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Twose P, Terblanche E, Jones U, Firshman P, Merriweather J, Rock C, Wallace S. Protected therapy services for critical care: A subanalysis of the UK-wide workforce survey. Aust Crit Care 2023; 36:821-827. [PMID: 36604266 DOI: 10.1016/j.aucc.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 11/07/2022] [Accepted: 11/13/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The existing United Kingdom (UK) allied health professional (AHP) workforce in critical care does not meet national standards, with widespread variation in the source of funding, service availability, and regularity of input. OBJECTIVES The aim of this subanalysis was to determine the impact of protected services on the involvement of AHPs on direct and nondirect aspects of patient care. METHODS This is a subanalysis of the previously published AHPs in critical care UK-wide workforce survey, an observational study using online surveys distributed to 245 critical care units across the UK. RESULTS/FINDINGS Services with protected funding provided more daily input within critical care. This was most apparent for occupational therapy where daily input varied from 82.1% of units with protected services compared to just 10.3% in those without (p < 0.001). For all professions, most notably occupational therapy and speech and language therapy, protected services increased the regularity in which specific interventions were completed and had impact on involvement in nonclinical aspects of care including involved in multidisciplinary team meetings, clinical governance, and research. CONCLUSIONS The absence of protected AHP services reduces compliance with national standards for therapy workforce. Based on these findings, UK and international critical care guidelines should promote protected AHP services for critical care.
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Affiliation(s)
- Paul Twose
- School of Healthcare Sciences, Cardiff University, UK; Physiotherapy Department, Cardiff and Vale UHB, UK.
| | - Ella Terblanche
- Kings College London, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, London SE1 8WA, UK.
| | - Una Jones
- School of Healthcare Sciences, Cardiff University, UK.
| | | | | | - Claire Rock
- Mid and South Essex NHS Foundation Trust, UK.
| | - Sarah Wallace
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, UK.
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2
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Borthwick M, Barton G, Ioannides CP, Forrest R, Graham-Clarke E, Hanks F, James C, Kean D, Sapsford D, Timmins A, Tomlin M, Warburton J, Bourne RS. Critical care pharmacy workforce: a 2020 re-evaluation of the UK deployment and characteristics. HUMAN RESOURCES FOR HEALTH 2023; 21:28. [PMID: 37004069 PMCID: PMC10064945 DOI: 10.1186/s12960-023-00810-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/18/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Critical care pharmacists improve the quality and efficiency of medication therapy whilst reducing treatment costs where they are available. UK critical care pharmacist deployment was described in 2015, highlighting a deficit in numbers, experience level, and critical care access to pharmacy services over the 7-day week. Since then, national workforce standards have been emphasised, quality indicators published, and service commissioning documents produced, reinforced by care quality assessments. Whether these initiatives have resulted in further development of the UK critical care pharmacy workforce is unknown. This evaluation provides a 2020 status update. METHODS The 2015 electronic data entry tool was updated and circulated for completion by UK critical care pharmacists. The tool captured workforce data disposition as it was just prior to the COVID-19 pandemic, at critical care unit level. MAIN FINDINGS Data were received for 334 critical care units from 203 organisations (96% of UK critical care units). Overall, 98.2% of UK critical care units had specific clinical pharmacist time dedicated to the unit. The median weekday pharmacist input to each level 3 equivalent bed was 0.066 (0.043-0.088) whole time equivalents, a significant increase from the median position in 2015 (+ 0.021, p < 0.0001). Despite this progress, pharmacist availability remains below national minimum standards (0.1/level 3 equivalent bed). Most units (71.9%) had access to prescribing pharmacists. Geographical variation in pharmacist staffing levels were evident, and weekend services remain extremely limited. CONCLUSIONS Availability of clinical pharmacists in UK adult critical care units is improving. However, national standards are not routinely met despite widely publicised quality indicators, commissioning specifications, and assessments. Additional measures are needed to address persistent deficits and realise gains in organisational and patient-level outcomes. These measures must include promotion of cross-professional collaborative working, adjusted funding models, and a nationally recognised training pathway for critical care pharmacists.
