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South West Medicines Information & Training
South West Pharmacy
Medicines Optimisation
Training Programme Portfolio Templates: Unit 2.2 Discharge
Facilitation
Version 1 June 2016
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
v1 June 2016
Contents
REGULAR REVIEW – UNIT 2.2 ......................................................................................................................... 1
ACCURACY LOG - UNIT 2.2 .............................................................................................................................. 2
COMPETENCY BASED ASSESSMENT – UNIT 2.2................................................................................................ 5
COMPETENCY BASED ASSESSMENT FEEDBACK – UNIT 2.2 ............................................................................... 6
RANGE OF EXPERIENCES – UNIT 2.2 ................................................................................................................ 7
CLINICAL PHARMACY MANAGER ASSESSMENT – UNIT 2.2 .............................................................................. 8
CLINICAL PHARMACY MANAGER REVIEW ON TRAINEE’S PERFORMANCE IN FINAL ASSESSMENT – UNIT 2.2 ... 10
CHIEF PHARMACIST AUTHORISATION TO ACCREDIT – UNIT 2.2 ..................................................................... 11
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
v1 June 2016 1
Regular Review – Unit 2.2
Discharge Facilitation
Suggested discussion points: or X
1. How well is the trainee progressing through the programme?
2. What is going well for the trainee?
3. Are there any challenges and what support does the trainee need?
4. Has the trainee made any errors and what action has been taken?
5. Is the trainee’s level of confidence developing in the clinical environment?
6. Is the trainee confident with their information gathering processes?
7. Is the trainee getting the required time in the clinical area?
8. How has the trainee performed in busy clinical areas?
9. Does the trainee feel well supported?
10. What are the next steps for the trainee?
11. Are there any other comments that you feel may be relevant?
12. How well is the trainee progressing through the programme?
Trainee comments on review of performance: Educational Supervisor feedback:
Trainee Signature:
Educational Supervisor signature:
Trainee: Educational Supervisor:
Date:
Review No:
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
v1 June 2016 2
Accuracy Log - Unit 2.2
Discharge Facilitation
Trainee Name……………………………………..Trust………………………………………..
Date Patient
type No. of meds on Rx
Discharged to:
Comments (Note: Reflective diary logs can be used to provide more detail)
Information communicated effectively and
accurately? Y/N?
All referrals made
appropriately Y/N?
Signature of trainee
Signature of assessor
Errors found (See error
codes)
Error codes: 1. Prescription/assembly errors
a) Lack of clinical check
b) Incorrect /unsuitable medicines assembled
c) Label incorrect or inappropriate
d) Missing medicines e) Discrepancy between inpatient chart and
discharge prescription
f) Medicines that are not prescribed on the
discharge prescription
Referral error a) Lack of referral
b) Inappropriate referral
Communication a) Missing information
b) Incorrect information provided
c) Omitted follow up information, e.g. obtaining
further meds supplies in primary care/follow-up tests/NMS reviews etc.
There is no scope for error within this module
*The trainee should be observed accurately performing the process of discharge facilitation a minimum of 10 times
This sheet is page
…… of ……..
Educational Supervisors initials…………….
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
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Error Analysis Record – Unit 2.2
To be completed for all errors made or missed by the trainee
Trainee name: Educational Supervisor name:
Date: Error reference number (Item log sheets – page and item number)
Brief description of error
Corrective actions taken
Potential impact of the error to the patient (trainee assessment)
Root cause of trainee’s error (trainee assessment)
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
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Preventative actions / Learning objectives
Root cause of initial error
Potential outcome (Educational Supervisor’s assessment) None / Minor / Major / Critical
Comments
Assessment of next steps / ability of the trainee to continue with assessment programme / restart the programme
Trainee signature:………………………………………… Educational Supervisor signature:……………………………………………………….
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
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Competency Based Assessment – Unit 2.2
Discharge Facilitation
Trainee:
Educational Supervisor: Date: Assessment number: 1/2/3/4
Number of patients seen during observation (must include minimum of 3):
The trainee must always: Achieved /
Knowledge
question
used
/
1. Communicate with relevant healthcare professionals to establish any issues affecting patient’s discharge to be aware of, e.g. swallowing difficulties
2. Ensure Medicines Reconciliation was carried out on admission and check any information regarding the patients discharge needs in the admission notes
3. Take any relevant action and liaise with the discharge facilitator and on-going care team e.g. traffic lights drugs/specials prescribed
4. Ensure discharge prescription has been clinically checked as per local protocol
5. Reconcile and assemble all required medication according to the discharge prescription
6. Before the patient is discharged: i. Explain the treatment and potential side effects and their management to the individual
and/or carer and accurately answer any questions at a level and pace that is appropriate to their:
1. level of understanding 2. culture and background 3. preferred ways of communicating 4. needs
ii. Check that the individual and/or carer understands the medication and monitoring regime and any potential side effects together with their management
iii. Ensure that the individual is given written information and instructions regarding their medication
iv. Support the individual to take their medication as prescribed v. Reaffirm the benefits of adhering to the medication regime and the potential consequences
of non-compliance on their health
7. Complete all records according to SOPs
8. Refer any issues outside personal limitations as appropriate i. To the pharmacist
ii. To another member of the multidisciplinary team
9. Ensure they work in accordance with the Standard Operating Procedures and within the scope of your responsibility and practice at all times
10. Comply with legal, professional and organisational policies at all times
Educational Supervisor’s signature:
o Each criteria can only be covered with a knowledge question on one occasion. o No more than three knowledge questions can be used during one assessment. o All questions and a description of how well the trainee has answered the question must be documented in the
feedback. o Each of the competency-based criteria must be achieved on at least 3 out of 4 assessments.
