What do emergency department pharmacist practitioners know and understand about patient safeguarding? A qualitative study.

BACKGROUND: Pharmacists with additional clinical skills now work in UK emergency departments. Known as Emergency Department Pharmacist Practitioners, the role was developed in response to a shortage of physicians and nurses. They carry out activities typical of traditional hospital pharmacists, but also novel 'practitioner' activities such as examining patients, and acting as designated care provider. The role includes a responsibility to safeguard patients from harm. Professional competence, i.e. to safeguard patients, is underpinned by knowledge of the subject, but also knowledge application. AIM: To investigate what Emergency Department Pharmacist Practitioners know and understand about safeguarding vulnerable children and adults. METHOD: Thirteen Emergency Department Pharmacist Practitioners were interviewed to explore their knowledge and understanding of safeguarding. Interview questions were developed from review of relevant literature, as were vignettes with variables identified and altered to produce different scenarios. Template analysis was used to code data to a priori themes for each of the stages of the initial safeguarding process, and new themes that emerged throughout the process. RESULTS: Six themes were identified in addition to the four a priori themes. Overall, participants frequently described how safeguarding concerns are both recognised and responded to, but seemed more comfortable when responding to medicines related concerns. Factors thought to influence the safeguarding process included: resources and setting; and education, training and experiential learning; and culture. CONCLUSION: While Emergency Department Pharmacist Practitioners interviewed were aware of the safeguarding process, there were some misconceptions as to the roles of different healthcare workers in this process.

Best practices: applying management analysis of excellence to immunization.

The authors applied business management tools to analyze and promote excellence and to evaluate differences between average and above-average immunization peformers in private practices. The authors conducted a pilot study of 10 private practices in Pennsylvania using tools common in management to assess practices' organizational climate and managerial style. Authoritative and coaching styles of physician leaders were common to both groups. Managerial styles that emphasized higher levels of clarity and responsibility managerial styles were evident in the large practices; and rewards and flexibility styles were higher in the small above-average practices. The findings of this pilot study match results seen in high performers in other industries. It concludes that the authoritative style appears to have the most impact on performance. It has interesting implications for training/behavior change to improve immunization rates, along with traditional medical interventions.