Impact of an immunization platform in community pharmacies

The role of pharmacy technicians in vaccination services: a scoping review

BACKGROUND

A busy pharmacy workload may limit a pharmacist's ability to meet the needs of vaccine-willing patients and also contribute to missed opportunities to engage with vaccine hesitant individuals. Opportunities for pharmacy technicians to support vaccination services may play a role in addressing increasing patient vaccination needs.

PURPOSE

This research aims to review the role of pharmacy technicians in vaccination services that is supported by pharmacy practice research to date.

METHODS

In compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocols, systematic searches were performed in PubMed, Embase, International Pharmaceutical Abstracts, Scopus, and CINAHL. Articles published through June 2020, in French, English, and Spanish, were screened for eligibility. Two independent reviewers screened titles and abstracts for inclusion. Data extraction of included study methodologies and results was performed by one reviewer and verified by a second reviewer.

RESULTS

A total of 656 records were identified through the search of published literature. Full-text screening of 145 records identified 14 articles for inclusion. Most articles evaluated emerging pharmacy technician roles in patient screening (n = 8, 53%) and vaccine administration (n = 5, 36%). Implementation of both emerging roles demonstrated positive patient outcomes (n = 10, 72%). Screening activities were complicated by the complexity of the role, as well as its potential to increase overall time spent on vaccination services. Pharmacists and technicians advocated for accredited vaccine administration training owing to consistent benefits in pharmacy workflow efficiency, pharmacist clinical time, and pharmacy technician job satisfaction.

CONCLUSION

This review supports the effective deployment of pharmacy technicians in delivering vaccination services. Despite pharmacy technician vaccine administration roles being highly regulated, professional advocacy by pharmacists and technicians can use the advantageous training, workflow, and patient outcomes benefits presented in this review. Early adopters of professional practice advancements for pharmacy technician vaccine administration may expand vaccination service capacity efficiently and safely, thereby reaching more patients.

Enhancing adult immunization care by community pharmacists: A qualitative analysis of Project VACCINATE

BACKGROUND

Project VACCINATE was a 1-year demonstration project conducted in 70 community pharmacies in Washington from September 1, 2016 to August 31, 2017 aimed at increasing adult vaccination and documentation in the state immunization information system (IIS). Key intervention features aligned with the Standards for Adult Immunization Practices and included incorporation of an immunization interface to facilitate proactive immunization screenings, patient engagement regarding vaccine needs, and vaccine documentation in the IIS as enhancements to the vaccination workflow.

OBJECTIVE

The objective of this qualitative study, a subanalysis of Project VACCINATE, was to identify community pharmacy staff members' perceptions of work system factors that influenced the implementation of key intervention features.

METHODS

Pharmacy staff at all Project VACCINATE locations were eligible to participate and were recruited by e-mail. Key informant interviews lasting 15-30 minutes were conducted by telephone using a semistructured interview guide. Interview transcripts were thematically analyzed using the Systems Engineering Initiative for Patient Safety (SEIPS) 2.0 model of work systems.

RESULTS

A total of 7 interviews were conducted with pharmacists from different pharmacy locations from September to December 2017. Nine factors emerged across all domains of the SEIPS 2.0 model regarding the implementation of the key intervention features. These factors were pharmacist-patient relationships, team culture, individualized patient education, technician involvement, electronic access to vaccine records, pharmacy layout, staff training, immunization documentation in other care settings, and insurance coverage.

CONCLUSIONS

Several key factors were identified that, when addressed, can enable the incorporation of proactive immunization screenings, patient engagement, and vaccine documentation as enhancements to the community pharmacy-based vaccination process. Community pharmacy organizations should consider incorporating the described factors into existing immunization programs when assessing the unique dynamics of their work system.