Construction and empirical study of competency model for perioperative medication management by clinical pharmacists in China.

BACKGROUNDS: Drug-related problems (DRPs) remain a critical concern in perioperative management. Improper perioperative medication decision-making will significantly increase patients' perioperative medical risks, increase medical expenses, and cause a great waste of medical resources.

OBJECTS: To enhance clinical pharmacists' perioperative medication management abilities and improve patient adherence, this study analyzes the current status of competency research to propose appropriate indicators. Using expert consultation, a suitable indicator system was selected. Based on survey data, a competency model for clinical pharmacists in perioperative medication management was constructed. The model was empirically tested to evaluate its effectiveness and aims to contribute to the development of a training and accreditation system for clinical pharmacists in China.

METHODS

Through literature review and expert consultation, a national survey was developed on perioperative medication management practices via a national-level working committee focused on perioperative medication (organization name blinded). A competency theoretical model was constructed using Delphi method and validated through confirmatory factor analysis. A six-month empirical study was conducted in the spinal surgery department of a tertiary hospital in Eastern China (institution name blinded) to evaluate model effectiveness.

RESULTS

The finalized model comprised four dimensions: pharmacist qualification, perioperative medication therapy management, teamwork, and academic involvement. The most influential factor was perioperative medication therapy management (path coefficient: 0.904), followed by qualification (0.857), teamwork (0.797), and teaching and research (0.669). Model-guided pharmacist training significantly improved clinical outcomes, including a 55.6% reduction in postoperative infection rate, a 0.61-day decrease in antimicrobial therapy duration (p = 0.007), a 51.4% reduction in respiratory symptoms, a 0.8-point reduction in pain scores (p < 0.05), and a 2-day reduction in incision healing time for diabetic patients (p = 0.01). Economic benefits included a 25.8% decrease in total treatment cost and a 97.5% reduction in proton pump inhibitor expenditure.

CONCLUSION

This study preliminarily developed a competency indicator system for Chinese clinical pharmacists in perioperative medication management, thereby enhancing the overall standard of clinical pharmacist practice in this domain.