Table 2 Factor analysis of Lebanese hospital pharmacists’ competencies (Promax rotated component matrix)

Domain 0: Fundamental skills

 0.1 Regulations

  1

Ensure prescriptions meet national legal requirements for medicines and medicinal products

0.835

0.781

  2

Ensure medicines are labelled appropriately and comply with legislation and national guidance

0.798

  3

Follow hospital regulations pertaining to the operations of the hospital pharmacy

0.783

  4

Apply pharmaceutical statutory regulations

0.702

  5

Demonstrate knowledge of the employment laws

0.608

  Note: Kaiser–Meyer–Olkin (KMO) 0.713; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 56.19%

 0.2 Drug Procurement and Management

  1

Acquire negotiation skills for drug procurement

0.847

0.896

  2

Learn the complexity of the drug and medical supplies market

0.804

  3

Supervise procurement systems

0.790

  4

Handle drug shortages and suggest suitable alternatives of medicines and medical devices in a timely manner

0.787

  5

Handle drug waste

0.751

  6

Manage backorders and recalls

0.737

  7

Consider cost-effectiveness when purchasing and dispensing stock and advising on prescribing choices

0.713

  8

Ensure drug inventory management, including tracking of expiry dates, production lot numbers, and storage conditions

0.655

  9

Select medications and develop a therapeutic formulary according the international and national guidelines

0.582

  Kaiser–Meyer–Olkin (KMO) 0.888; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 55.46%

 0.3. Optimize Processes Related to Organization, Medication Preparation, and Delivery

  1

Describe the appropriate roles of pharmacy staff and pharmacists in these processes

0.866

0.676

  2

Supervise pharmacy staff in their work in medication preparation and delivery

0.815

  3

Demonstrate organizational skills and develop standard operating procedures related to storage, safety, prescription, preparation, transcription, dispensing, administration, and monitoring steps

0.670

  Kaiser–Meyer–Olkin (KMO) 0.605; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 62.18%

 0.4. Aseptic Techniques

  1

Follow aseptic and sterilization techniques and describe processes and facilities needed to provide sterile compounded parenteral solutions, including the basic requirements of hospital accreditation standards

0.901

0.880

  2

Develop standards and maintain written procedures for sterile and aseptic production of medicines, and total parental nutrition

0.899

  3

Apply knowledge of hospital hygiene and infection prevention control (IPC)

0.897

  Kaiser–Meyer–Olkin (KMO) 0.746; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 80.88%

 0.5. Pharmaceutical and Hospital Technology/Automation

  1

Understand their appropriate and safe use as well as unintended consequences

0.928

0.889

  2

Outline the basic functionality of commonly used automated systems related to medication use (such as automated dispensing cabinets, computerized prescriber order entry systems, bar code, medication administration systems, programmable infusion devices, and robotics)

0.909

  3

Ensure the effective introduction of new technologies

0.890

  Kaiser–Meyer–Olkin (KMO) 0.739; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 82.66%

 0.6. Pharmaceutical/Medical Skills

  1

Integrate and interface the clinical and distributive functions, including the synergy that translates into safe and effective medication therapy

0.867

0.891

  2

Integrate pharmaceutical oncology, nutrition, and other fields when applicable

0.849

  3

Appraise the inter-relationships between formulation (including excipients), drug delivery and therapeutic product

0.835

  4

Participate in designing and implementing pharmaceutical/therapeutic protocols and algorithms

0.780

  5

Demonstrate knowledge of pharmaceutical radiotherapy: therapeutic and diagnostic applications (e.g., contrasts) when applicable

0.753

  6

Describe the use of medical devices, prostheses, and implants when applicable

0.704

  7

Implement the appropriate use of injectable medications, including intravenous, intrathecal, intraocular, intradermal, and other routes

0.686

  8

Formulate, reconstitute and compound medicines when needed

0.677

  9

Develop protocols for ensuring quality of prepared medicines

0.601

  Kaiser–Meyer–Olkin (KMO) 0.857; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 57.01%

 0.7. Business management skills

  1

Perform financial management

0.960

0.947

  2

Set budgeting proposals

0.928

  3

Perform accounting activities

0.917

  4

Manage the payment terms and schedules with the suppliers

0.913

  Kaiser–Meyer–Olkin (KMO) 0.792; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 86.04%

Domain 1: Safe and Rational Use of Medicines

 1.1. Patient Safety

  1

Manage the problems related to switch patients medication to formulary medicines

0.848

0.896

  2

Employ performance improvement techniques used in health systems and describe how they are used to appropriate communications to pharmacy providers involved

0.816

  3

Describe the impact of pharmacist involvement on medication safety and quality using appropriate literature

0.812

  4

Reconcile effectively the medications of a patient transitioning from one care setting to another and make appropriate communications to involved pharmacy providers

0.778

  5

Understand patient safety culture that relates to medication use, pharmaceutical care, and pharmacists role

0.771

  6

Implement and promote pharmacovigilance activities within the hospital

0.767

  7

Report and document patient safety incidents

0.752

  Kaiser–Meyer–Olkin (KMO) 0.874; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 62.82%

 1.2. Quality assurance

  1

Discuss with and advise healthcare providers on issues related to pharmaceutical products and quality standards

0.880

0.774

  2

Describe the quality standard of the accreditation bodies

0.833

  3

Apply national standards, guidelines, best practices, and established principles and processes related to quality and safe medication use (e.g., storage of look-alike/sound-alike medications, high alert medications, storage of concentrated potassium in patient care areas, dangerous abbreviations, leading decimal points and trailing zeros, quality measures related to medications, etc.)

