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Introduction It has long been felt that many contributions made by the ICU Pharmacy team, are not well showcased by the yearly regional network multi-speciality contributions audit. Themes specific to ICU are diluted amongst Trust and region wide data, and valuable learning for the multi-disciplinary team (MDT) is subsequently overlooked. Objective(s): The aims of this project were to: * Develop and pilot a MicrosoftTM Access © database for the ICU pharmacy team to record significant contributions. * Enable the production of reports to the ICU Quality & Safety board, to raise awareness, disseminate concerns, and influence future quality improvement projects. * Provide examples to contribute to the training of the whole MDT. * Generate evidence of team effectiveness and encourage further investment. * Provide team members with a means to recall contributions, for revalidation, appraisal, prescribing re-affirmation and framework mapping. Method(s): * A database was built with a user-friendly data-entry form to prevent overwriting. Fields were agreed with peers who would be using the database. * The team were invited to voluntarily enter their contributions which they thought added value and provided useful learning. * The pilot phase ceased with the emergence of the Omicron SARS-CoV-2 variant, due to staffing pressures and surge planning. Result(s): * Between 12/07/2021 and 25/11/2021, a total of 211 contributions were recorded. * Pharmacists entered 88.6% and a single technician entered 11.4% of these. * Independent Prescribing was utilised in 52.13% of contributions, and deprescribing in 25.12%. * Figure 1 demonstrates the contributions by drug group * The top 5 drugs associated with contributions were: ? Dalteparin ? Vancomycin ? Voriconazole ? Meropenem ? Co-trimoxazole * Treatment optimisation was an outcome for 76.3% of all contributions. Figure 2 stratifies these by type. Contributions. * Drug suitability was a cause for intervention in 12.8% of all contributions, encompassing allergies, contraindications, cautions and interactions and routes. * Medicines reconciliation accounted for 17.54% of all contributions, which almost half were Technician led. Admission was the most common stage to intervene (81.08%), followed by transcription. * Of all contributions, 37.91% were classified as patient safety incidents. Reassuringly 76.25% of these were prevented by the Pharmacy team. Themes have been extracted from these incidents and are presented in Table 1. Conclusion(s): PROTECTED-UK1 demonstrated the value pharmacists contribute to the quality and safety of patient care on ICU. Studies of similar quality and scale including Pharmacy Technicians are lacking, but even in this pilot study, it is evident how important their input is. Independent prescribing is a fundamental and well utilised part of our ICU Pharmacist skillset, supporting the GPICS2 recommendation that ICU pharmacists should be encouraged to become prescribers. Compiling a team interventions database is a useful tool to highlight local priority areas for guideline development;training;and ensuring that appropriate decision support is built into electronic prescribing systems. To improve the usefulness of the data, further stratification of contributions according to the Eadon Criteria3 may be worthwhile, to expand its use as a medication safety thermometer for ICU.
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Introduction: Older people face numerous challenges and safety risks when managing multiple medicines. They are required to cope with complex and changing regimens and co-ordinate input from multiple healthcare professionals. If not well managed, medicines can cause harm, and older people are more susceptible to errors. Some older people can devise and implement strategies to manage their medicines, e.g. creating checklists, ensuring timely supplies, solving problems, and seeking help (1). However, no interventions address the multiple tasks polypharmacy patients must perform to safely manage their regimens. Aim(s): To develop an intervention to support medicines self-management for older people living with frailty and polypharmacy using experience-based co-design (EBCD) (2). Method(s): Following video or audio-recorded qualitative interviews with 32 older people taking 5 or more medicines, a 'trigger film' of patients' medicines management experiences was produced and used during EBCD to facilitate priority setting. Separate meetings were held (1) with 16 staff (2 GPs, 4 GP practice administrators, 4 GP practice pharmacists, 1 practice lead, 2 senior nurses, 2 pharmacy technicians, 1 community pharmacist) and (2) with 13 patients and 2 family members, followed by a joint meeting with 8 older people and 9 staff where a shared set of three priorities was agreed. Two subsequent co-design workshops with 6 patients, 2 family members and 7 staff developed three candidate interventions. Workshop 1 explored key themes from the trigger film to develop solutions. Workshop 2 reviewed solutions and further developed design ideas. Intervention components were merged and those addressing patient safety challenges were retained to form the prototype intervention. Ethical approval was obtained for the interviews included in the trigger film, but not required for EBCD. EBCD meetings and workshops were conducted as quality improvement: people involved were collaborators, personal information was not captured, discussions were not recorded or analysed. Result(s): Co-design priorities were to support patients in: day-to-day practical medicines management;understanding the wider medicines