Pharmacy Work Research Articles

The Impact of Job Instruction Training Within Pharmacy.

Purpose: To provide pharmacy leaders and clinicians with the basic principles of a training method called job instruction (JI) and its application within pharmacy as a strategy to teach routine pharmacy work. Summary: Job instruction is a reliable way to teach a person to quickly learn how to perform a work standard correctly, safely, and efficiently. Job instruction is a proven and successful technique for improving time to train, productivity, employee turnover and quality of work. In healthcare, JI training is not well-known or widely utilized. Job Instruction was the strategy of choice to stabilize the variable training practices within The University of Kansas Health System pharmacy enterprise, and a prospective, single center, multi-cohort study was conducted to study its impact. Conclusion: The preliminary results of this study provide initial insight into the applicability of job instruction in pharmacy. The study indicated the benefits of JI training within different teams to standardize training practices, decrease error and safety event rates, and increase satisfaction of team members with on-the-job training. The results of this study will be used to further analyze and optimize training practices in The University of Kansas Health System pharmacy enterprise.

Types and Sources of Stigma on Opioid Use Treatment and Recovery Communities on Reddit

Background: Digitally-mediated peer support may improve opioid use disorder (OUD) recovery. Our objective was to examine the types and sources of stigma that people seek support for in online OUD recovery communities (subreddits) on Reddit. Methods: We extracted all posts containing stigma keywords from three subreddits as well as a random sample that do not contain stigma keywords. We conducted deductive content analysis to confirm that the post self-described an experience of stigma and identify the type (condition, intervention) and source (provider-based, public, self, structural) of stigma. Results: Two-hundred and fifty-nine posts self-reported a stigmatizing experience. The majority of posts described an intervention stigma associated with medications for OUD. Posts discussing intervention stigma acknowledged the role of stigma in their treatment decision-making and quality of their treatment program. The most frequent sources of stigma were the public (including family members), provider-based (healthcare and pharmacy workers), structural (workplace, law enforcement, child protective services, and abstinence-based self-help groups), and self. No posts mentioned courtesy stigma. Posts sought assistance in navigating their experiences and participating in advocacy to counter stigmatized narratives. Conclusions: Our study indicates that people in online communities seek support to disclose and manage experiences of stigma on Reddit in similar ways to people in offline communities with the noted exception of an absence of discussions of courtesy stigma. Since each subreddit is a microcosm of varying needs, we suggest areas of future work for collaborative resources developed between stakeholders of these subreddits and public health that work within the preexisting Reddit social norms.

A qualitative exploration of the enablers and barriers to the provision of outpatient clinics by hospital pharmacists.

BackgroundWith increasing demands on the National Health Service (NHS), Scottish Government-led pharmacy strategy has prioritised the development and expansion of outpatient services. Pharmacist-led outpatient clinics have been shown to reduce hospital admissions and improve patient outcomes. However, expanding these contemporary models of care has proved challenging, and there are few qualitative data about the factors affecting the provision of these. AimThis study aimed to explore the enablers and barriers to hospital pharmacists providing outpatient clinics within the largest health authority in Scotland, NHS Greater Glasgow & Clyde (NHSGGC).MethodBetween August and October 2020, one-to-one semi-structured interviews were conducted virtually using the videoconferencing platform Microsoft Teams®, with NHSGGC hospital pharmacists who did or did not provide clinics. Audio- and video-recordings of the interviews were transcribed verbatim and underwent thematic analysis.Results16 hospital pharmacists were interviewed; 50% were clinic providers and 50% were not. Analysis generated seven themes: clinical or service need, individual factors, clinic structure and processes, additional clinical skills and training, competing priorities, macro-level pharmacy working, and external stakeholder relationships. Many of these were interdependent and had the potential to be an enabler or a barrier to clinic provision, depending on the context or individual. ConclusionThe enablers and barriers to hospital pharmacists providing outpatient clinics are multifaceted, incorporating individual, systematic and professional factors. The implementation of new national professional curricula may help address many of these factors, however prospective research needs to accompany this vision.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11096-022-01435-2.

Do community pharmacy workers know how to use adrenaline autoinjectors?

