Publications
270 results found
Bracey G, Miller G, Franklin BD, et al., 2008, The contribution of a pharmacy admissions service patient care, CLINICAL MEDICINE, Vol: 8, Pages: 53-57, ISSN: 1470-2118
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- Citations: 8
Gallivan S, Taxis K, Franklin BD, et al., 2008, Is the principle of a stable heinrich ratio a myth? - A multimethod analysis, DRUG SAFETY, Vol: 31, Pages: 637-642, ISSN: 0114-5916
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- Citations: 14
Franklin BD, O'Grady K, 2007, Dispensing errors in community pharmacy: Frequency, clinical significance and potential impact of authentication at the point of dispensing, International Journal of Pharmacy Practice, Vol: 15, Pages: 273-281, ISSN: 0961-7671
Objective: Our aims were to explore the nature of dispensing errors in community pharmacy, and investigate the potential impact of authentication at the point of dispensing using barcodes or radiofrequency identification tags. Objectives were to develop a dispensing error definition for use in the community setting, to describe the incidence, types and clinical significance of dispensing errors in UK community pharmacies and to assess the likely impact of authentication at the point of dispensing. Setting: Eleven UK community pharmacies. Method: A definition of a dispensing error was developed using the Delphi technique. A research pharmacist checked dispensed items awaiting collection and compared them against the original prescription to identify dispensing errors. An expert panel assessed the potential clinical significance of the errors identified. We then predicted the likely impact of three different systems of authentication at the point of dispensing: (a) stand-alone; (b) linked to patient medication records (PMR); and (c) linked to electronic transfer of prescriptions (ETP). Key findings: We found a content error in 49 (1.7%) of 2859 dispensed items, and a labelling error in 46 (1.6%). The majority (67%) were of minor clinical significance. We estimated that a stand-alone system would prevent about one in five content errors and very few labelling errors, a PMR-linked system would prevent one-quarter of content errors and one-third of labelling errors, and an ETP-linked system would prevent nearly half of content and labelling errors. While none of the three systems would have prevented the one serious error identified, 22-60% of moderate errors could have been prevented, depending on the system used. Conclusion: Content errors were identified in 1.7% of dispensed items, and labelling errors in 1.6%. Authentication at the point of dispensing could prevent a significant proportion of these, particularly if the system were linked to PMR or ETP. An experimenta
Shebl NA, Franklin BD, Barber N, 2007, Clinical decision support systems and antibiotic use, PHARMACY WORLD & SCIENCE, Vol: 29, Pages: 342-349, ISSN: 0928-1231
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- Citations: 35
Franklin BD, O'Grady K, Donyai P, et al., 2007, The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: A before-and-after study, QUALITY & SAFETY IN HEALTH CARE, Vol: 16, Pages: 279-284, ISSN: 1475-3898
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- Citations: 175
Brock TP, Franklin BD, 2007, Differences in pharmacy terminology and practice between the United Kingdom and the United States, AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, Vol: 64, Pages: 1541-1546, ISSN: 1079-2082
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- Citations: 14
Franklin BD, O'Grady K, Donyai P, et al., 2007, The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist's time and activities, International Journal of Pharmacy Practice, Vol: 15, Pages: 133-139, ISSN: 0961-7671
Objective: To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting: Surgical ward, London teaching hospital. Method: All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings: Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion: The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the desi
Franklin BD, O'Grady K, Paschalides C, et al., 2007, Providing feedback to hospital doctors about prescribing errors; a pilot study, PHARMACY WORLD & SCIENCE, Vol: 29, Pages: 213-220, ISSN: 0928-1231
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- Citations: 32
Bracey G, Miller G, Franklin BD, 2007, An audit of the pharmacy admissions service at a teaching hospital, PHARMACY WORLD & SCIENCE, Vol: 29, Pages: A255-A256, ISSN: 0928-1231
Franklin BD, Seedat H, Heinrich M, 2007, Use of herbal remedies by patients admitted to hospital, PHARMACY WORLD & SCIENCE, Vol: 29, Pages: A243-A244, ISSN: 0928-1231
Sanghera IS, Franklin BD, Dhillon S, 2007, The attitudes and beliefs of healthcare professionals on the causes and reporting of medication errors in a UK Intensive care unit, ANAESTHESIA, Vol: 62, Pages: 53-61, ISSN: 0003-2409
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- Citations: 91
Franklin BD, O'Grady K, Parr J, et al., 2006, Using the internet to deliver education on drug safety, QUALITY & SAFETY IN HEALTH CARE, Vol: 15, Pages: 329-333, ISSN: 1475-3898
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- Citations: 11