management system;communication with healthcare teams. The three solutions were: a quick-start guide to managing multiple medicines including talking about medicines and managing new routines;tips and tricks to support day-to-day management, including planning and adherence tools;a tool supporting preparation for medication reviews and asking questions about medicines. After merging intervention components and identifying those addressing medicinesself- management patient safety challenges, five areas were retained for the prototype intervention: checking what you get;keeping on top of supplies;monitoring how you take your medicines;times when problems are more likely;and how do I know if I need help? Discussion/Conclusion: Through EBCD patients and staff worked together to improve people's experiences of managing medicines and to enhance safety. The prototype intervention addresses five areas where older people with complex medicines regimens require support. The intervention requires feasibility testing and subsequent robust evaluation. Strengths and limitations: * A variety of staff roles joined the co-design, offering multiple different perspectives on medicines management * EBCD meetings and workshops were run online to avoid Covid infections. This may have excluded older people with no access to internet.
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Inevitably, most of us who work with laboratory animals will sometimes form bonds with the animals we are caring for. These relationships will positively enhance the care and wellbeing of the animals' but they also pose important emotional challenges, as was clearly exposed with some contingency managements associated with the COVID-19 pandemic. It is important that the industry acknowledge the existence of these bonds and provide institutional support mechanisms to help Animal Technologists to deal with the emotional challenges of their profession. Current COVID-19 associated working logistics pose further challenges such as delegation of responsibilities, separation of working teams and contingency management of stock to name but a few, along with the individual health and social, economic and personal relationship challenges. This article provides some tools and ideas to support a more open, communicative and emotionally-supportive working environment. The importance of 'self-care' is also discussed. There is a growing commitment to nurture a Culture of Care, and supporting our colleagues by raising awareness of our emotional challenges may support this.Copyright © 2021 Institute of Animal Technology. All rights reserved.
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No technologist, manager or director could have predicted what was going to happen in the lead up to, and during the COVID-19 pandemic;it is certainly a period of time no one will ever forget or want to witness again. However, within this, it is clear to see that staff felt looked after, and the efforts put in place helped them feel more positive as life began to return to the new 'normal'. We believe that the University of Birmingham had a significant focus on the Culture of Care provided for staff during these difficult times and that due to this, staff felt supported and looked after by their management. Going forward, the facility continues to place an emphasis on the proactive implementation of the 3Rs with the additional benefit of knowing this also has a visible positive impact upon the Animal Technologists too.Copyright © 2022 Institute of Animal Technology. All rights reserved.
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Introduction: Pharmacy technicians began administering immunizations in Idaho State as part of a new administrative rule in 2017. Rapid expansion of pharmacy technicians as immunizers occurred during the COVID-19 pandemic. Previous studies demonstrate the success of having technicians as immunizers but, the opinions of technicians themselves about immunizing have not been explored. Methods: Key informant interviews were conducted to evaluate the opinions of certified and immunization-trained pharmacy technicians in the State of Idaho. A key informant interview script was utilized and included questions regarding satisfaction with current position, feelings about responsibility in the pharmacy, confidence administering immunizations to patients, changes patient interactions after becoming immunization-trained, support in the pharmacy, and opinion about expansion of immunization training for technicians to other states. The aim of this research was to gather the opinions of pharmacy technicians regarding the impact of administering immunizations on job satisfaction and career outlook. Results: Fifteen pharmacy technicians were interviewed. All participants believed their role as immunizers improved job satisfaction and feelings of being a valuable part of the pharmacy team. Technicians also believed being able to immunize aided in pharmacy workflow, decreased wait time for immunizations at their respective pharmacies, and increased the number of immunizations being administered. Respondents also believed technicians should be allowed to administer immunizations nation-wide but also felt strongly that the decision to immunize should be up to each individual pharmacy technician. Conclusion: Immunizing technicians in this study believe that this advanced role has had a positive impact on their job satisfaction, feeling valued in the workplace, and likelihood of staying in their current position. Immunizing has also led to positive engagement with patients and beliefs that they are providing an impactful service to their communities.
