Istraživanje determinanti modela kolaborativne farmaceutske prakse u zdravstvenoj zaštiti starih osoba u Srbiji
Research of determinants of the collaborative pharmaceutical practice models in healthcare of the elderly in Serbia
Докторанд
Ilić, VeliborМентор
Marinković, ValentinaЧланови комисије
Tasić, LjiljanaKrajnović, Dušanka
Tadić, Ivana
Simin, Dragana
Метаподаци
Приказ свих података о дисертацијиСажетак
U prvoj fazi istraživanja je obavljena kritička analiza publikovanih modela kolaborativne
farmaceutske prakse (KFP), kao i razvoj konceptualnog dinamičkog modela KFP u zdravstvenoj i
socijalnoj zaštiti starije populacije. Desk analizom su pretraženi radovi iz elektronskih baza
podataka i dobijen je alat u obliku vodiča i ček-liste za donosioce odluka i regulativa za postizanje
preferiranih efekata prikupljenih kolaborativnih praksi, kroz označavanje modela i aktivnosti koje
treba preduzeti za implementaciju najprimenjivije kolaborativne zdravstvene i socijalne zaštite
starijih osoba. Pretraga je ponovljena u decembru 2021 godine i uočen je pad broja publikacija u
2020. i 2021. godini, uzrokovan svetskom COVID-19 pandemijom. Sprovodena je i studija preseka
o stavovima starijih osoba (65+) prema interprofesionalnoj saradnji i KFP uz metodološki
utemeljen (Delfi metod) i razvijen upitnik, adekvatnih psihometrijskih karakteristika. Istraživanje je
sprovedeno u gerontološkim centrima u Srbi...ji, a ispitanici su kao najveće probleme sa kojima se
suočavaju starije osobe u sistemu zdravstvene i socijalne zaštite naveli nedovoljnu vidljivost starije
populacije i nedovoljnu informisanost. Na kraju, sprovedena je prospektivna sistemska analiza
rizika u procesima propisivanja, izdavanja i načinu primene lekova za korisnike gerontoloških
domova, radi identifikacije potencijalnih grešaka, kvantifikacije i rangiranja prioriteta pridruženih
rizika, kao i definisanja korektivnih mera za smanjenje rizika za bezbednost pacijenata. Analiza
načina i efekata otkaza (FMEA) pokazala je da su predložene korektivne mere postigle značajno
unapređenje bezbednosti sistema u 36 od 38 slučaja potencijalnog otkaza sistema, uz smanjenje
ukupne vrednosti kvantifikacije prioriteta rizika (RPN) za 45,08%.
In the first phase of the research, a critical analysis of published collaborative pharmaceutical
practice (CPP) models was conducted, and conceptual dynamic model of CPP in health and social
care of the elderly population was developed. Desk analysis was used to review the publications
from electronic databases and provided a tool in the form of guides and checklists for decision
makers and regulators to achieve the preferred effects of collected collaborative practices, through
models` identifications and activities which needed to be conducted in order to implement the most
applicable collaborative health and social care for the elderly. The search was repeated in December
2021 and a decrease in the number of publications in 2020 and 2021 was noticed, caused by the
global COVID-19 pandemic. A cross-sectional study on the attitudes of older people (65+) towards
interprofessional collaboration and CPP was conducted with a methodologically based (Delphi
method) and developed questionna...ire, with good psychometric characteristics. The research was
conducted in nursing homes in Serbia, and the respondents mentioned the lack of visibility of the
elderly population and insufficient information as the biggest problems faced by the elderly in the
health and social care system. Finally, prospective systemic risk analysis was conducted in the
processes of drug prescribing, dispensing and administering to nursing home users, in order to
identify potential errors, quantify and rank the priorities of associated risks, and define corrective
measures to reduce risks to patient safety. Failure Mode and Effects Analysis (FMEA) showed that
the proposed corrective measures achieved a significant improvement in system security in 36 out
of 38 cases of potential system failure, with a reduction in the total value of RPN (Risk Priority
Number) by 45.08%.