There is increasing evidence to support reducing antibiotic duration of therapy (DoT). The Therapeutic Guidelines: Antibiotic (version 16 [TG]) have been updated accordingly. However, these recommendations are not consistently followed.
The project aimed to reduce antibiotic DoT for common infections using antimicrobial lanyard cards and education.
A retrospective pre- and post-implementation audit was undertaken to examine whether antimicrobial stewardship education and lanyard cards defined DoT per infection and severity in accordance with the TG improved antibiotic DoT for common respiratory, urinary, abdominal, and skin infections. Cards were distributed to doctors and pharmacists, with education delivered by an antimicrobial stewardship (AMS) pharmacist. This project was exempt due to the local policy requirements that constitute research by the Darling Downs Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2022/QTDD/86644). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities; education was incorporated as part of routine, scheduled sessions ran at Toowoomba hospital and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education nor for using the lanyard cards; the research did not include any assessment of the education program, use of lanyard cards, or involvement of staff.
For all patients an improvement was found in the percentage of antibiotics prescribed per the TG (55–72%, p = 0.0095). This included statistically significant differences for respiratory (42–89%, p = 0.0002), but not for urinary (87–91%, p = 0.99), skin (58–77%, p = 0.3039), or abdominal infections (48–44%, p = 0.6990). The mean total excess treatment days decreased across all infections from 1.86 to 0.95 days (p = 0.0036, 95% confidence interval = −1.52 to −0.30).
The introduction of antibiotic DoT cards, with AMS education, can improve antimicrobial prescribing in line with the TG in a regional hospital.
The expanding scope of practice for pharmacists in Australia now includes the provision of vaccination services. Therefore, it is crucial to understand the perceptions of pharmacists regarding vaccination services and the impact of providing this service on their job satisfaction and well-being.
This study aims to evaluate the job satisfaction and well-being of pharmacists in Australia regarding the provision of vaccination services. Additionally, it aims to determine the barriers to administering vaccines by pharmacists.
A mixed-methods study was conducted among pharmacists in Australia. An anonymous survey was distributed to pharmacies via email and advertised on social media sites. Ethics approval was granted by the RMIT Research Ethics Committee (Reference no: 24747) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained for all participants via a project information sheet and voluntary completion of an anonymous survey.
The study found that community pharmacists experienced moderate job satisfaction levels, with mean job satisfaction and well-being scores of 17.6 (±6.2) and 17.0 (±6.50) respectively. A correlation was identified between job satisfaction and well-being, indicating that lower job satisfaction corresponded to lower well-being. Factors such as years of experience (p = 0.001), work-related stress (p = 0.001), willingness to vaccinate (p = 0.001), workload (p = 0.001) and lack of support and reimbursement for vaccinating pharmacists influenced job satisfaction and well-being levels.
The study highlights the median to minimal job satisfaction levels among pharmacists in Australia and the correlation between pharmacists' willingness to administer vaccines and their job satisfaction and well-being. Additionally, the study underscores the need for additional support and reimbursement for vaccinating pharmacists. To enhance the pharmacy profession's role in the healthcare system, new strategies are required to support pharmacists in providing vaccination services.
Pneumococcal disease continues to be a large source of morbidity and mortality despite the availability of effective prevention via immunisation and treatment measures.
To assess the impact of a pharmacist-led opportunistic inpatient pneumococcal vaccination intervention on overall 13-valent pneumococcal conjugate vaccine (13vPCV) rates in eligible hospitalised subacute patients, aged 70 years and above.
This study was a pre- and post-intervention study conducted across two study sites at Monash Health, a large metropolitan health service in Victoria, Australia. Phase 1 (pre-intervention, August–October 2022) involved auditing the vaccine-eligibility of patients on admission and subsequent administration during inpatient stay. Phase 2 (intervention phase, October–December 2022) implemented the pharmacist-led opportunistic inpatient pneumococcal vaccine intervention. Following screening, identified vaccine-eligible patients were recommended to the treating physician via verbal discussion and Microsoft Teams for consideration of vaccination administration in hospital. The proportion of eligible patients vaccinated was compared between the pre-intervention and intervention groups. This project was exempt for ethics approval due to the local policy requirements that constitute research by the Monash Health Human and Research Ethics Committee (Reference no: RES-22-0000-454Q). The justification for this ethics exemption was as follows: the project complies with the National Health and Medical Research Council's Ethical considerations in quality assurance and evaluation activities; auditing the percentage of vaccine-eligible and non-vaccinated patients did not require written consent per local requirements; and it is standard practice to obtain verbal consent, followed by documentation on electronic medical records, for inpatient vaccinations. Informed consent was obtained from participants via verbal consent after the distribution of written medical information on the 13vPCV, as well as verbal information provided by the medical team.
A total of 360 patients were included in the study. Overall, 139 (77.2%) patients in the pre-intervention and 143 (79.4%) patients in the intervention phase were eligible for vaccination (non-vaccinated with age indication). The proportion of patients receiving inpatient 13vPCV was higher in the intervention group compared to the pre-intervention group (43.4 vs 2.2%, p < 0.001).
Clinical practice after hours and attendance at medical emergency team (MET) calls are two novel and emerging areas of pharmacy practice. During the COVID-19 pandemic, our institution's pharmacy services expanded from 8 am–5 pm to 24 h daily, including MET call attendance.
This study aimed to describe pharmacist roles, including medications charted by the general medicine and intensive care unit pharmacists during the period of extended-hours pharmacy practice and the characteristics of MET calls attended.
This descriptive, cross-sectional study included patients admitted to the Alfred Hospital, Victoria, Australia between 3 April 2020–28 February 2021, when a MET was called between 5 pm–8 am, a pharmacist attended, and medication changes occurred. Data collected included whether the MET call was medication related and a description of medication changes. Ethics approval was granted by the Alfred Hospital Human Research Ethics Committee (Reference no: 297/21).
One thousand six hundred and forty-four MET calls (average 5.4 calls per night) were attended by pharmacists during extended hours. Medication changes were made in response to clinical deterioration at 627 (38%) calls. The most frequent change was the initiation of cardiovascular medications (n = 206). Partnered pharmacist medication charting, including commencing, ceasing, or changing medications, occurred at 39% of MET calls with therapy changes.
Pharmacists can play a key role in managing deteriorating patients as part of a MET team. Medications may be implicated in clinical deterioration of patients and are frequently administered at MET calls. The expansion of pharmacy services provided the opportunity for pharmacists to contribute to MET calls across the 24-h period.
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