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Purpose: COVID-19 is an important public health problem impacting the whole world. This study aimed to evaluate health technician students' knowledge and behaviors regarding COVID-19 and protective measures. Material and Methods: This cross-sectional study was performed with Dokuz Eylul University Vocational School of Health Services students (n=648). Data were collected online using a descriptive data registration form that consisted of 65 questions via Google Forms. Results While the students' mean knowledge score on COVID-19 and protective measures was 15.31 +/- 3.22, the mean behavior score was 10.53 +/- 3.34. A significant difference was detected between the students' education program, gender, father's educational status, smoking, and exercise habits and total behavior score averages related to COVID-19 and protective measures (p<0.05). Students who received training on the prevention of infectious diseases during their student years and who stated that they received any training on COVID-19 had higher mean knowledge and behavior scores regarding protective measures against COVID-19 (p<0.05). Students who were afraid of being infected with COVID-19, who had had COVID-19, and whose relatives died due to COVID-19 had higher mean behavior scores regarding protective measures against COVID-19 (p<0.05). Conclusion: It was revealed that the students participating in the study had moderate knowledge about COVID-19 and protective measures and exhibited positive behavior regarding protective measures. Since increasing the knowledge levels of future health technicians will also be reflected in their protective behaviors, which are important for their professional life, it is recommended that necessary arrangements be made in the education curriculum to improve their knowledge and behavior.
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Introduction: Injectable medicines are increasingly used to manage risk factors for cardiovascular (CV) events, such as PCSK-9 inhibitors in dyslipidaemia and GLP-1 agonists in diabetes. However, there is a paucity of data around the administrative and clinical practicalities when using these injectables, and limited information on patient and healthcare professionals' perceptions. Purpose(s): To identify the facilitators and barriers on the use of injectable therapies with CV benefits by undertaking interviews with patients, caregivers and healthcare professionals (HCPs). Method(s): Interviews were conducted via telephone and using MS Teams due to Covid-19 restrictions in the United Kingdom (London and Leeds) and Italy (Rome and Milan) in 2021. Coding was undertaken using NVivo and thematic analysis performed. Result(s): A total of 56 patients were interviewed: 30 in the U.K. (mean age 66 yrs, 60% male) and 26 patients in Italy (mean age 63 yrs, 80% male) and 11 caregivers (mean age 59 yrs, 73% female). A total of 38 HCPs were interviewed, 19 in each country and composed of physicians (n=18), pharmacists (n=10), nurses (n=9) and pharmacy technician (n=1). Three distinct themes were identified: (i) Organisational and governance issues - relating to prescribing restrictions and availability of the drugs locally (PCSK9i are initiated and supplied from hospitals) and lack of communication between hospital and primary care setting;(ii) Clinical issues around HCPs' skills and experience - including: Lack of experience with these injectables, lack of time to provide education to patients and caregivers, therapeutic inertia (HCPs not adopting a change in practice despite the evidence or due to bureaucratic restrictions) as well as lack of knowledge on long-term effects, and finally (iii) Patient-related issues - relating to behaviours and beliefs such as reluctance about using injectable therapies, and lack of education about these injectables in terms of indications/clinical benefits for use. Despite some differences in the prescribing of these injectables in the two countries, the analysis captured similar facilitators and barriers. Facilitators included prior use of injectables (e.g. insulin), and the ability to reach a clinical target of lower cholesterol by having just a one shot . HCPs stated that access to rapid pathology tests would aid uptake of injectables with CV benefit as well as having educational tools on these injectables in practice. Conclusion(s): This qualitative study identified barriers to initiation, continuation, and adherence with injectable therapies with CV benefits but also highlighted areas where changes can be made especially around education and support for patients and HCPs.
