Community Pharmacists’ Beliefs about Suboptimal Practice during the Times of COVID-19

Abstract

Introduction: Community pharmacies are high-performance workplaces; if the environment is not conducive to safe practice, mistakes can occur. There has been increasing demand for pharmacists during the COVID-19 pandemic as they have become integral to the response. Suboptimal practices in the work environment and with pharmacists and their teams can impact the safe delivery of services. New Zealand pharmacists’ perceptions of the current work environment and beliefs around whether suboptimal practice have increased within the last five years and the effect of the COVID-19 pandemic on their practices are unknown. Aim/Objectives: To assess what New Zealand pharmacists associate with suboptimal practice in their workplace and investigate the effect of the COVID-19 pandemic on pharmacists and their workplaces. Methods: We employed an anonymous online questionnaire derived from a human factors framework utilised in the aviation industry to explore the potential environment, team and organisational factors as the determinants of suboptimal work practices. The software, hardware, environment and liveware (S.H.E.L.L) model was adapted to create questions classifying the risk factors to potentially identify aspects of work systems that are vulnerable and may provide risks to optimal practice. Additional perceptions around the effect of COVID-19 on their workplace and roles as pharmacists were explored. Participants were community pharmacists working in New Zealand contacted via a mailing list of the responsible authority for the profession. Findings: We received responses from 260 participants. Most participants indicated that suboptimal practice had increased in the last 5 years (79.8%). The majority of participants indicated that COVID-19 had impacted their workplaces (96%) and their roles as pharmacists (92.1%). Participants perceived that suboptimal practice was associated with a lack of leadership and appropriate management; poor access to resourcing, such as adequate staff and narrow time constraints for work tasks; a lack of procedures; competition; and stress. A lack of experience, professionalism and poor communication between staff, patients and external agencies were also issues. COVID-19 has affected pharmacists personally and their work environments. Further study in this area is required. Conclusions: We have identified that pharmacists across all sectors of New Zealand agreed that suboptimal practices had increased in the last 5 years. A human factors S.H.E.L.L framework can be used to classify themes to understand the increases in suboptimal practice and the role of COVID-19 on pharmacist practice. Many of these themes build on the growing body of the international literature around the effect of the pandemic on pharmacist practice. Areas for which there are less historical data to compare longitudinally include pharmacist wellbeing and the impact of COVID-19.

Understanding the Risk Factors and Stressors Impacting Optimal Work Practices in New Zealand Pharmacies: A S.H.E.L.L Model Analysis

“…The study was undertaken using a mixed methods approach in a similar manner to the previous publication to answer a query about suboptimal practice in the New Zealand setting [ 17 ]. The study gathered data by having registered New Zealand pharmacists complete an anonymous online Qualtrics TM XM survey.…”

“…The survey was available from 1 October 2021 until 30 November 2021. No further reminders of the survey were emailed, and no follow-up non-responder bias was examined [ 17 ].…”

“…Color encoding and circular diagram representations were employed for data presentation. Themes were then defended through scholarly argument, examination, and rationalization in research team meetings [ 17 ]. The overarching narrative is presented as a collection of general topics which overview the absolute key drivers of optimal practice.…”

Evaluation of community pharmacy workplace wellness: Literature review, environmental scan, and task force recommendations

“…Workforce related issues were hypothesized by Wong et al as a potential solution for suboptimal pharmacy practice. 70 In 2022, Wong et al found that 79.8% of pharmacists surveyed reported an increase in the suboptimal practice of pharmacy over the previous five years. 70 …”

“… 70 In 2022, Wong et al found that 79.8% of pharmacists surveyed reported an increase in the suboptimal practice of pharmacy over the previous five years. 70 …”