Ghaleb MA, Barber N, D Franklin B, et al., 2006, Systematic review of medication errors in pediatric patients, ANNALS OF PHARMACOTHERAPY, Vol: 40, Pages: 1766-1776, ISSN: 1060-0280
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- Citations: 173
Taxis K, Gallivan S, Franklin BD, et al., 2006, Is there a ratio that can be used to predict harm from minor medication errors?, PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Vol: 15, Pages: S103-S104, ISSN: 1053-8569
Desai M, Franklin BD, Holmes AH, et al., 2006, A new approach to treatment of resistant gram-positive infections: potential impact of targeted IV to oral switch on length of stay, BMC INFECTIOUS DISEASES, Vol: 6
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- Citations: 28
Pelle B, Gilchrist M, Lawson W, et al., 2006, Using defined daily doses to study the use of antibacterials in UK hospitals, Hospital Pharmacist, Vol: 13, Pages: 133-136, ISSN: 1352-7967
Objective - To explore the feasibility of using defined daily doses (DDDs) to measure antibacterial consumption in a UK hospital and identify the methodological issues encountered. DESIGN - Descriptive study. Subjects And Setting - A London teaching trust, with four hospital sites and 1, 000 beds. Outcome Measures - Total DDDs per 100 occupied bed days (OBD) for financial years 2002-03, 2003-04 and 2004-05;proportion of DDDs given intravenously and orally;usage by antibacterial class;comparison with UK and international data. Results - Antibacterial consumption ranged from 85. 5 to 91. 5 DDDs per 100 OBD across the three years studied. The proportion of oral DDDs increased over the three-year period. The antibacterial groups with the highest consumption were penicillins and cephalosporins. A range of methodological issues were encountered, such as how to address medicines dispensed for discharge as part of a one-stop dispensing scheme, and other practical issues. Usage was in line with other UK sites, but higher than elsewhere in Europe. Conclusion - It is possible to obtain data on DDDs in the UK hospital setting, although a variety of methodological issues may need to be addressed. A standardised UK approach is needed, so that data obtained from different sites can be compared in a meaningful manner.
Spinewine A, Swine C, Dhillon S, et al., 2005, Appropriateness of use of medicines in elderly inpatients: qualitative study, BMJ-BRITISH MEDICAL JOURNAL, Vol: 331, Pages: 935-938, ISSN: 0959-535X
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- Citations: 69
Ghaleb MA, Barber N, Franklin BD, et al., 2005, What constitutes a prescribing error in paediatrics?, QUALITY & SAFETY IN HEALTH CARE, Vol: 14, Pages: 352-357, ISSN: 1475-3898
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- Citations: 64
Cotton A, Franklin BD, Brett S, et al., 2005, Using imipenem and cilastatin during continuous renal replacement therapy, PHARMACY WORLD & SCIENCE, Vol: 27, Pages: 371-375, ISSN: 0928-1231
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- Citations: 8
Barber N, Safdar A, Franklin BD, 2005, Can human error theory explain non-adherence?, PHARMACY WORLD & SCIENCE, Vol: 27, Pages: 300-304, ISSN: 0928-1231
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- Citations: 17
Franklin BD, van Mil JWF, 2005, Defining clinical pharmacy and pharmaceutical care, PHARMACY WORLD & SCIENCE, Vol: 27, Pages: 137-137, ISSN: 0928-1231
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- Citations: 24
Beso A, Franklin BD, Barber N, 2005, The frequency and potential causes of dispensing errors in a hospital pharmacy, PHARMACY WORLD & SCIENCE, Vol: 27, Pages: 182-190, ISSN: 0928-1231
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- Citations: 98
Franklin BD, Vincent C, Schachter M, et al., 2005, The incidence of prescribing errors in hospital inpatients - An overview of the research methods, DRUG SAFETY, Vol: 28, Pages: 891-900, ISSN: 0114-5916
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- Citations: 91
Cooke FJ, Franklin BD, Lawson W, et al., 2004, Multidisciplinary hospital antibiotic stewardship: A West London model, Clinical Governance, Vol: 9, Pages: 237-243, ISSN: 1477-7274
Antibiotic resistance presents a major public health challenge at local, national and international levels. At a local level, the challenge is to tackle the antibiotic stewardship agenda, within the clinical governance framework, across all professional groups and specialities. This paper presents the response to this challenge in a large multi-site NHS trust. The approach focuses around a multi-disciplinary antibiotic steering group, in which a dedicated infectious diseases pharmacist plays a key role. Proposes seven key elements for a successful antibiotic stewardship programme and discuss examples of local action. These elements are: strong leadership; dedicated individuals with responsibility for leading on antibiotic use; integration into pre-existing trust structures; harnessing existing resources to deliver change; obtaining local data on prescribing patterns and resistance; communication; and education and training. All pillars of clinical governance are supported by the multi-disciplinary approach described. © Emerald Group Publishing Limited.
