scholarly journals P50 Time and motion study to assess workload versus staffing at in paediatric hospital chemotherapy manufacturing unit

2020 ◽  
Vol 105 (9) ◽  
pp. e33.1-e33
Author(s):  
Lamia Samrin-Balch ◽  
Jessica Laxaman
Keyword(s):  
Clinical Pharmacy ◽  
Economic Value ◽  
Position Statement ◽  
Substantial Part ◽  
List Type ◽  
Pharmacy Staff ◽  
Paediatric Hospital ◽  
Pharmacy Technician ◽  
Medication Therapy ◽  
Time And Motion

ObjectivesIn order to improve efficiency of the staff workload in the Paediatric Hospital Chemotherapy Manufacturing Unit, tasks conducted by the pharmacy staff were evaluated with their expected roles. The aims of this study were to establish an understanding of the workload at this unit and to develop a proposal for the unit to become technician-led.MethodsThe time taken to perform a pre-determined list of tasks by the senior pharmacy technician was recorded, collated, and compared to tasks performed by the pharmacist. This established the key activities that could be delegated from the pharmacist and the senior pharmacy technician to other members of staff. The findings were discussed with a focus group to establish the efficiency of the manufacturing unit and enable a proposal to be formed.Key findingsA substantial part of the pharmacist’s and senior pharmacy technician’s time was spent on activities which could be delegated to other members of staff of a lower pay band. The financial implication of this estimated that there would be a reduction of around £8,696.70 with the correct utilisation of the staff members. The pharmacists leading this manufacturing unit were spending most of their time on computing and training, therefore reducing the time available for them to focus on patient-facing clinical activities.ConclusionsThe current skill mix was highlighted as being inefficient, due to a lack of delegation from the pharmacists and senior pharmacy technician. A technician-led manufacturing unit can improve the focus of pharmacists on clinical tasks while reducing the cost of activities.ReferencesLord Carter of Coles. Operational productivity and performance in English NHS acute hospitals: unwarranted variations. An independent report for the Department of Health 2016; 10–11: 34–40.Willett MS BK, Rich DS, Ereshefsky L. Prospectus on the economic value of clinical pharmacy services. A position statement of the American College of Clinical Pharmacy. Pharmacotherapy 1989; 9:45–50.Barnett MJ, et al. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years. J Manag Care Pharm 2009;15:18–31.Napier P, et al. Introducing a checking technician allows pharmacists to spend more time on patient-focused activities. Res Social AdmPharm 2018;14:382–386.

scholarly journals Pharmacist-Provided Pharmacogenetic Point-of-Care Testing Consultation Service: A Time and Motion Study

2018 ◽  
Vol 34 (4) ◽  
pp. 139-143 ◽  
Author(s):  
David R. Bright ◽  
Michael E. Klepser ◽  
Logan Murry ◽  
Donald G. Klepser
Keyword(s):  
Community Pharmacy ◽  
Point Of Care ◽  
Pharmacy Practice ◽  
Point Of Care Testing ◽  
Pharmacy Staff ◽  
Pharmacy Technician ◽  
Time And Motion Study ◽  
Time And Motion ◽  
Motion Study ◽  
Pharmacy Setting

Background: With recent advances in pharmacogenomics (PGx) comes the potential to customize medication use based on genetic data. Support for PGx has found practical limitations in terms of workflow and turnaround time of a test. However, with the expansion of point-of-care testing (POCT) in pharmacy practice models comes opportunity for PGx testing in the pharmacy setting. Objective: The purpose of this study is to quantify the amount of time spent during each step of a PGx POCT encounter in a community pharmacy setting. Methods: A time and motion study was conducted using a mock community pharmacy space for a simulated PGx-focused encounter to manage antiplatelet therapy following hospital discharge. PGx POCT was conducted using the Spartan RX instrument. Simulated patient encounters were divided into 7 categories. Time spent in each step, as well as total time spent, was tracked. Results: A total of 54 simulated PGx POCT encounters took place with an average time of 9.49 minutes (SD ± 1.38 minutes). Instrument run time adds 60 minutes to the total time required to obtain a result. Duties that could be performed by an appropriately trained pharmacy technician totaled 6.86 minutes. Conclusions: PGx POCT would require 9.49 minutes of pharmacy staff hands-on time for the encounter, which could be reduced to 2.64 minutes of pharmacist time with appropriate pharmacy technician involvement. Time requirements for PGx POCT are similar to that of community pharmacy–based immunizations. Future studies could explore how practice could change if PGx testing were routinely performed in the pharmacy.

