Browsing by Author "Eshetu, Eskinder"

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    Quality Of Pharmaceutical Care In Government Hospitals Of Addis Ababa, Ethiopia
    (Addis Ababa University, 2010-04) Eshetu, Eskinder; Gedif, Teferi(PhD)
    Background: As the quality of medication use is the central aspect of quality health care, measuring and thus improving the quality of pharmaceutical care plays a pivotal role in improving medical care in hospitals. Quality of pharmaceutical care can be measured at the levels of the structure, process and outcome. And it is recommended that measurement of the quality of pharmaceutical care should give emphasis on the feelings of the customers of the service. The job satisfaction of pharmacy professionals is also expected to influence and be influenced by the quality of pharmaceutical care. Objective: to assess the quality of pharmaceutical care in some selected government hospitals of Addis Ababa, Ethiopia. Methodology: A descriptive cross sectional survey of the pharmacy units of selected hospitals in Addis Ababa was conducted between August and December, 2009. Six government hospitals were involved in the study (two university hospitals and the rest under the Addis Ababa city administration health bureau). The structural quality of pharmaceutical care, pharmacists’ level of involvement in pharmaceutical care provision, clients’ level of satisfaction, pharmacy professional’s job satisfaction and their perceived quality of pharmaceutical care were studied. The study used both quantitative and qualitative methods. Structured observation checklist, structured interview guides and self administered questionnaires were used to collect quantitative data. And qualitative data was collected by an in-depth interview with the heads of the pharmacy departments. Results: a total of nineteen pharmacy units in the six hospitals were studied for structural quality. Deficiencies were observed with most of the structural aspects. Simple dispensing aids like tablet counting tray were absent in 8 (42.1%) of the pharmacy units. And all had inadequate space for different purposes especially for storage of pharmaceuticals. Some of the hospitals also suffer from shortage of pharmacy professionals. Fifty one pharmacy professionals responded to questions regarding their level of involvement in the provision of pharmaceutical care. And the documentation and implementation of therapeutic objectives and monitoring plans aspects of pharmaceutical care were the most underperformed domains by the pharmacy professionals. The majority of pharmacy professionals (68.6%) never participated in ward rounds and the major reason for this was reported to be absence of system in the hospital for the involvement of pharmacists in ward rounds. A total of 2641 clients visiting the outpatient pharmacies of the studied hospitals were interviewed on exit from the pharmacies. The interviews were made in Amharic and factor x analysis of the Amharic questionnaire resulted in the factors: interpersonal relationship, general satisfaction and pharmaceutical care. Chronbach’s alpha for the whole questionnaire was found to be 0.90 and 0.82, 0.83 and 0.78 for the three factors, respectively. The least satisfaction scores were obtained in the pharmaceutical care domain. And many significant differences in satisfaction with some aspects of pharmaceutical services were observed with clients’ gender, frequency of visit, type of hospital and payment status. The mean job satisfaction score for pharmacy professionals in the studied hospitals was found to be 2.9 + 0.52 in a scale of 1-5. Statistically significant differences were observed among pharmacists and pharmacy technicians (pharmacists less satisfied than technicians) with respect to the full utilization of talents on the job (t = -2.21; p = 0.032) and knowledgeableness of the lay person about the level of education of pharmacists (t = -2.19; p = 0.033). Majority of the pharmacy professionals (≥ 50%) rated the availability of medicines and important dispensing aids as poor or fair. The qualitative aspect of this study complemented the quantitative part in many aspects (i.e. structural deficiencies, level of involvement in pharmaceutical care and job satisfaction). Conclusion and Recommendation: this study showed that there is a low level of pharmaceutical care quality in the studied hospitals with respect to the availability of important materials and space; the involvement of pharmacy professionals in pharmaceutical care and clients’ satisfaction. Accordingly improved government attention to the pharmaceutical sector, increased involvement of pharmacists in the provision of pharmaceutical care and further quality assessments of hospital pharmacy services are recommended. Key words: quality, pharmaceutical care, Addis Ababa, hospitals, job satisfaction, clients’ satisfaction