ABSTRACT
Doctors are perceived as the primary decision makers in antimicrobial therapy, but prescribing decisions are influenced by the multidisciplinary team. Antimicrobial stewardship (AMS) programs formalise interprofessional advice-giving. No studies capture the advice provided by pharmacists. This study aimed to describe the volume and nature of antimicrobial prescribing advice that healthcare professionals seek from hospital pharmacists. A prospective audit of antimicrobial-related advice requests received by pharmacists (n = 18) at an Australian public hospital was undertaken in July 2020. Antimicrobial advice was sought from 11 pharmacists on 300 occasions. Most requests (80%) were received by the AMS pharmacist. A mean (range) of 30 (17-40) requests per day was recorded and the AMS pharmacist received 24 (16-31) requests daily. Most requests came from the intensive care unit (22.1%), pharmacy (21.4%), and infectious diseases (17.1%). The AMS pharmacist was mostly contacted by consultants and pharmacists, and other pharmacists were contacted by registrars and junior medical officers. Despite COVID-19 adaptations, face-to-face interaction was most common. This audit demonstrates the value of an AMS pharmacist, and indicates the importance of face-to-face interactions and the formalisation of pharmacists' role in prescribing decision-making. Pharmacists provided antimicrobial advice daily to other healthcare professionals. Further research is required to provide insights into the barriers and enablers to effective advice-giving interactions.Copyright © 2022 The Authors. Journal of Pharmacy Practice and Research published by John Wiley & Sons Australia, Ltd on behalf of Society of Hospital Pharmacists of Australia.
ABSTRACT
Background: Healthcare workers (HCWs) are at significant risk of poor mental health (MH) because of the COVID-19 pandemic. MH services are available, but many are not sensitive to the needs and workplace culture of HCWs. 'Blended care', which integrates digital and person-to-person care, may leverage the scalability and anonymity of digital health while offering a choice of care options. Objectives: To outline the design and evaluation of The Essential Network (TEN), a blended mental health service created for Australian HCWs during the COVID-19 pandemic. Methods: We outline the development of TEN and service design methodologies, including stakeholder and user consultation, and strategies for adaptive service delivery. TEN was evaluated through an audit of service analytics (website analytics and clinical service analytics). A total of 105 HCWs also participated in an observational study to use TEN for 1 month. Participants completed MH and service acceptability measures at baseline and followup. Findings: TEN has serviced more than 57,000 HCWs. More than 7000 HCWs completed a digital MH assessment and received personalised referral to services. Engagement was highest for self-assessments and self-help resources. Preliminary results from the observational study indicate high service acceptability. Conclusion: TEN united peak professional bodies and service providers to create a digital hub offering HCWs a range of MH resources and help-seeking options. With more than 800,000 HCWs in Australia, uptake of the service has been relatively low. To leverage the potential of blended care, such services must be implemented in a way that ensures that HCWs feel safe to use them.