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Affiliation(s)
- Mark Borthwick
- Departments of Pharmacy and Critical Care, Oxford University Hospitals NHS Foundation Trust, Oxford, England, United Kingdom.
| | - Greg Barton
- Pharmacy Department, St Helens and Knowsley Teaching Hospitals NHS Trust, England, Prescot, United Kingdom
| | - Christopher P Ioannides
- Pharmacy Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom
| | - Ruth Forrest
- Departments of Pharmacy and Critical Care, NHS Greater Glasgow and Clyde, Glasgow, Scotland, United Kingdom
| | - Emma Graham-Clarke
- Department of Anaesthetics, Sandwell and West, Birmingham Hospitals NHS Trust, Birmingham, England, United Kingdom
| | - Fraser Hanks
- Pharmacy Department, Guy's and St Thomas' NHS Foundation Trust, London, England, United Kingdom
| | - Christie James
- Pharmacy Department, Aneurin Bevan University Health Board, Cwmbran, Wales, United Kingdom
| | - David Kean
- Pharmacy Department, Belfast Health and Social Care Trust, Belfast, Northern Ireland, United Kingdom
| | - David Sapsford
- Pharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, England, United Kingdom
| | - Alan Timmins
- Pharmacy Department, NHS Fife, Kirkcaldy, Scotland, United Kingdom
| | - Mark Tomlin
- Pharmacy Department, University Hospital Southampton NHS Foundation Trust, Southampton, England, United Kingdom
| | - John Warburton
- Pharmacy Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, England, United Kingdom
| | - Richard S Bourne
- Pharmacy Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, England, United Kingdom
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3
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Hilgarth H, Waydhas C, Dörje F, Sommer J, Kluge S, Ittner KP. [Drug therapy safety supported by interprofessional collaboration between ICU physicians and clinical pharmacists in critical care units in Germany : Results of a survey]. Med Klin Intensivmed Notfmed 2023; 118:141-148. [PMID: 35258694 PMCID: PMC9992023 DOI: 10.1007/s00063-022-00898-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/22/2021] [Accepted: 01/06/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Critically ill patients are particularly susceptible to adverse drug events. International studies show that pharmaceutical care has a positive impact on patient and drug therapy safety. Nationally, the integration of pharmacists into the multidisciplinary team and participation in ward rounds is required. The aim of this work is to assess the scope and extent of pharmaceutical care in intensive care units (ICU) in Germany. METHOD In a literature and database search, 13 relevant pharmaceutical activities were identified. Based on this, an online survey with 27 questions on the implementation of pharmaceutical care in ICU was prepared by a panel of experts. The survey was sent to heads of German ICUs. RESULTS Of the participants, 35.3% (59/167) have established regular pharmaceutical care. Drug information (89.7% [52/58]), pharmaceutical interventions with change of therapy (e.g., ward rounds; 67,2% [39/58]), regular evaluation of prescriptions (medication analysis; 65.5% [38/58]) as well as the monitoring of medication (e.g., side effects, effectiveness, costs; 63.8% [37/58]) were most frequently mentioned. The participants with pharmaceutical care (58/168) graded 7 of 13 but those without (104/168) only two activities as 'essential/indispensable'. CONCLUSION Only a few ICU in Germany have already integrated ward pharmacists into the multidisciplinary team. Once a pharmaceutical service has been established, a greater role/importance is assigned to several pharmaceutical activities.
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Affiliation(s)
- Heike Hilgarth
- Klinikapotheke und Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Ausschuss für Intensivmedizin und klinische Ernährung, ADKA - Bundesverband Deutscher Krankenhausapotheker e. V., Berlin, Deutschland
- Sektionsgruppe Qualitätsverbesserung und Informationstechnologie, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - Christian Waydhas
- Sektionsgruppe Qualitätsverbesserung und Informationstechnologie, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
- Klinik und Poliklinik für Chirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland
- Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland
| | - Frank Dörje
- Ausschuss für Intensivmedizin und klinische Ernährung, ADKA - Bundesverband Deutscher Krankenhausapotheker e. V., Berlin, Deutschland
- Apotheke des Universitätsklinikums Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Julia Sommer
- Apotheke des Universitätsklinikums Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - Stefan Kluge
- Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland
| | - Karl Peter Ittner
- Sektionsgruppe Qualitätsverbesserung und Informationstechnologie, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland.
- Lehr- und Forschungseinheit Pharmakologie, Fakultät für Medizin, Universität Regensburg, Regensburg, Deutschland.
- Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland.