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
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Competency Based Assessment Feedback – Unit 2.2
Discharge Facilitation
Trainee:
Educational Supervisor: Date: Assessment number: 1/2/3/4
Assessment Feedback
Trainee Signature:
Educational Supervisor
Signature:
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
v1 June 2016 7
Range of Experiences – Unit 2.2
Discharge Facilitation
Range of situations the trainee must reflect on in their case studies:
Note: All essential ranges must be covered The trainee must demonstrate that they have sufficiently covered a wide range of experiences throughout their assessment period by reflecting on these experiences and recording their reflection as CPD case study entries starting at ‘action’.
Range 1. Patient types 2. Information provided verbally
3. Non-verbal information sources
4. Situations you should reflect on
Essential Min of 2 from the list below a) Patient b) Patient’s carer/relative c) Care/Nursing home
a) Patient’s Own Drugs (PODs) Min of 3 from the list below
Optional Must
include a
min of 2
from each
category
unless
otherwise
stated
a) Surgical b) Medical c) Elderly d) Psychiatry e) Others (e.g. Paediatrics)
d) GP Surgery e) Community pharmacy f) Interim care team
b) Repeat prescription request c) MARS sheet, compliance
device d) Nursing notes e) Medical notes, clerking sheet,
discharge letters, clinic letters f) GP letter/GP patient summary g) Summary Care Record or
equivalent
a) Patient going to respite care on discharge and potential changes to the supply requirements
b) Patient going to a nursing / residential home on discharge and potential changes to the supply requirements
c) Patient newly started on a compliance device on discharge and potential changes to the supply requirements communicated to the GP and chemist
d) Palliative care discharge e) Patients with swallowing difficulties: NG / PEG etc. f) Changes to the discharge letter after it has been processed g) Discharge medication left behind: patient either choosing
not to wait or to come back later h) No medication required on discharge: ward TTA packs
available / no changes to medication /Trust policy regarding time since admission
i) No discharge letter written j) Discharge letter written but no pharmacist clinical screen k) Patients with changes to an existing compliance aid l) Patient needing to be discharged urgently
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Clinical Pharmacy Manager Assessment – Unit 2.2
Trainee name………………………………………. Date…………………………
The trainee must demonstrate that they have the following skills: Competent = C
Not competent = NC
Comments
Communication skills
The trainee must:
o Demonstrate a range of communication skills
o Demonstrate empathy and developing a rapport with the individual/carer
o Demonstrate that their beliefs, attitudes, feelings and values do not affect their
communication with others
o Demonstrate an awareness of the referral process for patients with a range of
needs
o Liaise effectively within the multidisciplinary team
o Communicate the outcome of activities undertaken to the appropriate person
o Demonstrate an understanding of equality and diversity
Problem Solving Skills
The trainee must:
o Identify and prioritise problems within scope of own competence and practice
o Collect and evaluate relevant information
o Appraise available options for resolution of identified problems
o Demonstrate clear decision making
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© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
v1 June 2016 9
The trainee must demonstrate that they have the following skills: Competent = C
Not competent = NC
Comments
Professional skills and attitude
The trainee must :
o Comply with relevant and current legislation, policy, good practice, organisa-
tional and professional codes of conduct, practice and ethical standards
o Provide accurate information whilst working within own knowledge base and
operating within the scope of the job role
o Demonstrate an understanding of clinical governance issues
o Demonstrate knowledge and understanding of additional precautions required
for high risk medicines, in accordance with organisational procedure
o Demonstrate a working knowledge of risk management, incident management
and error reporting systems
o Demonstrate an awareness of issues relevant to clinical areas
o Manage their time effectively
o Refer appropriately when required to do so
Documentation/transcription skills The trainee must :
o Use the appropriate approved documentation
o Demonstrate accurate and legible transcription skills
o Ensure information is recorded in the appropriate records and that documenta-
tion is filed in the correct location (medical notes for example)
SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
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Clinical Pharmacy Manager Review on Trainee’s Performance in Final Assessment – Unit 2.2
Clinical Pharmacy Manager’s Review on Trainee’s Performance in Final Assessment/Reference for Assessment Panel
The trainee has*/has not yet* met all of the above criteria and has*/has not yet* demonstrated an appropriate level of competence and confidence to become accredited in Unit 2.2 of the South West Pharmacy Medicines Optimisation Training Programme. PASS Trainee should proceed to the external assessment * REFER Trainee is not yet at a suitable standard to be accredited * FAIL Trainee is not of a suitable standard to become accredited and should not continue *
* delete as appropriate
Signature of Clinical Pharmacy Manager
Name Date
Name Date
SOUTH WEST TRAINING PROGRAMME FOR PHARMACY LED MEDICINES OPTIMISATION SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME
© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust
v1 June 2016 11
Chief Pharmacist Authorisation to Accredit – Unit 2.2
Please retain original
Upon satisfactorily meeting the requirements for accreditation set by the South West Pharmacy Medicines Optimisation Training Programme, this trainee has demonstrated that they are competent to carry out the following aspects of the medicines optimisation role:
Unit 2.2 Discharge Facilitation
I hereby authorise the South West Medicines Information & Training department to proceed with the accreditation and certification of this trainee.
Trainee name............................................................
Approved for certification Signature of Chief Pharmacist (or approved designated deputy)
Name Date