Pharmacists in advanced clinical practice roles in emergency departments (PARED)

Abstract

Background Following evidence published in the Pharmacists in Emergency Departments (PIED 2016) study Health Education England funded novel advanced clinical practitioner training for pharmacists (ACP-p), to support service delivery.Objective To explore experiences and clinical activity of trainee ACP-p, and opinions and recommendations of both trainees and clinical supervisors.Setting Five Urgent/Emergency Care Departments in London UK.Method Longitudinal mixed-methods study in three phases of registered UK pharmacists appointed as trainee ACP-p. Phase 1 (May-July 2019) – early semi-structured interviews and focus group using an experiences, opinions and recommendations (EOR) framework, Phase 2 (January-December 2019) – prospective recording of trainee clinical activity, standardised using bespoke spreadsheet, Phase 3 (November-December 2019) – as Phase 1 but at conclusion of training.Main outcome measure Experiences, clinical activity, opinions and recommendations of study participants.Results Twelve (92 %) eligible trainee ACP-p and five supervisors were recruited. Identified themes were: trainee personality, educational components, length of programme, support/supervision, career transition, university and placement training alignment, recommendations. Success was dependent on effective support and supervision. Clinical supervisors should be allocated adequate supervision time. Trainees, their supervisors and emergency department staff should be given a clear brief. Study participants agreed that the programme could be successful. Trainee ACP-p reported that they could manage 82 % of 713 pre-selected clinical presentations. Additional training needs include: ECGs, X-rays and CT scans.Conclusions Pharmacists can successfully train as ACP-p in this setting over a two-year period. This career transition needs careful management and clear structures. Training ACP-p is a useful way of enhancing skills and supporting clinical services to large numbers of patients.

Development of innovative simulation teaching for advanced general practice clinical pharmacists

“…In general, there was also strong agreement as to the benefit of simulation where all respondents expressed a strong desire to have future simulation experiences. Advanced pharmacist practice is changing: there is growing expectation that the role of the clinical pharmacist now include the autonomous assessment, investigation, diagnosis and management (including prescribing) for complex patients [18]. There is a need to adapt clinical pharmacist training -from undergraduate through advanced pharmacist programmes-to encompass more simulation and preceptored experiential learning in practice (i.e.…”

“A little bit more looking…listening and feeling” A qualitative interview study exploring advanced clinical practice in primary care and community pharmacy

“…Nonetheless, the scope of practice of community pharmacists has broadened over the past decade to include publicly-funded Minor Ailments schemes (branded as 'Pharmacy First' in Scotland) whereby patients eligible for free prescriptions get free medication after an over-the-counter consultation, New Medicine services and Medicines Use Reviews (MURs) [13][14][15]. Community pharmacists have also supported patients with chronic conditions and successfully substituted for urgent and emergency healthcare services [16][17][18][19][20]. In 2020, the General Practice Community Pharmacist Consultation Service (GP CPCS) was launched in England, allowing patients with low acuity conditions to be referred directly to community pharmacy [21].…”

General practice pharmacists’ implementation of advanced clinical assessment skills: a qualitative study of behavioural determinants

“…This blended skillset enables a versatile workforce, optimising what pharmacists can offer patients and the healthcare system in general. Similar to the GPCP cohort, the effectiveness of pharmacists in these advanced roles is positively correlated with the supportiveness of the learning environment [ 28 ].…”

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