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4
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Twose P, Terblanche E, Jones U, Bruce J, Firshman P, Highfield J, Jones G, Merriweather J, Newey V, Newman H, Rock C, Wallace S. Therapy professionals in critical care: A UK wide workforce survey. J Intensive Care Soc 2023; 24:24-31. [PMID: 36874286 PMCID: PMC9975796 DOI: 10.1177/17511437221100332] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction National guidelines suggest recommended staffing levels for therapies. The aim of this study was to capture information on existing staffing levels, roles and responsibilities and service structures. Methods An observational study using online surveys distributed to 245 critical care units across the United Kingdom (UK). Surveys consisted of a generic and five profession specific surveys. Results Eight hundred sixty-two responses were received from 197 critical care units across the UK. Of those that responded, over 96% of units had input from dietetics, physiotherapy and SLT. Whereas only 59.1% and 48.1% had an OT or psychology service respectively. Units with ring fenced services had improved therapist to patient ratios. Discussion There is significant variation in access to therapists for patients admitted to critical care in the UK, with many services not having services for core therapies such as psychology and OT. Where services do exist, they fall below the recommended guidance.
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Affiliation(s)
- Paul Twose
- Physiotherapy Department, University Hospital of Wales, Cardiff, UK
| | - Ella Terblanche
- Applied Technologies for Clinical Care, King's College London, UK
| | - Una Jones
- Occupational Therapy Department, Torbay Hospital, Torbay, UK
| | - James Bruce
- Occupational Therapy Department, Torbay Hospital, Torbay, UK
| | - Penelope Firshman
- Occupational Therapy Department, Denmark Hill, Kings College Hospital NHS Foundation Trust, London, UK
| | - Julie Highfield
- Critical Care Department, University Hospital of Wales, Cardiff, UK
| | - Gemma Jones
- Speech and Language Therapy Department, University Hospital of Wales, Cardiff, UK
| | | | - Vicky Newey
- Physiotherapy Department, St Marys Hospital, London, UK
| | - Helen Newman
- Therapists Department, Barnet Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Claire Rock
- Occupational Therapy Department, Mid and South Essex NHS Foundation, Basildon, UK
| | - Sarah Wallace
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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5
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Li XX, Zheng SQ, Gu JH, Huang T, Liu F, Ge QG, Liu B, Li C, Yi M, Qin YF, Zhao RS, Shi LW. Drug-Related Problems Identified During Pharmacy Intervention and Consultation: Implementation of an Intensive Care Unit Pharmaceutical Care Model. Front Pharmacol 2020; 11:571906. [PMID: 33013415 PMCID: PMC7516263 DOI: 10.3389/fphar.2020.571906] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 08/20/2020] [Indexed: 12/29/2022] Open
Abstract
Aim To identify common drug-related problems (DRPs) during pharmacy intervention and consultation in an intensive care unit (ICU); to explore the gap between physicians and pharmacists on their understanding of each other’s capabilities and needs. Method We conducted a single-center prospective study in the ICU of a tertiary academic hospital for 21 months. A pharmaceutical care (PC) model was implemented by a pharmacy team, and data were collected during pharmacy intervention and consultation. Data analysis was performed on identified DRPs, causes and their relationships. DRPs’ frequency during intervention and consultation was compared. Problem-level descriptive analysis and network analysis were conducted using R 3.6.3. Result Implementation of PC model greatly improved the efficacy of pharmacists in both interventions proposed to solve DRPs (from 13.6 to 20.1 cases per month) and number of patients being closely monitored (from 7.7 to 16.9 per month). Pharmacists identified 427 DRPs during pharmacy intervention with primarily adverse drug events (ADEs, 34.7%) and effect of treatment not optimal (25.5%), and 245 DRPs during consultation (mainly ADEs, 58.4%). About three-fifths DRPs were caused by antibiotics. Comparing DRPs identified during pharmacy intervention and consultation, physicians consulted pharmacists more on questions related to medication safety, while pharmacists also paid attention to treatment effectiveness, which was consulted less commonly. Conclusion Implementation of PC model is beneficial in guiding pharmacy practice and improving efficacy especially under limited human resources. Physicians and pharmacists shall continue ensuring drug safety and be familiar with the scope of PC and clinical need for a better cooperation.
