ABSTRACT
Objective: To describe the impact of the COVID-19 pandemic on safe prescribing, using the PINCER prescribing indicators; to implement complex prescribing indicators at national scale using GP data. Design: Population based cohort study, with the approval of NHS England using the OpenSAFELY platform. Setting: Electronic health record data from 56.8 million NHS patients' general practice records. Participants: All NHS patients registered at a GP practice using TPP or EMIS computer systems and recorded as at risk of at least one potentially hazardous PINCER indicator between September 2019 and September 2021. Main outcome measure: Monthly trends and between-practice variation for compliance with 13 PINCER measures between September 2019 and September 2021. Results: The indicators were successfully implemented across GP data in OpenSAFELY. Hazardous prescribing remained largely unchanged during the COVID-19 pandemic, with only small reductions in achievement of the PINCER indicators. There were transient delays in blood test monitoring for some medications, particularly ACE inhibitors. All indicators exhibited substantial recovery by September 2021. We identified 1,813,058 patients at risk of at least one hazardous prescribing event. Conclusion: Good performance was maintained during the COVID-19 pandemic across a diverse range of widely evaluated measures of safe prescribing.
Subject(s)
COVID-19ABSTRACT
Context: Because of the coronavirus disease 2019 (COVID-19) pandemic, many athletic training programs (ATPs) moved to mandatory virtual learning environments (VLEs) as access to clinical education sites was restricted for nonessential personnel, such as athletic training students (ATSs). Objective: To describe the development of a program for delivering clinical education for all ATSs through a VLE model. Background: Athletic training programs were faced with the task of delivering clinical education for all students through a virtual learning model. Further complicating the situation was that no blueprint for a VLE existed for athletic training. Description: The ATP developed clear, definitive objectives for a 6-week VLE, but afforded each clinical site the autonomy to determine how it could best implement the objectives of the VLE based upon its individual strengths and limitations. Advantage(s): Students reported increased self-motivation, improved communication skills and self-confidence, an improved ability to adapt to new situations, increased independence, personal and professional growth, the ability to stay positive and focused in the face of unexpected challenges, increased appreciation and application of evidence-based practice, and a more in-depth understanding and confidence related to organization and administration topics. Conclusion(s): Virtual learning environments offer an alternative for accomplishing the clinical education of ATSs when they cannot be physically present because of extenuating circumstances, such as a pandemic. Additionally, the objectives and implementation strategies of the VLE can be integrated into the face-to-face clinical education plan to create an improved comprehensive approach to clinical education.