SP8 Introducing a ward-based pharmacy technician to support the administration of paediatric medicines: an evaluation of parent and staff perspectives

2018 ◽  
Vol 103 (2) ◽  
pp. e1.50-e1
Author(s):  
Barker Catrin ◽  
Bartlett Donna ◽  
Brown Pauline ◽  
Bracken Louise ◽  
Bellis Jenny ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Positive Impact ◽  
Alternative Methods ◽  
List Type ◽  
Pharmacy Technician ◽  
Change In Practice ◽  
Specialist Knowledge ◽  
Medicines Optimisation ◽  
Medicine Administration ◽  
The Impact

AimTo determine the impact of replacing a nurse with a ward-based pharmacy technician as the second checker, in the process of administering medicines to children in hospital by exploring the views and experiences of parents and staff involved in the change in practice.MethodHaving undertaken additional in-house training, a pharmacy technician replaced the second nurse on medication ward rounds (second checker) for 10 months over two wards. This took place on a neuro-medical ward and a medical specialty ward. The pharmacy technician undertook roles relating to medicines administration, including: attending day time medicine administration rounds; checking accuracy and appropriateness of prescriptions; preparing/administering prescribed medicines; independently undertaking dosage calculations; recording the administration of medicines. Using their specialist knowledge and skills, the role aimed to improve medicines optimisation for patients and their families during their inpatient stay.Research staff conducted semi-structured qualitative interviews with parents of patients who were administered medicines during the study period (n=12) and with staff involved with the change in practice, as well as an interview with the pharmacy technician themselves after leaving each ward. Families were recruited from the two wards. Semi-structured interviews with staff (n=14) gathered data on the perspectives and experiences of the contribution of the ward-based pharmacy technician across two wards. An exploratory approach was taken using Thematic Analysis.1 Interviews were transcribed verbatim and anonymised. The research team familiarised themselves with transcripts by reading in full and generating initial codes using text from the data. Themes were generated and discussed between the team to produce an overall story of the analysis. Interviews were conducted over a 4 month period.ResultsParents discussed the importance of communication about their child’s medicines in hospital. Some parents were aware of the pharmacy technician’s role as second checker. Parents recognised the benefits of the technician’s background and expertise, and their contribution to the ward team.Fourteen staff interviews were conducted including the ward based pharmacy technician (after leaving each ward), the Chief Pharmacist, the Director of Nursing, a Ward Manager, Nursing and Pharmacy staff. Staff commented how the pharmacy technician provided a link between the Pharmacy and Nursing teams, alleviating nurses of administration duties and allowing them to spend more time with patients. The role was also seen as educational allowing for nurses to refresh their knowledge on medication storage procedures and alternative methods of administration.ConclusionTo the research team’s knowledge, this is the first study of its kind to assess the potential benefits of introducing a ward-based pharmacy technician as a second checker. This novel role extension releases nursing staff time to undertake more patient-centred nursing duties. In addition, the specialist knowledge of the pharmacy technician at the point of medicine administration had a positive impact on medicines optimisation for children in hospital, providing more effective administration of medicines and contributing to wider patient safety in paediatric settings. Although further evaluation is required, our findings indicate that parental and staff support the future development of this service.ReferenceBraun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology 2006;3(2):77–101.

scholarly journals Time and Motion Study of Influenza Diagnostic Testing in a Community Pharmacy