Adrenaline is the first line and most effective treatment of anaphylaxis and should be administered as soon as possible. Professionals in community pharmacies (pharmacists and pharmacy technicians) dispense adrenaline autoinjectors to allergic patients and could have a crucial role in reinforcing training regarding the use of theses devices. A survey to pharmacy workers was conducted in pharmacies located in the north of Portugal. The same professionals were invited to simulate adrenaline administration with training devices of the two autoinjectors available in Portugal. The majority of the pharmacy workers reported not having training regarding adrenaline autoinjectors and more than a third were unable to correctly demonstrate adrenaline administration with the trainer devices. Pharmacy workers in community pharmacies could have an essential role in reinforcing patient education. Consequently, it is important to encourage and ensure their training in order for them to provide clearer and more detailed instructions to patients. Keywords: adrenaline autoinjector; anaphylaxis; community pharmacies; allergy; knowledge

SARS-CoV-2 infections and attitudes towards COVID-19 vaccines among healthcare workers in the New York Metropolitan area, USA

ObjectiveBecause of their increased interaction with patients, healthcare workers (HCWs) face greater vulnerability to COVID-19 exposure than the general population. We examined prevalence and correlates of ever COVID-19 diagnosis and...

Community pharmacist's perspective regarding patient-centred communication in conjunction with pharmaceutical practice: A cross-sectional survey

Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists’ perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the „patient-centred communication” concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations.

"Doing palliative care with my hands tied behind my back": telepalliative care delivery for oncology inpatients during a COVID-19 surge.

New York City was a “global COVID-19 hotspot” in spring 2020. Many health teams rapidly transitioned to telehealth platforms. Little is known about the experiences of inpatient palliative care services who delivered telehealth services during the pandemic. This study was aimed to explore the experiences of an interdisciplinary palliative care team in meeting the holistic needs of oncology inpatients via telehealth over a 10-week period during the first COVID-19 surge. A targeted sample of interdisciplinary palliative specialists at an urban comprehensive cancer center participated in in-depth interviews that explored participants’ experiences delivering physical, psychosocial, and spiritual care via telehealth. An interdisciplinary coding team followed a rigorous thematic text analysis approach and met regularly to reach consensus on emerging themes. Eleven palliative specialists from six disciplines (chaplaincy, medicine, nursing, pharmacy, physician assistant, and social work) participated. Seventy-three percent reported not receiving telehealth training prior to COVID-19 and 64% were “not at all” or “somewhat comfortable” delivering telepalliative care. Several themes were identified, including the barriers related to telehealth, the impact of telehealth on the quality of relationships with patients, their families, and coworkers, and the changes in perceived self-efficacy of fulfilling job responsibilities. Telehealth use has increased significantly during COVID-19, requiring further evaluation of its utility. Participants reported both positive and negative inpatient telepalliative care experiences associated with various domains of professional functioning, such as communication, relationships with key stakeholders, and self-efficacy. Enhanced telehealth training and support must be improved to sustain the palliative workforce and promote high-quality patient and family care in the future.

Development, validation and evaluation of an online medication review tool (MedReview)

ObjectivesTo develop, validate and evaluate a computerized clinical decision support system (MedReview) that aids medication reviewers with pharmacological decision-making.MethodsThis study included three phases; the development phase included computerizing a consolidated medication review algorithm (MedReview), followed by validation and evaluation of MedReview and responding to a web-based survey designed using patient scenarios. Participants had to be ‘fully registered’ with the Malaysian Pharmacy Board and work full-time at a community pharmacy.ResultsMedReview was developed as a web app. It was validated among 100 community pharmacists from May-July 2021 using the Technology Acceptance Model (TAM). There was acceptable content validity and fair inter-rater agreement, and good convergent and discriminant validity. Exploratory factor analysis resulted in five domains to determine the attitude of pharmacists about using MedReview: perceived ease of use, perceived usefulness, intention to use, trust, and personal initiatives and characteristics; the total variance explained by five factors was 76.36%. The survey questionnaire had a high overall reliability value of 0.96. Evaluation of MedReview was based on mean scores of survey items. Of all items included in the survey, the highest mean score (out of 7) was achieved for ‘I could use MedReview if it is meaningful/relevant to my daily tasks’ (5.78 ± 1.10), followed by ‘I could use MedReview if I feel confident that the data returned by MedReview is reliable’ (5.77 ± 1.21), and ‘I could use MedReview if it protects the privacy of its users’ (5.73 ± 1.20).ConclusionCommunity pharmacists generally had a positive attitude towards MedReview. They found that MedReview is trustworthy and they had the intention to use it when conducting medication reviews. The adaptation of the TAM in the survey instrument was reliable and internally valid.