0.713

  4

Identify storage conditions and secure the medicines cold chain conditions

0.697

  Kaiser–Meyer–Olkin (KMO) 0.697; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 61.59%

 1.3. Pharmacovigilance

  1

Identify a potential adverse drug reaction

0.931

0.761

  2

Plan and implement medicines management actions to minimize the risk related to these medicines

0.815

  3

Consider that reporting an ADR is part of pharmacist duties

0.719

  Kaiser–Meyer–Olkin (KMO) 0.529; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 68.27%

Domain 2: Patient-centered care

 2.1. Literature Evaluation/Search/Trials

  1

Read recently published studies critically

0.870

0.846

  2

Develop and implement methods for clinical trials and observational studies

0.858

  3

Provide accurate and evidence-based answers

0.858

  4

Access appropriate drug information resources, including primary literature

0.779

  Kaiser–Meyer–Olkin (KMO) 0.764; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 70.92%

2.2. Pharmacokinetic-Based Assessment

  1

Evaluate drug-response and monitor patients

0.950

0.949

  2

Evaluate medication-use patterns in a specified patient population

0.948

  3

List the medications that need pharmacokinetic evaluation

0.918

  4

Apply dosing principle

0.909

  Kaiser–Meyer–Olkin (KMO) 0.805; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 86.79%

 2.3. Drug Use Optimization

  1

Optimize use of drugs, including addition, deletion, dose adjustment, intravenous to oral route switch, renal dosing, dose reduction, etc.

0.852

0.861

  2

Draft and distribute information and recommendations

0.826

  3

Provide quality care through the best use of resources

0.812

  4

Contribute to the establishment of medication use policies, including anti-microbial stewardship, criteria, and maintenance of the formulary as a member of the Pharmacy and Therapeutics Committee

0.811

  5

Demonstrate an appropriate level of clinical knowledge related to medications and therapeutics in making decisions or recommendations related to the clinical use of drugs when appropriate

0.726

  Kaiser–Meyer–Olkin (KMO) 0.829; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 65.05%

Domain 3: Professional skills

 3.1. Written and Oral Communication

  1

Communicate with pharmacy and healthcare team members

0.881

0.844

  2

Respond to questions with the appropriate level of detail necessary to ensure proper patient care and communication with other relevant parties

0.874

  3

Develop and maintain appropriate therapeutic recommendations related to medication therapy

0.833

  4

Demonstrate effective verbal and written communications

0.719

  Kaiser–Meyer–Olkin (KMO) 0.742; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 68.72%

 3.2. Professional Advancement

  1

Engage in regular professional development activities

0.973

0.943

  2

Engage in professional organization activities

0.973

  Kaiser–Meyer–Olkin (KMO) 0.500; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 94.59%

  3.3. Behavior and Ethics

  1

Support staff in their professional and personal development

0.880

0.764

  2

Able to carry out staff appraisals

0.855

  3

Apply ethical principles

0.720

  4

Demonstrate professional behavior (attitude, dress, appearance, etc.) in practice settings

0.620

  Kaiser–Meyer–Olkin (KMO) 0.681; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 60.22%

 3.4. Management

  1

Prioritize multiple patient care and triage in times of high activity and workload

0.864

0.852

  2

Implement the medication management strategy or plan

0.838

  3

Plan and manage physical and financial resources

0.829

  4

Demonstrate project and team management skills

0.728

  5

Demonstrate efficient problem-solving skills

0.719

  Kaiser–Meyer–Olkin (KMO) 0.755; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 63.63%

Domain 4: Pharmacist preparedness and response in emergency situation

 4.1. Emergency Preparedness and Response (EPR)

  1

Partner with local authorities

0.856

0.914

  2

Balance stockpile and availability of drugs for existing/chronic conditions

0.851

  3

Address medication shortage and mitigation plan

0.806

  4

Follow actions and recommendations of local authorities

0.798

  5

Involve trainees and staff in emergency response

0.796

  6

Check for training opportunities

0.784

  7

Check for FDA/EMA Emergency Use Authorizations (EUAs) and expedited review and approval of tests/drugs for treatment

0.751

  8

Check for volunteering opportunities

0.712

  Kaiser–Meyer–Olkin (KMO) 0.879; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 63.27%

 4.2. Operation management

  1

Adapt working hours to meet essential services during crises

0.888

0.918

  2

Secure personal protective equipment or other needed materials

0.870

  3

Secure sanitizers and other medications when needed

0.857

  4

Develop workplace training and safety protocols (e.g., social distancing)

0.807

  5

Monitor workers/assistants for symptoms

0.798

  6

Participate in interdisciplinary training to emergency preparedness and response teams

0.790

  7

Ensure medication delivery/safe storage

0.719

  8

Procure essential medications and supplies

0.655

  Kaiser–Meyer–Olkin (KMO) 0.876; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 64.23%

 4.3. Patient Care and Population Health Interventions

  1

Educate peers about the ongoing crisis using evidence-based information and communications

0.892

0.828

  2

Identify at-risk populations

0.847

  3

Continue medication reviews, screening and/or testing/vaccination services safely

0.816

  4

Answer EPR-related calls

0.784

  5

Maintain patient confidentiality

0.483

  Kaiser–Meyer–Olkin (KMO) 0.792; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 60.53%

 4.4. Evaluation, Research, and Dissemination for Impact and Outcomes

  1

Publish and/or disseminate findings

0.941

0.924

  2

Participate in research and studies on EPR

0.919

  3

Develop training programs to peers and other healthcare workers

0.878

  4

Combat misinformation by disseminating evidence-based information to patients and sharing it on social media

0.870

  Kaiser–Meyer–Olkin (KMO) 0.831; Bartlett’s test of sphericity < 0.001; Percentage of variance explained 81.42%