Duggan C, Engová D, Franklin BD, et al., 2004, Bridging the gap between academia and practice, Hospital Pharmacist, Vol: 11, Pages: 155-157, ISSN: 1352-7967
Academic pharmacy practice units link the research expertise of university-based academics with the experience of practising pharmacists. This article outlines one partnership between a university and four hospital pharmacy departments.
Brady D, Franklin BD, 2004, An evaluation of the contribution of the medical admissions pharmacist at a London teaching hospital, International Journal of Pharmacy Practice, Vol: 12, Pages: 1-6, ISSN: 0961-7671
Objective: To evaluate the contribution of the medical admissions pharmacist (MAP) at a London teaching hospital. Method: A descriptive study using quantitative methods to compare the activities of former non-designated pharmacists with that of the currently employed MAP in relation to interventions made regarding the drug therapy of patients in one medical admissions ward in a London hospital. The outcome measures were numbers of pharmacist interventions made and their clinical significance. A multi-disciplinary panel assessed clinical significance using an adapted form of a previously validated method. Key findings: Overall, significantly more interventions were made per day after appointment of the MAP (P = 0.003). In particular, interventions relating to drug administration/route, choice, dose, medication history and need for drug therapy significantly increased. Interventions made by the MAP were found to be of greater clinical significance when compared with those made by the non-designated pharmacists (P = 0.005). In a separate assessment of medication history accuracy, 12% of the patients' regular medicines were unintentionally omitted and 6% of prescriptions unintentionally changed. All unintentional omissions and discrepancies identified resulted in an intervention by the MAP. The majority of these interventions were found to be of moderate clinical significance. Conclusions: The MAP made more interventions than the previous non-designated ward pharmacists and, overall, the interventions were of greater clinical significance. The research demonstrates the potential contribution of an MAP on post-admission ward rounds to ensure the safe and appropriate prescribing of medicines on the medical admissions ward. Confirming medication histories was shown to be important in ensuring appropriate prescribing of patients' regular medicines on admission to hospital.
Joseph A, Franklin BD, James D, 2004, An evaluation of a hospital-based patient medicines information helpline, Pharmaceutical Journal, Vol: 272, Pages: 126-129, ISSN: 0031-6873
Aim. To determine patient satisfaction with a medicines information telephone helpline and assess the service's impact on patient outcomes. Design. Questionnaire survey. Subjects and setting. Users of the medicines helpline at Charing Cross Hospital between January and March 2001. Results. Of the 87 callers who consented to take part in the study, 58 (67%) returned questionnaires. The most common type of call was regarding administration and dosage (28%). The most common group of callers were surgical patients (36%). 92% of recommendations given were found to be appropriate by an expert panel. A third of calls were thought to have arisen from inadequate information given to the patient. All callers reported a high level of satisfaction with the information received. Recommendations made were reported to have been followed by 97% of respondents. Nearly 90% thought the information had a positive impact on their lives. Conclusion. The helpline provides a valued service to patients, who are generally satisfied with the information given and believe that it has a positive impact on their lives. However, the types of calls received highlights areas where inadequate information is being given to patients.
Wong IC, Ghaleb MA, Franklin BD, et al., 2004, Incidence and nature of dosing errors in paediatric medications - A systematic review, DRUG SAFETY, Vol: 27, Pages: 661-670, ISSN: 0114-5916
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- Citations: 172
Franklin BD, 2003, Standardisation is key to improving patient safety, Pharmaceutical Journal, Vol: 271, ISSN: 0031-6873
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- Citations: 1
Barber N, Rawlins M, Dean Franklin B, 2003, Reducing prescribing error: Competence, control, and culture, Quality and Safety in Health Care, Vol: 12, ISSN: 0963-8172
Medication errors are probably the most prevalent form of medical error, and prescribing errors are the most important source of medication errors. In this article we suggest interventions are needed at three levels to improve prescribing: (1) improve the training, and test the competence, of prescribers; (2) control the environment in which prescribers perform in order to standardise it, have greater controls on riskier drugs, and use technology to provide decision support; and (3) change organisational cultures, which do not support the belief that prescribing is a complex, technical, act, and that it is important to get it right. Solutions involve overt acknowledgement of this by senior clinicians and managers, and an open process of sharing and reviewing prescribing decisions.
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