Health professionals’ attitudes on integrated care and social work practice

ABSTRACT Research regarding the intersection of social work and integrated care has recently increased. Although research specific to the role and engagement of social workers in integrated care is promising, research regarding attitudes toward social workers on integrated behavioral health (IBH) teams remains scant. This study provides perspective regarding healthcare professionals’ attitudes toward the role of social workers on IBH teams. A survey was constructed and distributed to health professionals (n = 104) from medicine, nursing, pharmacy, and social work. Mixed methods were used to evaluate survey findings. Results suggest attitudes toward social workers on IBH teams are generally favorable.

What factors facilitate interprofessional collaboration outcomes in interprofessional education? A multi-level perspective

ObjectivesInterprofessional education (IPE) harnesses the power of teams to facilitate collaborative learning across disciplines. However, prior research has not paid sufficient attention to the role of team-level factors on IPE outcomes, posing a major theoretical and methodological limitation. In response to this, using social interdependence theory (SIT), this study aimed to delineate the independent contributions of both team-level and student-level interprofessional attitudes (teamwork, roles, and responsibilities; patient-centeredness; and community-centeredness) in predicting IPE collaboration outcomes (goal achievement, team effectiveness, and team performance) employing multi-level analysis. MethodsTo test whether interprofessional attitudes at the team and student levels predict IPE collaboration outcomes, conducted multilevel modeling. We used the pretest and posttest data from 323 healthcare students in Hong Kong from Chinese medicine, medicine, nursing, pharmacy, and social work programmes enrolled in the IPE Cancer module. ResultsAmong the interprofessional attitudes, “teamwork, roles, and responsibilities” was found to be the best predictor of IPE outcomes, both at the student and team levels. Students who recognized the benefits of shared learning had better goal achievement and team effectiveness. Furthermore, teams that emphasized shared learning also had better overall team performance. ConclusionsStudents' attitudes towards teamwork, roles, and responsibilities in interprofessional collaborative practice, both at the student and team levels, are important to attaining positive student- and team-level outcomes. The study contributes to the expansion of existing knowledge in medical education, theoretically, by adopting SIT as a lens through which collaborative learning in healthcare teams can be understood, and methodologically, by applying multi-level approaches and delineating important student- and team-level predictors of IPE outcomes.

An Examination of Student Pharmacists' Perceptions Toward Immunization.

Introduction: Pharmacists are considered the most accessible health care professionals, especially when it comes to preventative services such as immunizations. Studies have assessed student knowledge and comfort in administering vaccinations immediately after receiving formal training or completing a vaccination clinic experience; however, few have examined students after applying the knowledge to a pharmacy work experience. A survey of student pharmacists regarding these experiences may identify areas that students are less confident in and thus where immunization training could be improved. Methods: A non-validated survey was created in Google Forms and distributed via email from November through December of 2019. The survey was sent to student pharmacists enrolled in one doctor of pharmacy program at a US institution in Western New York who had completed immunization training almost one year prior to the survey. Results: The survey was distributed to 365 student pharmacists. A total of 189 students (51.8%) completed the survey. Student perceptions of providing immunizations were positive overall, with 173 students (91.5%) responding that they agreed or strongly agreed to feeling confident administering intramuscular injections. In contrast, only 110 students (58.2%) agreed or strongly agreed to feeling confident administering subcutaneous injections. Also, 111 students (58.7%) indicated they had not administered an immunization in the 9 months after they had completed their immunization training. Conclusions: Based on this cohort, perceptions are positive overall; however, there is room for continued improvement in training pharmacy students for immunization proficiency as well as increasing the cooperation of pharmacies to allow students to immunize.

Wellbeing and Stress Coping among Healthcare and Pharmacy Workers: Experiences during the First COVID-19 Lockdown in Lithuania.