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Donald Klepser ◽  
Allison Dering-Anderson ◽  
Jacqueline Morse ◽  
Michael Klepser ◽  
Stephanie Klepser ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Clinical Laboratory ◽  
Vital Signs ◽  
Pharmacy Practice ◽  
Original Research ◽  
Pharmacy Technician ◽  
Time And Motion Study ◽  
Time And Motion ◽  
Motion Study ◽  
Time Required

Background: It has been shown that use of rapid diagnostic tests (RDTs) is able to reduce costs and improve the prescribing practice of antivirals (i.e. oseltamivir) among patients with influenza-like illnesses (ILIs). Using existing Clinical Laboratory Improvement Amendment (CLIA)-waived RDTs and collaborative practice agreements, similar to those used to allow pharmacists to administer vaccines, it is possible for patients to seek point-of-care treatment for influenza or flu-like symptoms at a local pharmacy. Following a review of the patient's symptoms by a trained pharmacist, the qualified patient is offered an RDT to determine if the influenza virus is the cause of the symptoms. Based on the results of the RDT, the patient is provided with the appropriate treatment as defined by an approved practice agreement. Objective: The aim of this study was to evaluate the feasibility of incorporating an RDT for influenza into community pharmacy practice. Methods: This time and motion study was conducted at three community pharmacy locations, and a total of eight simulated patient visits were completed utilizing a standardized patient. In addition to determining a total time of the encounter, each simulation was divided into nine timed sub-categories. For data analysis, the time spent in each of the nine sub-categories was assigned to the pharmacist, pharmacy technician, or patient. Time and motion methodologies were used to estimate the total time required to provide the RDT service, to determine the amount of active time required of the pharmacist and pharmacy technician, and to evaluate the ability of the staff to provide the service within its existing workflow. Results: The average total time to complete the entire patient encounter for an influenza assessment utilizing an RDT was 35.5 minutes (± 3.1 minutes). On average, the pharmacist spent 9.4 minutes (± 3 minutes) per encounter or about 26.5% of the entire encounter. When the pharmacy technician collected the vital signs, the pharmacist-required time was reduced to 4.95 minutes (± 2.7 minutes), which was about a 48% reduction. Conclusions: The results indicate that an RDT program for influenza assessment required no more than a modest amount of pharmacist time and could be successfully incorporated into regular workflow with little to no disruption of other activities. As such, this approach to influenza management may be a feasible service for community pharmacies to offer patients. This was especially true if the pharmacy had well-trained technicians on staff that could support the service with collection of patient histories and vital signs.   Type: Original Research

Primary care pharmacy technicians: Effect on pharmacist workload and patient access to clinical pharmacy services

2020 ◽  
Vol 77 (Supplement_4) ◽  
pp. S93-S99
Author(s):  
Dmitry Walker ◽  
Katherine J Hartkopf ◽  
David R Hager
Keyword(s):  
Primary Care ◽  
Clinical Pharmacy ◽  
Relative Increase ◽  
Relative Reduction ◽  
Pharmacy Services ◽  
Patient Access ◽  
Pharmacy Technician ◽  
Work Sampling ◽  
Clinical Pharmacy Services ◽  
Pharmacy Technicians

Abstract Purpose Improve patient access to clinical pharmacy services and decrease pharmacist technical task workload in primary care (PC) clinics. Summary Due to concerns with the amount of technical tasks performed by University of Wisconsin Health PC clinical pharmacists negatively impacting their capacity to care for patients and perform clinical tasks, the pharmacy department piloted a new PC pharmacy technician role that involved completion of technical tasks previously performed by PC pharmacists. PC pharmacist daily technical and clinical activities were identified through shadowing and quantified by a 4-week period of work sampling. A PC pharmacist workgroup determined the technical tasks that would be appropriate for a pharmacy technician to complete and developed the technician workflows. A PC pharmacy technician was implemented during a 3-week pilot, when pharmacist daily technical and clinical activities were quantified through work sampling. Following implementation, a 52.7% (P < 0.001) relative reduction and a 10.2% (P < 0.001) relative increase in pharmacist technical and clinical activities, respectively, were identified. Additionally, a 10% relative increase from the previous 3-month average was observed in the PC pharmacist rolling patient panel size during the pilot period, correlating with an increase of patient access to pharmacist clinical services. Conclusion Up to 17% of PC pharmacist daily activities are technical tasks. Leveraging pharmacy technicians to support pharmacists with completion of these tasks increases patient access to clinical pharmacy services but requires additional staff resources.