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Affiliation(s)
- Xiao-Xiao Li
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Si-Qian Zheng
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Jia-Hui Gu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Tao Huang
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Fang Liu
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
| | - Qing-Gang Ge
- Department of Intensive Care Unit, Peking University Third Hospital, Beijing, China
| | - Bin Liu
- Information Management and Big Data Center, Peking University Third Hospital, Beijing, China
| | - Chao Li
- Department of Intensive Care Unit, Peking University Third Hospital, Beijing, China
| | - Min Yi
- Department of Intensive Care Unit, Peking University Third Hospital, Beijing, China
| | - You-Fa Qin
- Department of Clinical Pharmacy, SSL Center Hospital of Dongguan City, Dongguan, China
| | - Rong-Sheng Zhao
- Department of Pharmacy, Peking University Third Hospital, Beijing, China.,Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China
| | - Lu-Wen Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,International Research Center for Medicinal Administration, Peking University, Beijing, China
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6
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Zare M, Zarei L, Afifi S, Karimzadeh I, Ghaeminia M, Peiravian F, Salehi-Marzijarani M, Lankarani KB, Peymani P. Evaluating Pharmacist's Patient Care Process in Shiraz, using a newly-validated questionnaire: The First Report from Iran. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020059. [PMID: 32921756 PMCID: PMC7717002 DOI: 10.23750/abm.v91i3.8027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 02/23/2020] [Indexed: 02/08/2023]
Abstract
Background: The Pharmacists’ Patient Care Process (PPCP) as one of many inter-related foundations for the delivery of evidence-based and outcomes-focused patient care has a positive trend in academic literatures in the world. Unfortunately, PPCP has not been establish well in community pharmacies in Iran, yet. This study was performed to explore the current status of the provision and perception toward patient care services and finally evaluate professional competency of pharmacists about PPCP implementation, in both patients and pharmacist’s perspectives. Methods: A cross-sectional study was conducted using two self-administrated Likert-based questionnaires_ one for pharmacists and another one for patients. In total, 121 pharmacists and 479 patients participated to the study. Questionnaires were distributed and collected in the Shiraz during the Oct 2017 till Jun 2018. Obtained data were analyzed through the statistical package for social sciences (SPSS) version 25. In addition, the competency to PPCP implementation was classified to three groups _good, moderate, and weak _ based on achieving ≥75%, 50%-75%, and <50% of the dimensions’ total score, respectively. Results: The pharmacist’s age range was 23-76 years (mean age: 40.61±12.85 years). Their Competency to PPCP implementation was good (43.8%), moderate (52%), and just 4% weak. Patient’s response to PPCP was 11.2% good, 50.7% moderate and 35.6% weak. Conclusion: Besides promotion of public awareness about PPCP, improvement of pharmacists’ motivation toward these services seems necessary. In addition, the introduced instrument may be useful for practice of pharmacists, but it should be used cautiously until it is tested among clients of pharmacies known to provide all levels of pharmacy care within pharmacy stores. (www.actabiomedica.com)
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Affiliation(s)
- Marziyeh Zare
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences.
| | - Leila Zarei
- Health Policy Research Center, Institute of Heath, Shiraz University of Medical Sciences, Shiraz, Iran..
| | - Saba Afifi
- Health Policy Research Center, Institute of Heath, Shiraz University of Medical Sciences, Shiraz, Iran..
| | - Iman Karimzadeh
- Clinical Pharmacy Department, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran..
| | - Mustafa Ghaeminia
- Research and Development Department, Vice-chancellor for Food and Drug, Shiraz University of Medical Sciences, Shiraz, Iran..
| | - Farzad Peiravian
- Department of Pharmacoeconomics and Pharma Management, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran..
| | | | - Kamran B Lankarani
- Health Policy Research Center, Institute of Heath, Shiraz University of Medical Sciences, Shiraz, Iran..
| | - Payam Peymani
- Health Policy Research Center, Institute of Heath, Shiraz University of Medical Sciences, Shiraz, Iran..