(1) Background. During the COVID-19 pandemic, healthcare professionals faced psychological and social challenges in addition to a sharp increase in workload. The aim of this work was to reveal how healthcare and pharmacy workers assessed their wellbeing and the methods of coping they employed to overcome stress during quarantine. (2) Methods. The mixed-method study was conducted between August and October 2020, integrating quantitative (n = 967) and qualitative (n = 27) strategies. Doctors, nurses, healthcare administrative staff, pharmacy specialists, and other employees of the healthcare system were interviewed retrospectively about their experiences during and following lockdown (March–June 2020). (3) Results. Overall, 38.7% of the respondents reported a decrease in psychological wellbeing, while 23.4% of the respondents reported a decrease in physical wellbeing during quarantine. The healthcare professionals’ narratives identified a shift from nonspecific fears at the beginning of the pandemic to the more concrete fear of contracting COVID-19, of infecting others, and about their loved ones, as well as undifferentiated fear. Multivariate analysis revealed that a subjective decrease in wellbeing was typical in professionals who had had direct contact with patients infected with COVID-19, as well as those with stronger fears, and those who were more likely to employ compulsive distancing and substance use as ways to cope with stress. (3) Conclusions. The results suggest that lockdown had a negative impact on healthcare workers’ wellbeing during the first pandemic wave in 2020.

Surveying the persistence of age- and gender-based restrictions on over-the-counter emergency contraception across pharmacies in Los Angeles County, CA

BackgroundOver-the-counter levonorgestrel emergency contraception (OTC EC) is safe and effective but underutilized for postcoital pregnancy prevention. Unnecessary restrictions imposed by pharmacies and pharmacy workers may impede EC uptake. ObjectiveTo assess the persistence of age- and gender-based barriers to OTC EC access among pharmacists and pharmacy staff across Los Angeles, CA. MethodsWe conducted a cross-sectional survey of registered community pharmacies randomly chosen from regions with the highest unintended pregnancy rates in Los Angeles County. Using an adaptation of the 2017 American Society for Emergency Contraception EC Access and Price Survey, we interviewed pharmacy staff about their attitudes and practices related to OTC EC, with attention to age- and gender-based barriers. ResultsWe surveyed 139 staff members (45% pharmacists, 20% technicians, 26% retail) from 93 publicly accessible pharmacies. Thirteen pharmacies did not stock EC. Half of respondents cited age-based restrictions; only 4% noted gender-based restrictions. More than 75% reported being asked for EC by a man; 7% reported refusing to sell to a man. Nearly 40% reported that men never or rarely purchased EC. Pharmacists were more likely than technicians or retail staff to believe men rarely purchased EC (P = 0.01). The most frequently cited concern about selling to men was inability to confirm the female partner’s age. ConclusionAlthough gender-based restrictions to EC are rare, more than half of pharmacy staff continue to report age-based restrictions. Inability to verify the female partner’s age may underlie cases where men are unable to purchase OTC EC.

MODERN SCIENTIFIC RESEARCH DEVELOPMENT ISSUES OF HIGHER PHARMACY EDUCATION, SCIENCE, INNOVATION AND PERSPECTIVES TOWARDS ON UNIVERSAL PHARMACIST’ PROFESSION GLOBALLY