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Background Significance: A shortage of clinical sites has made it difficult for the psychiatric technician (PT) to practice skills, such as therapeutic communication. Therapeutic communication is an important component of the PT curriculum. The development of virtual reality (VR) software has the potential to enhance communication skills, addressing students' self-efficacy when communicating with patients suffering from mental illness. Problem: A lack of available clinical sites and COVID-19 has made it challenging for students to obtain hands-on performance skills, including their ability to develop the skill of therapeutic communication, and complete their training and certification. PT students are required to develop skills to assess the status of a patient's mental state and appropriately interact with their clients. Traditionally, this has been accomplished via on-site clinical experiences at health care sites. Methods: This was a feasibility and acceptability project using post-implementation surveys. The Simulation Evaluation Tool-Modified (SET-M) evaluates how well simulation met student learning outcomes, communication skills, and self-perception on ability to communicate. The System Usability Scale (SUS) evaluates the usability of the VR simulation technology. Interventions: A VR scenario featuring a patient with post-traumatic stress disorder (PTSD) was designed, and developed. The platform allowed the student to make critical decisions through the given scenario. Development of the scenario was guided by the "INACSL Standards of Best Practice" of the International Nursing Association for Clinical Simulation and Learning (INACSL) and the "Clinical Practice Guidelines for the Management of PTSD and Acute Stress Disorder" of the Department of Defense (DoD) and U.S. Veterans Affairs (VA). Content for the scenario was approved by content experts for validity. Training on the use of the VR platform was provided for faculty and PT students prior to completing the VR scenario. Evaluation: Data were analyzed to determine if the project aims were achieved. The aims of this project were to: (a) develop a 3D immersive clinical decision scenario using VR platform;(b) assess acceptance of the new technology;and (c) measure communication skills in a 3D VR environment. Results: The results of this project suggested that most students (84%) agreed that the VR software was easy to use. Ninety-six percent of students felt more confident in clinical decision and communication skills with the PTSD patient. The implementation of the VR was feasible and acceptable to students. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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BACKGROUND: The coronavirus pandemic (COVID-19) has focused attention on healthcare workers' concerns about working during a pandemic, yet research on the effect of the pandemic specifically on paramedics is lacking. This literature review aims to critically examine the current knowledge of paramedics' experience of barriers to, and enablers of, responding to suspected or confirmed COVID-19 cases. METHODS: An integrative review was undertaken using articles found by a systematic search of four research databases. Inclusion criteria included paramedics or emergency medical technicians who had experience of barriers or enablers responding to patients during the coronavirus pandemic. RESULTS: Nine articles met the inclusion and exclusion criteria. Barriers included communication and poor leadership, fear of infection to self and family, frequent changes in guidelines and inconsistencies across agencies, stress/burnout, and concerns with personal protective equipment. Enablers included job security, perceived social support, solidarity with other paramedics, and use of modern technologies for communication. CONCLUSIONS: There are unique experiences of working during the COVID-19 pandemic in the prehospital environment. Particular challenges occurred with leadership, communication within the organisation and between agencies, and working in an unpredictable environment.
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Background: Dr Gray's Hospital Elgin provides an outpatient chemotherapy service as a satelite unit to Aberdeen Royal Infirmary (65 miles away). Treatment is ordered at Dr Gray's by a suitably trained and experienced clinical pharmacist, pending patient blood test results. Purpose(s): The COVID-19 pandemic has brought with it many challenges. Anticipated staff shortages, coupled with the complete removal of shielded staff from the department, have necessitated changes to normal working practices. Method(s): Remote access to the NHS Grampian network was enabled for a pharmacist, working at home on an NHS Grampian device. Subsequently it was possible to access Chemocare, the chemotherapy prescribing and administration system, and Trakcare, the electronic patient records system. Following patient toxicity screening and reporting of their blood test results, the Macmillan nurses authorise the prescription, allowing final verification by the pharmacist. The technician then accuracy checks the chemotherapy and releases it for delivery to the unit, ready for administration to the patient. Result(s): The clinical pharmacy service to the outpatient chemotherapy clinic has been safely maintained by an appropriately qualified pharmacist, while minimising the level of input required from pharmacy technicians. Conclusion(s): There have been minimal alterations to the service. This has been possible through small adaptations to access existing electronic resources, and frequent communication between the pharmacist and technician. Through full utilisation of remote access to NHS systems it has been possible to implement this alteration to service whilst maintaining at all times patient confidentiality and full professional accountability.
