Starting the journey: overcoming research challenges for beginners
Ella M. Mullins
BPharm (Hons); GradCertClinPharm | Clinical Pharmacist, University Hospital Geelong | ella.mullins@barwonhealth.org.au
[Pharmacy GRIT article no: 20251411]
While undertaking the Residency Training Program, I completed an evaluation of the perioperative service provided at Barwon Health, located in Geelong, which currently has no perioperative pharmacist involvement. My project focused on the medication errors and discrepancies that surgical patients who attended the orthopaedic perioperative clinic encountered post-operatively as a result of this service gap. Patients’ drug charts were assessed for medication related issues upon admission to hospital.
The journey begins…
At the time of starting this project, I had limited experience in research and had not been involved in any kind of research since my internship in 2020.
My first challenge: creating a survey aimed for the ward pharmacists to collect data, generated using REDCap, a browser-based data collection tool. I had previously utilised REDCap during the research project I completed in my intern year. However, due to the significant time that had passed since the last time I used it, I required a refresher on how to navigate the program. This was quite time consuming as nearly every question was branched, and I had to ensure the survey was easy for the ward pharmacists to read and understand to ensure engagement in the project and accurate data. Luckily, my project supervisors were helpful in guiding me and ensuring the data collection tool had face and content validity.
Next came the ethics submission. This was one of the most challenging aspects of the research project. The road to ethics approval was long, as our initial quality assurance activity application required modification and clarification. I learned that while the clinical pharmacy processes were quite apparent to us, the ethics review committee members had lesser understanding of these and therefore detailed descriptions required. For example, we were asked by the ethics committee to detail any clinical implications this audit would have on patient care, if any at all. For example, if discrepancies were found, what would occur? We had explained that the pharmacist would continue undertaking their usual processes. We had to clarify that medication discrepancies are commonly found with all patient admissions, and it is the responsibility of the reviewing clinical pharmacist to identify and resolve these issues in collaboration with the treating team and/or prescriber. We even referred the ethics committee to a local protocol on the processes undertaken by a pharmacist when medication issues are identified and require resolution.
While the previously discussed issues were notable, data collection proved to be the most challenging part of the journey by far. By this stage, I had moved on from my surgical rotation. This meant that data collection was completed by clinical ward pharmacists no longer in my team. I had to ensure to engage with relevant pharmacists, explain project and data collection tool and encourage them to participate. This became even more challenging when there were lots of different pharmacists and interns working on the specific ward due to staff shortages or rotations. At times, this meant daily updates to staff to ensure no potential patients were missed. In addition to this, elective surgeries were suppressed due to surgeon staffing issues, extending the data collection beyond our original planned one month to three months.
Consolidating the learnings
Once the data collection was complete, I wrote up the research report, which seemed to have been the easiest part, seeing our data collection tool was set up well for analysis. The findings of the project were encouraging and we are hoping to continue the study post-implementation of a perioperative pharmacist service to assess impact of this pharmacy service. However, the next challenge is approval of budget for this service, which is out of my control.
Undertaking this project provided a valuable learning experience. It allowed me to explore current literature and evidence, develop research skills such as data collection, analysis and interpretation, and enhanced my ability to communicate these findings effectively to a variety of audiences. Overall, the project equipped me with transferable skills essential for future academic and professional endeavours.
Acknowledgements
I would like to acknowledge Diana Bortoletto and Megan Denton-Brown for their contribution to this research study.