The main objective of the study was to analyze the modern scientific research development issues of higher pharmacy education, science, innovation and perspectives towards on universal pharmacist’ profession globally. The study was a quantitative investigation and analysis of the characteristics of pharmaceutical vocational inquires and challenges in the direction on pharmacists’ profession, role, problems, perspectives and innovations in pharmaceutics and medicine in Georgia by using questionnaires. Were conducted a survey study. The in-depth interview method of the respondents was used in the study. The 7 types of approved questionnaires were used (Respondents were randomly selected): Questionnaire for chief pharmacists: 410 chief pharmacists participated in the study. Questionnaire for patients: 1506 patients (customers of drug-stores) participated in the study. Questionnaire for the employed pharmacy faculty-student: 222 employed pharmacy faculty students participated in the study. Questionnaire for health-care specialists: 307 public health specialists participated in the study. Questionnaire for pharmacist specialist, 810 pharmacist specialists participated in the study. Were used methods of systematic, sociological (surveying, questioning), comparative, mathematical-statistical, graphical analysis. The data were processed and analyzed with the SPSS program. We conducted descriptive statistics and regression analyses to detect an association between variables. Statistical analysis was done in SPSS version 11.0. A Chi-square test was applied to estimate the statistical significance and differences. We defined p< 0.05 as significant for all analyses. According to the study results, the level of basic training of pharmacists should be in compliance with the contemporary requirements. The pharmacist should have deep knowledge in pharmacology, in pharmacotherapy, in toxicology, in pharmaceutical care, in clinical pharmacy, in pharmacokinetics, in pharmacodynamics, in basic of medicine and in other pre-clinical and clinical directions. Such knowledge can be obtained only in the higher pharmaceutical education institutions. Therefore, pharmacist working in pharmacy must have only higher pharmaceutical education. It is necessary to provide a deep cooperation between pharmacists and physicians on the issues of pharmacotherapy and healthcare to ensure the patients’ health state effective improvement, and also to provide the best feedback regulation and revision in the healthcare specialists’ team work. Pharmacists also should be responsible for registration of the drugs’ side effect, as well as be attentive in case of improperness and professional defects of drugs they provide. To achieve that it is necessary to raise awareness of specialists on the essence of pharmacists’ profession and functions among the medical personnel and general public. Keywords: scientific, pharmacist, pharmacy, profession, medicine, pharmaceutics, education.

MPharm students’ response to pharmacy staff shortages during lockdown

IntroductionDuring the first lockdown period of the COVID-19 pandemic, pharmacy students, particularly those with previous experience, were encouraged to help address staff shortages in pharmacy practice (1).AimThis study investigated the response of pharmacy students at Keele University to the request for help to address staff shortages in practice during lockdown.MethodsAn online survey using Google Forms was developed based on addressing the aim of the study and a working knowledge of pharmacy practice. The survey was piloted on academic pharmacists, and after minor amendments, was disseminated to all students in years 2, 3 and 4 of the MPharm course, along with a participant information sheet. Questions regarding consent were incorporated into the Google Form. The survey consisted of a range of question types: tick-box, Likert scale, multiple-choice and free text. A reminder email was sent out to increase response rate. The data were analysed using descriptive and inferential statistics, using Microsoft Excel and SPSS version 24.0.ResultsThe online survey was distributed to 352 students. A total of 106 responses were collected; providing a response rate of 30.1%. Fifty-nine (55.7%) of these students did not undertake paid employment in a pharmacy during lockdown, compared to 47 (44.3%) who did. Of the 47 who did, most obtained paid employment in a community pharmacy (n=42; 89%), the rest in hospital. Seventy percent of respondents (n = 74) had undertaken work experience in a community pharmacy prior to lockdown. A number of reasons were given for choosing not to work in a pharmacy, including needing time to study for exams or living with a vulnerable family member, but the most frequent reason reported (40.7%) was that students found it difficult to find work. For those students who did work in a pharmacy during lockdown, the reported reasons varied, with the most frequent being to gain experience (n = 35; 74.5%), followed by a sense of duty to help the community (n=31; 66.0%). The time spent working ranged from 8 to 40 hours per week. The majority of students reported working in the dispensary and on the medicines counter, undertaking a wide range of activities. Final year students and those who had previously undertaken work experience in a pharmacy were statistically more likely to obtain paid employment during lockdown. Perceived advantages to working during lockdown included the opportunity to improve communication and clinical skills and apply theory to practice, as well as being able to ‘give back’ to the community. 97.9% (n= 46) reported feeling under pressure whilst working, although 72.3% (n=34) reported that they enjoyed working despite this.ConclusionPharmacy students had various reasons for choosing to work in practice or not during lockdown. Those who did work reported benefiting from the experience in a number of ways. This suggests that pharmacy students with prior experience of pharmacy working, should be encouraged to offer their support in times of staff shortages if future lockdowns occur.Reference(1) Supporting the COVID-19 response: Joint Guidance: Facilitating deployment of pharmacy undergraduate students to support the pharmacy workforce. Health Education England, NHS Education for Scotland, Health Education and Improvement Wales, Pharmacy Schools Council, Royal Pharmaceutical Society and the British Pharmaceutical Students’ Association. 09 April 2020, pp.1–9. Available at: https://www.hee.nhs.uk/sites/default/files/documents/MPharm%20student%20deployment%20joint%20guidance%20FINAL.pdf [Accessed 14 October 2021].