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Practice-oriented learning is essential in emergency medical Technician (EMT) education to impart the ability to respond to various emergency situations based on major knowledge. The application of S-PBL in connection with simulation allows the improvement in competencies such as problem-solving strategies, skills, and teamwork by providing realism related to the field situation. This study aimed to design a simulation problem-based learning (S-PBL) module on respiratory care cases, intended to be applied to the curriculum for EMT students, and then the effectiveness of the module within the class was analyzed by focus group interview. The module developed in this study was applied to 16 EMT students in their third year at S University in Chungnam who were enrolled in classes opened for the first semester of 2021. Following implementation of the S-PBL module, an additional focus group interview was conducted with five students. The developed module was configured to directly or indirectly evaluate emergency communication ability, emergency patient assessment ability, advanced treatment ability, as well as communication and collaboration ability, and was evaluated through expert consulting formed by the Institute for Innovative Education of S University.Overall class satisfaction was evaluated as high (4.92 out of 5), and the students were determined to have experienced " needs for modification of learning strategy," "self-efficacy," and "cooperative learning" through the class with the S-PBL module. © 2022,Journal for ReAttach Therapy and Developmental Diversities. All Rights Reserved.
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This article describes the workforce and educational challenges faced by pharmaconomists in Denmark as a consequence of the first wave of the COVID-19 pandemic. In Danish pharmacies, pharmaconomists make up the majority of the staff. They hold a higher level of qualification than the general European pharmacy technician, more comparable to that of a Bachelor's degree. In the community pharmacies, pharmaconomists worked long hours and faced new questions and a change in behaviour by the public due to the pandemic. An emergency agreement between The Danish Association of Pharmaconomists and the Association of Danish Pharmacies made flexible planning possible, and guidelines with recommendations meant that most community pharmacies ended up introducing safety measures. In hospitals, pharmaconomists were directly engaged in deciding which kinds of medicine to stock up on to help the COVID-19 patients as they were admitted to hospital. A high level of cooperation and the slashing of red tape made things run relatively smooth. The training of pharmaconomist students went online in spring of 2020, as did exams. It required planning, as did the return to physical school activities as well as CPE in the autumn of 2020. Copyright © 2020 FIP.
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At the beginning of the COVID-19 outbreak, the public was under the impression that this crisis would last a short time, a few days at worst, weeks. However, cases of positivity grew, and the world closed in on itself. Life came to a standstill. The economy stopped. Transport stopped. Necessary components of society had to continue to keep functioning. Critical infrastructure employees kept the country running. The spread of contagion was reduced by the carriers through various measures. The main measures were taken from government regulations. Several European carriers had nearly unified requirements for passengers on their vehicles. The setting of measures was in accordance with the governments' regulations so as to provide and ensure the highest level of elimination of infection of passengers and maintenance personnel in the means of transport.
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BACKGROUND: During the Sars-CoV-2 virus pandemic, Italy faced an unrivaled health emergency. Its impact has been significant on the hospital system and personnel. Clinical neurophysiology technicians played a central role (but less visibly so compared to other healthcare workers) in managing the COVID-19 pandemic. This research aims to explore the experiences of clinical neurophysiology technicians during the pandemic and contribute to the debate on the well-being of healthcare workers on the front line. METHODS: We implemented a cross-sectional survey across Italy. It contained questions that were open-ended for participants to develop their answers and acquire a fuller perspective. The responses were analyzed according to the framework method. RESULTS: One hundred and thirty-one responses were valid, and the following themes were generated: technicians' experiences in their relationship with patients, technicians' relationship with their workgroup and directors, and technicians' relationship with the context outside of their work. The first theme included sub-themes: fear of infection, empathy, difficulty, a sense of obligation and responsibility, anger, and sadness. The second theme contained selfishness/solidarity in the workgroup, lack of protection/collaboration from superiors, stress, and distrust. The last theme included fear, stress/tiredness, serenity, sadness, and anger. CONCLUSION: This study contributes to building a humanized perspective for personnel management, bringing attention to the technical work of healthcare professionals in an emergency and the emotional and relational dimensions. These are the starting points to define proper, contextually adequate support.