医院药剂师伦理推理互动教育研讨会评估:一项观察研究。

IF 3 1区 哲学 Q1 ETHICS BMC Medical Ethics Pub Date : 2024-07-23 DOI:10.1186/s12910-024-01082-4
Nallini McCleery, Adam La Caze, Karl Winckel, H Laetitia Hattingh
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引用次数: 0

摘要

背景:药剂师在实践中经常会遇到需要运用道德推理和决策技能的情况。有关医院药剂师伦理决策过程的研究十分有限。富有同情心并将患者利益放在首位的药剂师被认为会对患者护理产生积极影响,但医院环境中往往存在复杂的医疗保健系统压力,导致药剂师的行为可能与专业价值观和行为相冲突。这项多地点研究旨在评估医院药剂师道德推理技能互动教育研讨会,并探讨持续培训和支持的必要性:这项混合方法研究在两家医疗服务机构(包括三家医院)进行。其中包括一项工作坊前调查、一项工作坊后即时反馈调查和一项工作坊四周后的第三次调查。在伦理研讨会结束至少四周后,对医院药剂师进行了半结构式访谈:共有 32 名学员完成了工作坊前的问卷调查,他们认为同行/同事是他们在做出伦理决策时最常咨询的支持来源(17/118 支持来源)。几乎所有学员(n = 31/33;94%)都非常同意/同意教育课程为他们提供了伦理推理技能以及在遇到伦理问题时可以使用的程序/框架。会前和会后调查显示,参与者在识别适用于药房隐私要求的监管框架(p = 0.011)和适用于药房隐私要求的伦理问题(p = 0.002),以及将伦理推理应用于涉及药房隐私困境/问题的情景(p = 0.004)方面的自信心有所增强。参与者在面对临床和非临床伦理问题时知道从哪里寻求支持的自信心得到了提高(分别为 p = 0.002 和 p = 0.003)。与研讨会前相比,与会者支持在研讨会后引入季度伦理咖啡馆(p = 0.001):医院药剂师依赖与同事的讨论来集思广益解决伦理问题。本研究表明,有针对性的互动教育研讨会有助于熟悉伦理资源和决策流程。研究还表明,这种方法可用于提高医院药剂师的准备度、信心以及识别和应对具有挑战性的伦理问题的能力。
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Evaluation of an interactive education workshop on hospital pharmacists' ethical reasoning: an observational study.

Background: Pharmacists are often faced with scenarios in practice that require application of ethical reasoning and decision-making skills. There is limited research on the ethical decision-making processes of hospital pharmacists. Pharmacists who are compassionate and put the interests of their patients first are thought to positively impact on patient care, but there are often complex health-care system pressures in the hospital setting that cause pharmacists to behave in ways that may conflict with professional values and behaviours. This multisite study aimed to evaluate an interactive education workshop on hospital pharmacists' ethical reasoning skills and explore the need for ongoing training and support.

Methods: This mixed-methods study was carried out across two health services including three hospitals. It incorporated a pre-workshop survey, a feedback survey immediately post-workshop and a third survey four weeks after the workshop. Semi-structured interviews were conducted with hospital pharmacists at least four weeks after the ethics workshop.

Results: In total, 32 participants completed the pre-workshop survey, nominating peers/colleagues as the most common source of support they would consult to inform ethical decision-making (17/118 sources of support). Almost all (n = 31/33; 94%) strongly agreed/agreed that the education session provided them with ethical reasoning skills and a process/framework which they could use when faced with an ethical issue. Pre- and post-survey responses showed increased self-confidence in identifying the regulatory frameworks applicable to pharmacy privacy requirements (p = 0.011) and ethical issues applicable to pharmacy privacy requirements (p = 0.002), as well as applying ethical reasoning to scenarios that involve pharmacy privacy dilemmas/issues (p = 0.004). Participants' self confidence in knowing where to find support when faced with clinical and non-clinical ethics questions was improved (p = 0.002 and p = 0.003 respectively). Participants supported the introduction of quarterly ethics cafes after the workshop, compared to before the workshop (p = 0.001).

Conclusion: Hospital pharmacists rely on discussions with colleagues to brainstorm how to address ethical issues. This study showed that a targeted interactive education workshop facilitated familiarity with ethics resources and decision-making processes. It also demonstrated that this approach could be used to enhance hospital pharmacists' readiness, confidence, and capabilities to recognise and respond to challenging ethical issues.

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来源期刊
BMC Medical Ethics
BMC Medical Ethics MEDICAL ETHICS-
CiteScore
5.20
自引率
7.40%
发文量
108
审稿时长
>12 weeks
期刊介绍: BMC Medical Ethics is an open access journal publishing original peer-reviewed research articles in relation to the ethical aspects of biomedical research and clinical practice, including professional choices and conduct, medical technologies, healthcare systems and health policies.
期刊最新文献
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