FromSep-Dec2017approximately60discrepancieswereiden;fiedfromtechnician kardex reviews which were then themed into fourteencategories (Table 1) which informed the content development of thePMRCs.
• Toequipandfocusallpharmacytechnicians(neworestablished)with up to date and succinct medicines informa;on whichiden;fieshighriskpa;entsfor;melyreviewbyapharmacist.
• To iden;fy key medicines discrepancies/medicines informa;onacrossdifferentspeciali;es.
• To produce and test the usability and effec;veness of quickpocket medicine reference cards (PMRC) to improve pa;entsafetyandqualityofcare.
• Overafourmonthperiodacrossseveralin-pa;entwardswithinalarge acute teaching hospital pharmacy technicians reviewedin-pa;ent kardexes daily and iden;fied common medicinediscrepanciese.g.incompleteVTEassessment.
• DiscrepanciesweregroupedwithinCategories(Table1)toinformthecontentdevelopmentofPMRCs(Figure1)usinglocalguidanceand BNF 742, they were then reviewed and quality assured byspecialistclinicalpharmacists.
• The number, type, and clinical significance (using the EADONGrade2 (Table 2) of referralsmade to the pharmacistwere thenmeasuredpreandpostintroduc;onofthePMRCsovera2weekperiodwithintwosurgicalwards.
References1. Health-ni.gov.uk.MedicinesOp;misa;onQualityFramework2018[cited5April2018].Availablefrom:
h_ps://www.health-ni.gov.uk/sites/default/files/consulta;ons/dhssps/medicines-op;misa;on-quality-framework.pdf2. BNFBri;shNa;onalFormulary-NICE[Internet].Bnf.nice.org.uk.2018[cited5April2018].Availablefrom:h_ps://bnf.nice.org.uk/3. EADONH.Assessingthequalityofwardpharmacists'interven;ons.Interna;onalJournalofPharmacyPrac;ce.1992;1(3):145-147.
JayneBlack¹,LindaRobinson¹,SheilaMcCann¹.1.WesternHealthandSocialCareTrust(WHSCT),PharmacyDepartment,AltnagelvinAreaHospital
DevelopmentofPharmacyTechnicianPocketMedicinesReferenceCards(PMRCs)
• In March 2016, the Northern Ireland Medicines Op;misa;onQualityFramework1outlinedhowwecansupportpa;entstogainthe best outcomes from their medicines through the safe andeffec;veuseofmedicinesatimportanttransi;onsofcare.
• Soonaferadmissionandini;a;onofnewtreatments,pharmacytechniciansareofen thefirstmemberof thepharmacy teamtosee an inpa;ent kardex and have the appropriate medicinesknowledgeandfocustodeliverMedicinesOp;misa;onaspartofrou;necare.
Sincetheintroduc;onofthePMRCs,althoughthenumberofreferralstothepharmacisthasincreased,itcanbeseenfromtheclinicalsignificanceof these that they have helped to improve pa;ent safety and overallqualityofcare.Theresultsfromthisini;altestwillbeusedtoinformthedevelopmentofnew PMRCs and their applicability within the remaining surgical andmedical wards. PMRCs were ini;ally intended to be used by newlyappointed ward pharmacy technicians and to support techniciansworkingacrossarangeofspeciali;es,but ithasbeendecidedthattheycouldalsobeusedtosupportjuniorclinicalpharmacists.
ContactDetails:[email protected]
PocketMedicinesReferenceCard(PMRC)CategoriesVTE Specialistmedica;onsParacetamol-Doses&co-prescribing Inpa;entsupplyofClozapine
Hip&KneeReplacementMedica;onProtocol Parkinson’sCombina;onproduct
CommonAn;microbialInterac;ons Therapeu;cdrugmonitoring
CommonMacrolideInterac;ons Cri;calmedica;ons
An;microbials CardiologyKeypointsCommonrestrictedAn;microbials Ipratropium(Co-prescribing)
Table1:CategoriesofPocketMedicinesReviewCard
Table2:EadonGradeScale
PMRCCategory Exampleofreferrals Clinicalsignificance(Eadongrade)
VTE VTEassessmentnotcompleted 4
Paracetamol Paracetamole.g.POprn&IVregular 5
Cardiology Clopidogrel&Omeprazoleco-prescribed
4
Cri;calMedica;ons An;-Epilep;cmedica;ons–misseddoses
5
SpecialistMedica;ons Highlightedpa;entonredlistmedicinesforM.S.topharmacist
3
An;bio;c Administeredtopa;entaferstopdate
4
Introduc;on
Aims&Objec;ves
Method
Results
Conclusion
Afour-foldincrease(preinterven;onn=7;postinterven;onn=28)inthenumberofreferralsmadebythetechnicianforapharmacistreviewwasseenpostintroduc;onoftheuseofPMRCs.Table3outlinesexamplesofthe most common referring categories made by the technician to thepharmacist. Seventy-five percent (n=21) of referrals were clinicallysignificant (Chart1)and resulted inan improvement in thestandardofpa;entcare(EADONgrade≥4).
EadonGrade
1
2
3
4
5
6
IntervenOon ScoreInterven;onwhichisdetrimentaltopa;ent’swell-being 1
Interven;onisofnosignificancetopa;entcare 2
Interven;onissignificantbutdoesnotleadtoanimprovementinpa;entcare 3
Interven;onissignificantandresultsinanimprovementinthestandardofcare 4
Interven;onisverysignificantandpreventsmajororganfailureoradversereac;onofsimilarimportance
5
Interven;onispoten;allylifesaving 6
Grade4
54%
Grade5
21%
Grade3
25%
Figure1:CompletedPMRC’skeyrings
Table3:Mostcommonreferralcategories
Chart1:Eadongradingofreferrals
