Portrait de l’exercice de la Loi 41 à l’Institut universitaire de cardiologie et de pneumologie de Québec – Université Laval

2020 
Objectif : Decrire les activites reservees de la Loi 41 realisees par les pharmaciens de l’Institut universitaire de cardiologie et de pneumologie de Quebec – Universite Laval (IUCPQ-UL). Methode : Il s’agit d’une etude retrospective recensant les neuf activites reservees de la Loi 41 sur une periode de 13 jours. Les rapports quotidiens des pharmaciens oeuvrant a l’urgence ou aux unites de soins ont permis d’etablir les actes realises. Le dossier patient electronique et le dossier pharmacologique informatise ont servi a la collecte des donnees. Le suivi de l’acte consistant a prescrire une analyse de laboratoire ainsi que l’impact clinique des activites utilisant une echelle adaptee ont ete determines. Resultats : Les pharmaciens ont effectue 287 activites reservees decoulant de la Loi 41, et 72,1 % d’entre elles sont considerees comme cliniquement significatives. Les activites les plus frequentes sont : la prescription d’une analyse de laboratoire (27,9 %), la prolongation d’une ordonnance (26,5 %) et la modification de la dose afin d’assurer la securite du patient (19,2 %). Parmi les 80 actes consistant a prescrire une analyse de laboratoire, 52,5 % ont beneficie d’un suivi documente par le pharmacien au dossier medical ou au dossier pharmacologique de l’usager. Conclusion : Les pharmaciens a l’IUCPQ-UL effectuent plusieurs activites de la Loi 41. Malgre l’elaboration d’un agenda electronique pour assurer un suivi des interventions, il est necessaire d’ameliorer la documentation du suivi de l’acte de prescrire une analyse de laboratoire. Objective: To describe the reserved activities specified in Bill 41 that are performed by the University Institute of Cardiology and Respirology of Quebec – Universite Laval (IUCPQ-UL)’s pharmacists. Summary Method: This is a retrospective study in which an inventory was taken of the nine reserved activities specified in Bill 41 over a 13-day period. The daily reports by the pharmacists working in the emergency department or wards were used to determine the activities performed. Electronic health records and computerized medication profiles were used to gather data. The follow-up on the activity consisting of prescribing a laboratory test and the clinical impact of the activities, as assessed using a customized scale, were determined. Results: There were 287 reserved activities specified in Bill 41 performed by the pharmacists, 72.1 % of which are considered clinically signif icant. The most frequent ones were ordering a laboratory test (27.9 %), renewing a prescription (26.5 %) and modifying the dosage to ensure the patient’s safety (19.2 %). Among the 80 acts whereby the pharmacist prescribed a laboratory test, 52.5 % of these had a documented follow-up in the patient’s health record or medication profile. Conclusion: The IUCPQ-UL’s pharmacists perform several of the reserved activities specified in Bill 41. Despite the fact that an electronic agenda has been created to ensure procedure follow-up, the activity consisting of prescribing a laboratory test needs to be documented better.
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