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7
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The Bedside Critical Care Pharmacist: A Mandatory ICU Team Member Essential for Patient Care. Crit Care Med 2020; 47:1276-1278. [PMID: 31415315 DOI: 10.1097/ccm.0000000000003888] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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8
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Rennie T, Nangombe V, Mangombe T, Kibuule D, Hunter CJ. Health workforce planning in Namibia: assessing a pilot workforce survey of pharmacists. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2019; 27:565-574. [DOI: 10.1111/ijpp.12547] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 05/02/2019] [Indexed: 11/30/2022]
Abstract
Abstract
Background
Southern Africa lacks resources necessary to combat presenting health challenges. This crisis will likely be remedied through the in-country training of healthcare professionals, for example, in Namibia. Monitoring the workforce will be essential to inform planning in health services and training. A national pilot workforce survey in Namibia using a multi-modal sampling approach aimed to test methodology for describing the pharmacy workforce and quantifying preferences towards further training.
Methods
The survey tool included questions relating to socio-demographics, professional and practice aspects. A conjoint analysis approach was utilised to quantify preferences around study programme, modality of study and cost.
Key findings
Respondents (N = 135; ~20% response) represented a diverse range of individuals in various pharmacy sectors in Namibia. The majority of respondents reported female gender, private sector working, studying outside Namibia and societal group membership. Societal membership and pharmacy ownership – indicators of professional engagement – were associated with higher age; ownership was also associated with study outside Namibia and practice in community pharmacy. Regarding further study preferences, respondents placed more importance on study programme and modality over cost with the most preferred scenario being a 2-year full-time Masters programme in pharmaceutical industry/regulation by distance learning at the highest cost bracket.
Conclusions
This national survey sampled the population of pharmacists in Namibia exploring the composition of the profession and preferences towards training. Further work will validate the findings and provide ongoing monitoring of the pharmacy workforce that can be expanded to other professional groups over a larger geographical area.
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Affiliation(s)
- Timothy Rennie
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Vulika Nangombe
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Tafadzwa Mangombe
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Dan Kibuule
- School of Pharmacy, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
| | - Christian J Hunter
- School of Medicine, Faculty of Health Sciences, University of Namibia, Windhoek, Namibia
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Abstract
The use of medication to support patients and optimise outcomes is a fundamental strand of care. Pharmacists provide a key role managing medication within the complexity of various routes of administration, severe and rapidly shifting pharmacokinetic and dynamic parameters, and extremes of physiology in critical illness. Pharmacists intercept and resolve medication errors, optimise medication therapy and undertake broader professional activities within the job role that contribute to the smooth running of ICU. These activities are associated with improved quality, reduced mortality and reduced costs.
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Affiliation(s)
- Mark Borthwick
- Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, UK
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10
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Seneviratne RE, Bradbury H, Bourne RS. How Do Pharmacists Develop into Advanced Level Practitioners? Learning from the Experiences of Critical Care Pharmacists. PHARMACY 2017; 5:pharmacy5030038. [PMID: 28970450 PMCID: PMC5622350 DOI: 10.3390/pharmacy5030038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 06/20/2017] [Accepted: 06/30/2017] [Indexed: 11/16/2022] Open
Abstract
The national UK standards for critical care highlight the need for clinical pharmacists to practise at an advanced level (equivalent to Royal Pharmaceutical Society, Great Britain, Faculty Advanced Stage II (MFRPSII)) and above. Currently the UK is unable to meet the workforce capacity requirements set out in the national standards in terms of numbers of pharmacist working at advanced level and above. The aim of this study was to identify the strategies, barriers and challenges to achieving Advanced Level Practice (ALP) by learning from the experiences of advanced level critical care pharmacists within the UK. Eight participants were recruited to complete semi-structured interviews on their views and experiences of ALP. The interviews were analysed thematically and three overarching themes were identified; support, work-based learning and reflective practice. The results of this study highlight that to increase the number of MFRPSII level practitioners within critical care support for their ALP development is required. This support involves developing face-to-face access to expert critical care pharmacists within a national training programme. Additionally, chief pharmacists need to implement drivers including in house mentorship and peer review programmes and the need to align job descriptions and appraisals to the Royal Pharmaceutical Society, Great Britain, Advanced Practice Framework (APF).
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Affiliation(s)
- Ruth E Seneviratne
- Departments of Pharmacy and Critical Care, Sheffield Teaching Hospitals, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
| | - Helen Bradbury
- Faculty of Medicine and Health, University of Leeds, Leeds LS2 9JT, UK.
| | - Richard S Bourne
- Departments of Pharmacy and Critical Care, Sheffield Teaching Hospitals, Northern General Hospital, Herries Road, Sheffield S5 7AU, UK.
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