Implementing a pediatric pharmacy educational program for health-system pharmacists

Objective. To implement an educational program to improve pediatric content knowledge and confidence in providing pediatric care among health-system pharmacists.Design. Pharmacists were asked to voluntarily participate in this prospective, observational education program. A demographic assessment, pre- and post-intervention confidence assessments, and pre- and post-lecture competency assessments were conducted to evaluate the program.Assessment. Five of the 6 confidence scores improved from the preintervention to the postintervention stage. Test scores for 2 of the 8 postlecture tests improved significantly, and the average test scores for all postlecture tests combined were significantly higher than those for the prelecture tests.Conclusion. This study demonstrated significant improvements in both confidence and competence in pediatric pharmacotherapy among health-system pharmacists following implementation of a pediatric pharmacy education program.     

Clinical privileges program for pharmacists.

A clinical privileges program for pharmacists is described. In 1985 and 1989 the Department of Veterans Affairs (VA) issued circulars defining policy on clinical privileges for pharmacists at its medical centers. Pharmacists at one large VA medical center responded by developing a clinical privileges program. Bylaws under which medical staff members are granted clinical privileges were used as a model for the pharmacist program. A pharmacist seeking privileges prepares an application detailing his or her background and the practice areas involved in the request; the applicant also drafts a quality assurance protocol. The application is reviewed by a pharmacist clinical privileges review board (PCPRB). The PCPRB uses the quality assurance plan to verify that adequate measures are in place to meet standards of care. If a question of patient safety arises, the board meets to review the pharmacist's activities. Each pharmacist who is granted privileges must have a physician sponsor. Since the first meeting of the PCPRB in 1990, clinical privileges have been requested by all 24 clinical pharmacy specialists at the center. No pharmacist has been denied privileges, although the board has required additional training or improved quality assurance protocols for many. Acceptance of the program by the medical staff has been good. A clinical privileges program at a VA medical center offers pharmacists the opportunity to practice pharmaceutical care.     

Evaluation of a training and communication-network nephrology program for community pharmacists

Objectives To assess the feasibility and impact of implementing ProFiL program to optimize community-pharmacist management of drug-related problems among chronic kidney disease patients followed in a predialysis clinic. The program comprises a training workshop, communication-network program and consultation service. Setting Forty-two community pharmacies, 101 pharmacists, and 90 chronic kidney disease patients attending a predialysis clinic in Laval (Canada). Patients were followed-up for 6 months. Method In a six-month, pilot, open, cluster-randomized controlled trial, community pharmacies were assigned to ProFiL or the usual care. Chronic kidney disease patients of these pharmacies attending a predialysis clinic were recruited. ProFiL pharmacists attended a workshop, received patient information (diagnoses, medications, and laboratory-test results) and had access to a consultation service. Their knowledge and satisfaction were measured before and after the workshop. The mean numbers of pharmacists’ written recommendations to physicians (pharmaceutical opinions) and refusals to dispense a medication were computed. Results Of the ProFiL pharmacists, 84% attended the workshop; their knowledge increased from 52% to 88% (95% CI: 29–40%). Most ProFiL pharmacists rated workshop (95%), communication program (82%) and consultation service (59%) as “excellent” or “very good”; 82% said the program improved the quality of their follow-up. The consultation service received 21 requests. ProFiL and usual care pharmacists issued a mean of 0.50 and 0.02 opinion/patient, respectively, (95% CI of the adjusted difference: 0.28–1.01 opinion/patient). Conclusion The results of this pilot study suggest that ProFiL can be implemented and may help community pharmacists intervene more frequently to manage drug-related problems. However, a larger-scale study with longer follow-up is necessary to evaluate the impact of the program on management of drug-related problems and its clinical relevance. Institution where the study was conducted: Centre ambulatoire, Centre de santé et de services sociaux de Laval. Information about presentation of the work as an abstract or poster: Abstracts of this study have been published in the proceedings of the 3rd Canadian Joint Therapeutics Congress of the Canadian Society for Clinical Pharmacology—Canadian Association for Population Therapeutics—Canadian College of Clinical Pharmacy (Toronto, Canada, May 2006), the Colloque 2006 of the Réseau québécois de recherche sur l’usage des médicaments (Quebec, Canada, June 2006), the 22nd International Conference of the International Society of Pharmacoepidemiology (Lisbon, Portugal, August 2006), and the North American Primary Care Research Group (NAPCRG) annual meeting (Vancouver, Canada, October 2007).     