scholarly journals P32 An audit to assess the suitability of patients at a tertiary/quaternary paediatric hospital to switch from intravenous (IV) to oral (PO) antimicrobial therapy

2020 ◽  
Vol 105 (9) ◽  
pp. e23.1-e23
Author(s):  
Orlagh McGarrity ◽  
Aliya Pabani
Keyword(s):  
High Risk ◽  
Antimicrobial Resistance ◽  
Blood Culture ◽  
Antimicrobial Stewardship ◽  
Antimicrobial Therapy ◽  
Blood Cultures ◽  
Antimicrobial Use ◽  
List Type ◽  
Paediatric Hospital ◽  
Oral Agents

Introduction, Aims and ObjectivesIn 2011 the Start Smart then Focus campaign was launched by Public Health England (PHE) to combat antimicrobial resistance.1 The ‘focus’ element refers to the antimicrobial review at 48–72 hours, when a decision and documentation regarding infection management should be made. [OM1] At this tertiary/quaternary paediatric hospital we treat, immunocompromised, high risk patients. In a recent audit it was identified that 80% of antimicrobial use is IV, this may be due to several factors including good central access, centrally prepared IV therapy and oral agents being challenging to administer to children. The aim of the audit was to assess if patient have a blood culture prior to starting therapy, have a senior review at 48–72 hours, and thirdly if our high proportion of intravenous antimicrobial use is justified.MethodElectronic prescribing data from JAC was collected retrospectively over an 8 day period. IV antimicrobials for which there is a suitable oral alternative, this was defined as >80% bioavailability, were included. Patients were excluded in the ICU, cancer and transplant setting, those with absorption issues and with a high risk infection, such as endocarditis or bacteraemia. Patient were assessed against a set criteria to determine if they were eligible to switch from IV to PO therapy; afebrile, stable blood pressure, heart rate <90/min, respiratory rate < 20/min for 24 hours. Reducing CRP, reducing white cell count, blood cultures negative or sensitive to an antibiotic that can be given orally.Results100% of patients (11) had a blood cultures taken within 72 hours of starting therapy55% of patients had a positive blood culture82% of patients had a senior review at 48–72 hours46% of patients were eligible to switch from IV to PO therapy at 72 hours33% of eligible patients were switched from IV to PO therapy at 72 hoursConclusion and RecommendationsThis audit had a low sample size due to the complexity of the inclusion and exclusion criteria, and the difficulty in reviewing patient parameters on many different hospital interfaces. It is known that each patient is reviewed at least 24 hourly on most wards and therefore there is a need for improved documentation of prescribing decisions. Implementation of an IV to oral switch guideline is recommended to support prescribing decisions and educate and reassure clinicians on the bioavailability and benefits of PO antimicrobial therapy where appropriate. Having recently changed electronic patient management systems strategies to explore include hard stops on IV antimicrobial therapies, however this will require much consideration. Education of pharmacist and nurses is required to raise awareness about antimicrobial resistance and the benefits of IV to PO switches, despite the ease of this therapy at out Trust. This will promote a culture in which all healthcare professionals are active antimicrobial guardians, leading to better patient outcomes, less service pressures, and long term financial benefit.ReferenceGOV.UK. 2019. Antimicrobial stewardship: Start smart - then focus. [ONLINE]Available at: https://www.gov.uk/government/publications/antimicrobial-stewardship-start-smart-then-focus [Accessed 3 July 2019]

