Table 2.

Unmet Information needs of pharmacists for ADE detection and specific examples under each category.

Missing Information and Information Needs	Theme
What were his medications on admission? I would like to know the dose of the aspirin. It could also be over the counter. I don’t know. The first thing that I would do is look at his outpatient meds.	Inability to access outpatient medications
Just tell me on the H&P what is the IR pacemaker placement? What kind of a pacemaker placement (is it?) I just wanted to know what’s different in her blood, you know what is different in her blood pre-op/post –op, I guess. When did her Afibs start? It says the patient remains in Afib. Is she controlled, is she rate controlled Afib? Tele (telemedicine) seems to keep more or less everything at the bedside. They do a template. The template tells you nothing. Yeah the templates are really bad.	Incompleteness of information entered in the notes
When they started the templates, it was just a bad idea. That made the nursing notes utterly useless. I actually did that (looked at the notations next to the BCMA records), because I was the one who brought BCMA up on line. And I still can’t get the nurses to do that. So on finger sticks they’re supposed to put the blood sugar and how much insulin they gave and everyday I’ll have some patient who just has nothing.	Institutional change
I have to look in three different places (for the blood sugar level and amount of insulin received). You can look in BCMA and look under the medication log is one place you can look and see if they have added comments but you have to check what is it? View order or view audits and comments. You have to click on that to see that but you have to look at the individual day or you can go under the lab and type in finger stick and then up will come finger sticks. Then see you’ve got results in there, then you’ve got results in BCMA (it’s really easy, P1, all they have to do under dose is put 352 = 10) and that is exactly what nurses are doing now. So if someone is in tele and they are going to convert him to oral dose, I want to know what IV dose they were on. Like how much it was running per hour and sometimes I can’t find that information anywhere. It’s just not there. I don’t know how many milligrams for an hour. Sometimes they write, sometimes it’s there and sometimes it’s not and then you can’t make a great conversion to oral therapy if you don’t know where they were. Like you will look at the BCMA stuff and it is actually does not list the missed doses yet.	Need related to CIS
Or when the rates were changed and you can’t even find it on the bedside. There is no, it is an incomplete chart in my mind cause I don’t know when you increase the rate, what the rate is now, unless you look at the flow charts.	Reliance on Paper Resource
I think you would have to interview the patient rather than anything because it (reasons for noncompliance) is usually not documented. So I probably get a lot more information from nurses in person. Um, and I have a lot smaller unit so I tend to get a lot more one on one from social workers and stuff. I have noticed that it is helpful, when some patients come in like this, is to interview the family. They will actually talk about this is baseline or this is not baseline and this is different or this is the same as what he is usually like.	Sources of Information other than the CIS