住院药房药师分层培训计划的构建

目的： 基于住院药房各类药师岗位胜任力的要求,为确保工作间所有新员工的带教工作全面、统一、有序执行,探索药师分层培训的具体培训计划的构建。方法： 积累并记录各类药师工作实际内容和教学要点,通过住院药房教学小组共同讨论,形成住院药房药师分层培训计划。结果： 形成住院药房培训计划共68条目,将培训内容和时长分为三层。规范化培训药师培训内容最多、时间最长,药品调配、药品管理和用药合理性并重;药师（包括合同制药师）注重药品调配和药品管理;药工注重药品调配相关工作技能。结论： 构建覆盖全部新职工、统一而分层的培训计划,有助于提升住院药房培训质量、促进分工合作、提升药师胜任力。     

An evaluation of Enpharm,a computer assisted learning program for pharmacists

Enpharm is a computer assisted learning program for pharmacists. It is based on case studies which occur in community practice. Pharmacists using the program respond to cases presented by free-text entry, then compare their input with that of a peer group of 76 community pharmacists. There has been a high level of demand for the package. Many of the packages requested are used by pharmacists other than those making the original request. This paper presents an analysis of 100 evaluation questionnaires that were sent out with the package then returned to the authors. The analysis focused on the profile of users, when the program was used and pharmacists' perceptions of the value of Enpharm as a method of continuing education. Pharmacists using the program were mainly in full-time community practice. Half used a work-based computer, the other half used a computer at home. Difficulties in loading the software were rare and were confined to incompatibilities with hardware or to corruption of software during transit. Patterns of use varied but the majority spent between 16 and 30 minutes, on average, per session. The case studies were perceived as being realistic to community practice and although, in general, no new ideas were evident, the cases provided a valuable refresher on the points raised. Enpharm was judged overwhelmingly to be a form of continuing education which would be of benefit to other pharmacists.     

A self-medication program for rehabilitation patients

The purpose of this project was to develop and establish a self-medication program on the rehabilitation ward at Mount Sinai Hospital. Upon discharge most of the patients on this ward are responsible for the self-administration of medications, some of which they will be taking chronically. The objective of this program is to teach patients about their medications while still under medical supervision. Patients are counselled throughout the program by nurses and a pharmacist. Family members are also counselled on request. The program is completed by a final discussion with the patient prior to discharge. As a result of the program a manual was produced for use by pharmacy and nursing personnel to help define their respective roles in the program. Results of a patient survey indicated that a definite benefit was perceived by all patients who were helped to develop their ability to self-medicate. Errors made while in the hospital were discovered and corrected prior to discharge. Pharmacy time required to set up the program was, initially, extensive. Once the program was established, however, nursing medication administration time was greatly decreased and freed for other activities on the floor.     

Supporting rehabilitation for the impaired healthcare employee: a case study.

A case study describing detection, intervention and treatment of a chemically dependent hospital pharmacist, leading to generalizations and conclusions concerning the handling of impaired health care workers. The willingness of one hospital's management and administration to offer continued employment and support to an impaired pharmacist throughout an extended period of rehabilitation has resulted in a story of success on both a personal and an institutional level. From this experience, the authors have concluded that this humane reaction to an employee in need is a viable alternative to more typical reactions involving legal prosecution.     

Train-the-trainer program on cardiovascular health for community pharmacists in Malaysia

Background Studies have highlighted the benefits of having community pharmacists to deliver cardiovascular screening to patients. However, only few of such trainings are provided in Malaysia. Objective To describe the implementation and evaluation of a cardiovascular train-the-trainer program for community pharmacists. Method Community pharmacists’ attended a 5 h train-the-trainer program. A pre and post-training survey was administered to participants who attended the workshop to determine their requirements for education and effectiveness of the training provided. Results Forty community pharmacists participated and were trained with 35 of them completing both the pre and post training assessment. Participants self-reported confidence, knowledge and ability to conduct a workshop on cardiovascular health increased between 0.22 and 0.75 points post-training (p < 0.05). The program was rated as very good or excellent by 55% of participants. Eight participants implemented the program at 6 months follow-up within their own pharmacy organisations to further train another 114 participants on cardiovascular health. Conclusion Participation in a train-the-trainer program significantly increases community pharmacists’ perceived ability and confidence in conducting a cardiovascular health workshop.     

Pharmacist involvement in a chemical-dependency rehabilitation program

Pharmacist involvement in a small hospital for the treatment and rehabilitation of patients with chemical dependency is described. The pharmacist's primary responsibilities include provision of pharmaceutical services to meet the medical needs of patients during detoxification; development of detoxification protocols for management of withdrawal from drugs of abuse; education of patients and their families, other clinical staff members, and pharmacy students about the pathophysiology of addiction, treatment options, and the foundations of recovery; medication and addiction counseling; and multidisciplinary team support of recovery. To successfully fulfill this complex role, the pharmacist must have specialized education on alcoholism and addiction, develop good communications skills, and learn the dynamics of recovery support groups. The pharmacist employed at this hospital spends about 70% of her time with pharmaceutical services and 30% with counseling services. A pharmacist working in a chemical-dependency rehabilitation program has a unique opportunity to affect positively the physical and emotional health of the recovering individual by taking on responsibilities beyond those traditionally associated with pharmacy practice.