Pharmacist-assisted prescribing in an Australian hospital: a qualitative study of hospital medical officers’ and nursing staff perspectives

Background: Pharmacist-assisted prescribing (also known as pharmacist charting) has been adopted widely across Australia. The perspectives of medical and nursing staff, however, is poorly understood. Aim: To explore the perceived benefits and drawbacks of pharmacist-assisted prescribing on admission and discharge, from the perspective of hospital medical officers (HMOs) and nurses. Methods: Face-to-face, semi-structured interviews were conducted with orthopaedic junior HMOs, the orthogeriatric HMO and nurses during a study evaluating pharmacist-assisted prescribing in an orthopaedic unit. Participants were individually interviewed to explore the perceived impacts of pharmacist-assisted prescribing on patient safety, workflow and HMO skill development. Interviews were audio-recorded and verbatim transcriptions were analysed independently by two investigators using a simple thematic analysis. Results: Interviews were conducted with six HMOs and six nurses. Emergent themes highlighted various factors which may affect the ability of HMOs to prescribe medications accurately and in a timely manner when there is no pharmacist assisting with prescribing, and the impact of pharmacist-assisted prescribing on patient flow, safety and staff workload. Participants felt that having a pharmacist assist with prescribing improved patient safety by reducing prescribing errors and admission charting delays, and assisted with patient flow by reducing delays in discharging patients. Participants felt that pharmacist-assisted prescribing reduced their workload. They noted a drawback was the potential to de-skill HMOs, but felt this was outweighed by the benefits. Conclusions: Hospital medical officers and nurses reported that pharmacist-assisted prescribing had benefits on patient safety, patient flow and workload and that these outweigh the potential drawbacks of potentially de-skilling junior HMOs.