КЛИНИЧЕСКАЯ ЭПИДЕМИОЛОГИЯ ИНФЕКЦИЙ МОЧЕВОЙ СИСТЕМЫ В ПОПУЛЯЦИИ ЖЕНЩИН УКРАИНЫ Часть 2: АНАЛИЗ МЕДИЦИНСКОЙ ПОМОЩИ

The purpose of this work was to analyze the frequency and structure of seeking medical assistance by patients with urinary tract infections (UTI) in the Ukraine, taking into account the main providers – providers of medical services for the diagnosis and treatment of the disease in correlation with the type of its course. Materials and Methods. The analysis of the respondents’ medical histories reliably testifies that during the UTI debut self-treatment and non-medical care are factors favoring subsequent chronization of the disease, which determine the further trend towards recurrence. Results. The debut episode of UTI in 49.3% of women resulted in visiting a doctor, in 26.5% of cases patients sought help for their symptoms from pharmacists or nursing staff, and in 24.2% of cases the episode was diagnosed and treated by patients themselves. In case of a recurrent UTI episode 36.7% of the interviewed patients sought medical assistance, 13.2% received treatment on the recommendation of the pharmacist and other health workers, and self-treatment was reported by 48% of respondents. The detailed analysis of the health care visits pattern showed that 11.2% of patients received treatment from a urologist in the case of a debut episode and 17.4% in the case of a recurrent UTI episode, treatment from a gynecologist was received by 14.2% and 12.9% of patients respectively. Pharmacy workers were responsible for managing patients with this pathology in 20.9% and 13.2% of cases respectively. Main vectors of selftreatment were the advertising of medications (4.7% and 10.1%, respectively) and the Internet (10.2% and 14.2%), while in case of recurrent UTI episodes, the most important self-treatment strategy was the previous own experience of medicines administration (20.2%). Conclusions. A significant prevalence of self-treatment cases was noted at the debut of the disease among those patients, whose further course of pathology led to sporadic and frequently recurrent UTI forms (1.7 times and 2.2 times more often, respectively), while visits to doctors at the UTI debut in these cohorts of patients were somewhat less frequent (1.1 and 1.3 times respectively).

Psychological impact of COVID19 on community pharmacists and pharmacy technicians

BackgroundThe unique situation related to the COVID-19 outbreak and the consequent worldwide lockdown can have a psychological impact on specific populations. Community pharmacists and pharmacy technicians, as essential healthcare workers on the front line who continue to do their jobs during this pandemic, can also experience psychological distress. Few data are available on the mental health impact of the COVID-19 pandemics on this population. ObjectivesThis study aimed to assess the psychological impact of COVID-19 on Spanish community pharmacists and pharmacy technicians during lockdown, and to identify factors contributing to psychological distress. MethodsA cross-sectional, quantitative, correlational study was designed including 1162 pharmacy team members. The Impact of Event Scale revised was used to assess the psychological impact. Data collection was performed by emailing the instrument to individuals or by using social networks. ResultsOverall participants, almost 70% revealed severe levels of psychological impact. The outbreak of COVID-19 has significantly affected community pharmacy workers, the degree of which is related to gender, age, and feelings of fear/stress. ConclusionsIn the initial phase of the lockdown associated with the COVID-19 outbreak, the majority of the respondents rated the psychological impact as severe. Our findings allow for the identification of factors associated with a greater psychological impact.

Mapping the resilience performance of community pharmacy to maintain patient safety during the Covid-19 pandemic.