Clinical pharmacy service practice in a Chinese tertiary hospital

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Bing Chen ◽  
Jing-Jing Huang ◽  
He-feng Chen ◽  
Bei-ming Xu
Keyword(s):  
Clinical Pharmacy ◽  
Early Stage ◽  
Tertiary Hospital ◽  
Training System ◽  
Pharmacy Service ◽  
Clinical Pharmacy Service ◽  
Therapeutic Drug ◽  
Clinical Pharmacokinetics ◽  
Clinical Pharmacists ◽  
Medication Therapy

AbstractClinical pharmacy service is focused on the rationality and safety of medication therapy. Clinical pharmacists play an important role in designing therapeutic regimen, preventing medication errors, reducing the incidence of adverse drug reaction, and saving medical costs. Although clinical pharmacy service in China is in its early stage, its development is rapid. In this manuscript, the working model of clinical pharmacists in a Chinese tertiary hospital is introduced, including ward rounds, consultation, stewardship of antimicrobial therapy, drug adverse reaction monitoring, therapeutic drug monitoring, clinical pharmacokinetics and pharmacogenetics, and training system. With the efforts of clinical pharmacists, there will be a significant increase in the optimization of medication therapy and a notable reduction in preventable adverse drug events as well as health-care cost in China.

Characterization of drug-related problems identified by clinical pharmacy staff at Danish hospitals

2014 ◽  
Vol 36 (4) ◽  
pp. 734-741 ◽  
Author(s):  
Lene Juel Kjeldsen ◽  
Trine Birkholm ◽  
Hanne Fischer ◽  
Trine Graabæk ◽  
Karina Porsborg Kibsdal ◽  
...  
Keyword(s):  
Clinical Pharmacy ◽  
Drug Related Problems ◽  
Pharmacy Staff

Establishing a clinical pharmacy technician at a United States Army military treatment facility

2016 ◽  
Vol 56 (5) ◽  
pp. 573-579.e1 ◽  
Author(s):  
Jennifer L. Evans ◽  
Ellen M. Gladd ◽  
Alicia C. Gonzalez ◽  
Salman Tranam ◽  
Joni M. Larrabee ◽  
...  
Keyword(s):  
United States ◽  
United States Army ◽  
Clinical Pharmacy ◽  
Treatment Facility ◽  
Pharmacy Technician ◽  
Military Treatment Facility

scholarly journals Analysis on Clinical pharmacy services provided by pharmacists for promoting elderly patients care

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 745-750
Author(s):  
Bushan Kumar GG ◽  
Jyothi Singamsetty ◽  
Rajasekhar K V ◽  
Sahitya Meda
Keyword(s):  
Patient Care ◽  
Adverse Drug Reactions ◽  
Clinical Pharmacy ◽  
Clinical Pharmacist ◽  
Pharmacy Services ◽  
Care Hospital ◽  
Drug Reactions ◽  
Clinical Pharmacy Services ◽  
Medication Therapy ◽  
Prescription Errors

Clinical pharmacy services are the services provided by the pharmacists to promote patient care, optimizes medication therapy, promote health and disease prevention. This prospective cross sectional study was conducted in tertiary care hospital over a period of 6 months. This collected data is checked for their appropriateness of any prescription related errors and DRPs were identified. Results obtained were assessed to determine the influence of Clinical pharmacist services. Majority of the prescriptions were with 5-9(62.5%) drugs. The majority of co-morbidities among 125 enrolled patients in age group of 60-70, 55 patients were with 3-4 co-morbidities. Among 125 prescriptions around 12 prescriptions were identified with 622 drug interactions. Among 125 patients 2 (0.277) adverse drug reactions were observed and according to Naranjo's probability assessment scale these adverse drug reactions were mild and 15(2.08%) dispensing errors, 10(1.386%) prescription errors where majority of prescription errors are due to missed written frequencies in the prescriptions. 5(0.693%) administration errors, 5 (0.693%)untreated indications were observed. Presence of clinical pharmacist in hospital settings can reduce drug related problems and they can assist other staff in improving patient care.

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