapy and improving collaborative practices and communication as identified by those involved in different stages of the study.
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(2013)Hospital pharmacies and drug centers are responsible for pharmaceutical services for inpatient care in the public health care in Finland. Each of the 20 hospital districts have a central hospital pharmacy. Every hospital district is a member of one of the five regional hospital groups (called erva-alue). In each regional hospital group the area's university hospital is responsible for the specialized hospital care. Most of the regional hospital groups cooperate in drug purchasing. The drug purchasing policies need to be in line with the legislation regulating public sector's purchasing policies. Usually procurement and organizing a tender competition are coordinated by university hospitals. With centralization hospital pharmacies can get cost-benefits. This study deals with drug purchasing policies in hospitals and regional hospital group cooperation in Finland. The objective was to explore drug purchasing process in hospital pharmacies and related cooperation in regional groups. The study was carried out as a postal survey which was sent to the head pharmacists of all 20 hospital districts in spring 2012. The survey instrument was reviewed by selected experts and revised according to their comments before it was sent to the respondents. Most of the questions were open-ended enabling the respondents to reflect their opinions. The response rate was 90% (n=18). All respondents answered to the most of the questions. There were seven procurement groups. Most of the regional cooperation groups procured drugs together. Only Helsinki University Hospital's (HYKS) regional cooperation group did not procure and organize a tender competition together. Purchasing period was generally two years. Usually procurement was centralized to the university hospitals in the regional groups. The hospital pharmacies that had two years purchasing periods reasoned the duration of the period most commonly by cost savings. The pharmacies that had a three-year or longer period explained its length by drug safety. The areas also differed in the way they involved specialists in selecting pharmaceutical products and making final decisions. The expertise of the specialists involved varied widely. Some areas involved a very broad range of experts, while some others had few. The drugs were selected independently by or within groups. Procurement criteria varied a lot, but the main criterion in all the responses was price or total cost-effectiveness. The respondents reported that drug safety was considered in the procurement but its inclusion as a purchasing criterion was challenging. Few of the respondents reported having studied cost savings of using purchasing groups. However, cost savings were believed to be significant. Particularly, the respondents reported that workloads had decreased because of the cooperation in procurement. Some changes were reported to happen in the drug procurement processes of some purchasing groups. All these ideas concerning drug purchasing policies and cooperation are described in the research report. For example, some head pharmacists indicated their willingness to have national cooperation in establishing drug guidelines. Most of them were satisfied with the current cooperation and purchasing policies and were ready to continue and develop the cooperation. The study achieved its goal in exploring drug purchasing policies and cooperation between hospitals in Finland. The study can perform as a baseline evaluation for further studies in the field. It also provides useful information to those people working on drug procurement and purchasing policies.
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