Exploring an extended role for pharmacy assistants on inpatient wards in UK hospitals: using mixed methods to develop the role of medicines assistants

Rathbone, Adam Pattison; Jamie, Kimberly; Blackburn, Jayne; Gray, William K.; Baqir, Wasim; Henderson, Elaine; Campbell, David

doi:10.1136/ejhpharm-2018-001518

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…The increased utilisation of pharmacy assistants has been shown to result in higher numbers of discharge medicine lists [ 34 , 35 ] whilst also enabling pharmacists to spend more time on other clinical activities [ 36 – 38 ]. This is an area that needs ongoing evaluation, with international studies showing the involvement of ward-based assistants also reducing the time needed by nursing staff on medication-related activities [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study

et al. 2022

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Background Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from hospital. Hospital pharmacists play an important role in preparing these lists although this process is time consuming. Aim To measure the time required by hospital pharmacists to complete the various tasks involved in discharge medicine handover. Method Time-and-motion study design was used to (1) determine the time involved for pharmacists to produce discharge medicine lists, (2) explore how pharmacists utilise various software programs to prepare lists, and (3) compare the time involved in discharge medicine handover processes considering confounding factors. An independent observer shadowed 16 pharmacists between 22 February and 12 March 2021 and recorded tasks involved in 50 discharge medicine handovers. Relevant information about each discharge was also collected. Results Pharmacists observed represented a range of practice experiences and inpatient units. Mean time to complete discharges was 26.2 min (SD 13.6), with over half of this time used to check documentation and prepare discharge medicine lists. A mean of 4.0 min was spent on manually retyping and reconciling medicine lists in different software systems. Medical inpatient unit discharges took 4.6 min longer to prepare compared to surgical ones. None of the 50 discharges involved support from pharmacy assistants; all 50 discharges had changed or ceased medicines. Conclusion There is a need to streamline current discharge processes through optimisation of electronic health software systems and better delegation of technical tasks to trained pharmacy assistants. Supplementary Information The online version contains supplementary material available at 10.1007/s11096-022-01436-1.

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Section: Discussionmentioning

confidence: 99%

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study

et al. 2022

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“…In one study, investigators reported the utilisation of pharmacy technicians and assistants to support the supply of time critical medicines led to a reduction of omitted doses of antimicrobial and antiseizure medication [9]. The utilisation of pharmacy assistants led to a signi cant reduction in time to complete nurse medication rounds in a second study [10].…”

Section: Introductionmentioning

confidence: 99%

Critical care pharmacy service provision and workforce in adult extracorporeal membrane oxygenation centres: a multicentre cross-sectional survey

Remmington,

Cameron,

Hanks

et al. 2024

Int J Clin Pharm

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BackgroundThere is good evidence describing pharmacy workforce and service provision in general critical care units. However, no data exists from adult extracorporeal membrane oxygenation (ECMO) centres. AimTo describe workforce characteristics, pharmacy service provision, and pharmaceutical care activities in critical care units providing an adult ECMO service in the United Kingdom (UK), and compare to national sta ng standards for critical care units. MethodWe conducted a multicentre, cross-sectional electronic survey inviting one pharmacy professional response per UK ECMO centre. ResultsThe survey response rate was 90.9%: representatives of 10/11 tertiary hospitals providing ECMO services responded. The median ratio of critical care pharmacists per critical care bed was 1:12.1 (interquartile range (IQR) -1:9.4 -1:14.9). Most centres (90.0%) did not meet national standards for pharmacy professionals to critical care bed sta ng ratios for weekday services. Total critical care beds covered by the critical care pharmacy team varied across the UK: median (IQR) -45 (37-80) beds. Two centres funded pharmacist time for ECMO activity, and one centre funded a pharmacy technician post. Median peak ECMO activity was 4 ECMO patients in a single day (IQR: 3-5). Most respondents reported reduced pharmacy service at weekends compared to weekday, with limited on-site support. ConclusionMost responding ECMO centres reported pharmacy sta ng ratios below nationally agreed critical care standards. There was high variability in clinical pharmacy services to ECMO patients over 7 days. Future work should address the gap in clinical pharmacy services, the 7-day service and ensure adequate technician provision across each ECMO centre. Impact Statements• Extracorporeal membrane oxygenation (ECMO) provides advanced respiratory and/or cardiac support to patients when conventional therapies on the critical care unit have failed.• ECMO patients have a high disease severity and pharmaceutical complexity.• Most responding ECMO centres reported pharmacy sta ng ratios below nationally agreed standards.

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“…Task shifting is increasing, but research is scarce [ 2 ]. Studies evaluating task shifting to established professionals groups, like Nurse Practitioners (NP’s) and Physician Assistants (PA’s) have reported higher quality of care, higher patient satisfaction and improvements in clinical outcomes [ 3 ] and often saved time [ 4 ]. The evidence for this is strongest with nurses [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating task shifting to the clinical technologist in Dutch healthcare: A mixed methods study

Haan

Eijk-Hustings²,

Bessems-Beks³

et al. 2023

PLoS ONE

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Background Expected rise in the demand for healthcare and a dropping supply of healthcare professionals, has generated an increased interest in the most effective deployment of healthcare professionals. Consequently, task shifting has become a common strategy to redistribute tasks between established professional groups, however, little is known about the effects of shifting tasks to emerging professional groups. The aim of this study was to evaluate a legal amendment to facilitate task shifting to an emerging profession in Dutch healthcare: Clinical Technologists (CTs). CTs were introduced and provided an Extended Scope of Practice (ESP) to perform nine ‘reserved procedures’ independently. Methods A concurrent multi-phase mixed methods study was used to evaluate whether a legal amendment to facilitate task shifting to CTs was effective and efficient. Results The results show that CTs use their ESP frequently to perform five categories of reserved procedures independently and suggest that the ESP increased the efficiency of care delivery for those procedures. Additionally, the findings highlight that task shifting was influenced by the setting in which CTs worked, time allotted to patient-contact as well as external factors (e.g., financing). Conclusions This study provides tentative lessons for policymakers on how task shifting to emerging professional groups can be improved. Providing a legal amendment to facilitate task shifting to CTs seems to be effective and efficient. However, it also poses multiple challenges. While established professional groups can face similar challenges, it is likely that these are exacerbated for emerging professional groups, particularly when shifting tasks occurs horizontally.

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Exploring an extended role for pharmacy assistants on inpatient wards in UK hospitals: using mixed methods to develop the role of medicines assistants

Cited by 6 publications

References 16 publications

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study

Critical care pharmacy service provision and workforce in adult extracorporeal membrane oxygenation centres: a multicentre cross-sectional survey

Evaluating task shifting to the clinical technologist in Dutch healthcare: A mixed methods study

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