BackgroundThe first UK wave of the Covid-19 pandemic in 2020 placed unprecedented stress on community pharmacy. Various policies and initiatives were announced during this period to support community pharmacy to continue to perform in a manner that prioritised patient safety. However, little is understood about how these policies and initiatives were implemented by staff working in community pharmacy, and the system adaptions and responses that were initiated to maintain patient safety.ObjectiveThe study aimed to investigate how staff working in UK community pharmacy during the first waves of the COVID-19 pandemic in 2020 responded and adapted to system stressors to maintain patient safety.MethodsWe adopted a qualitative interview approach, underpinned by Resilient Healthcare theory, with interview data collected between July 2020 and January 2021. Data were synthesised and analysed using Framework Analysis.Results23 community pharmacy staff from England and Scotland were interviewed. We identified five themes supported by between two and six sub-themes: 1. Covid-19, an impending threat to system; 2. Patient safety stressors during the first waves of Covid-19; 3. Altering the system, responding to system stressors; 4. Monitoring and adjusting and 5. Learning for the future.ConclusionPrivileging the accounts of community pharmacy staff working on the frontline during the pandemic illuminated how responses and adaptions were developed and deployed, how continual monitoring occurred, and the factors that supported or hindered system resilience. The key learning derived from this study can serve to shorten the gap between ‘work as imagined’ and ‘work as done’, and in doing so, support the future resilience performance of community pharmacy during future outbreaks of Covid-19 or similar events.

A Study on Legal Policy of Pharmacy Education and Pharmacy Workers Related to the Urgency of Establishing Pharmacy Law

According to the 1945 Constitution of the Republic of Indonesia, health is one of the basic human rights. One of the aspects that support health is the aspect of pharmacy. Pharmacy workers consist of Pharmacists and Pharmacy Technical Workers according to Law No. 36/2014 regarding Health Workers. In practice, pharmacy education in Indonesia is considered not sufficient to prepare the pharmacy workforce. There are currently contradictions in the applied pharmaceutical policy, where the number of pharmacy undergraduate programs is 279, while the number of pharmacist study programs is only 45. This results in an imbalance of graduates. There is a tendency that most pharmaceutical graduates will continue their professional education to become a pharmacist so that he can have full authority and is responsible for pharmaceutical work. Differences in curriculum background and type of education will lead to confusion regarding competency assessment. At the Pharmacist education level, there is no nationally applicable curriculum until this date. The difference in curriculum causes variations in the knowledge and abilities of graduates. The method used in this study is a review of articles from various legal rules related to pharmaceutical education in Indonesia. The results of this study indicate a need for synchronization of the pharmaceutical policy into one legal aspect so that there is no disharmony among the applied legal regulations. Eventually synergistic legal regulations will emerge, from education to legal certainty for Pharmacist as health professionals.

Identify Early and Involve Everyone: Interdisciplinary Comprehensive Care Pathway Developed for Inpatient Management and Transitions of Care for Heart Failure Patients Reported Using SQUIRE 2.0 Guidelines.

IntroductionHeart failure accounts for 1-2% of overall healthcare costs. While the link between re-hospitalization and mortality is unclear, care pathways that standardize inpatient management and establish outpatient follow-up improve patient outcomes and reduce morbidity.AimTo implement a comprehensive interdisciplinary care pathway for heart failure patients with the goal of optimizing inpatient management and improving transitions of care.MethodsTo address this clinical need, New York-Presbyterian Brooklyn Methodist Hospital (NYP-BMH) identified resources needed to optimize patient care, developed an inpatient admission order set (so-called “power plan”), and implemented a multidisciplinary clinical care pathway. The Plan-Do-Study-Act cycle addressed the implementation obstacles. Interdisciplinary rounds guided day-to-day management and addressed barriers. Our team developed a sustainable care pathway, and measured the utilization of pharmacy, nutrition, physical therapy, case management, and social work resources; outpatient appointments were made prior to discharge. We used the Standards for Quality Improvement Reporting Excellence (SQUIRE) 2.0 guidelines to guide our planning and evaluation of this quality improvement initiative.ResultsOur intervention markedly increased the number of heart failure hospitalizations that were identified on admission, and the use of pharmacy/nutrition services was greater after the intervention. The utilization of our “power plan” promoted adherence to a series of evidence-based best practices, but these measures had no significant impact on readmissions as a whole. The involvement of the case management support team increased outpatient appointments made for patients prior to discharge and aided in the transition of care from inpatient to outpatient management.ConclusionThe management of heart failure patients starts in the hospital and continues in the community. Patients who are treated in a standardized dedicated care pathway have reduced morbidity and better outcomes. Identifying these patients early, involving a comprehensive team, and transitioning their care to the outpatient setting improves the quality of care in these patients.