Participation in emergency preparedness and response: a national survey of pharmacists and pharmacist extenders

Crisis management in community pharmacies during a pandemic

BACKGROUND

Although the COVID-19 pandemic required community pharmacies to implement several adaptation strategies to ensure medicines' and services' availability, related empirical research based on crisis management theory is lacking.

OBJECTIVE

This study sought to holistically depict crisis management in Finnish community pharmacies and explore whether (1) pre-existing crisis plans, (2) crisis teams, (3) shared decision-making or (4) collaboration and communication with external stakeholders can protect staff resilience, pharmacy owners' resilience, organisational cohesion ('team spirit') and pharmacies' resources or finances during the pandemic.

METHODS

A cross-sectional survey was developed based on the crisis management process model and sent to Finnish community pharmacy owners (n = 602) during the pandemic's second wave in October-November 2020. Descriptive statistics were calculated, and logistic regression analysis was performed to explore effects of crisis management efforts. Open-field responses were analysed qualitatively using deductive content analysis.

RESULTS

In total, 221 (36.7 %) pharmacy owners participated in the study. Pharmacies responded to the pandemic with increased order volumes and new suppliers, home deliveries and remote consultations, hand sanitiser production and additional customer counselling concerning the COVID-19. Shared decision-making with pharmacy colleagues (p = 0.025) and collaboration with peers or stakeholders in the supply chain (p = 0.015) protected pharmacy owners' resilience during the pandemic. Additionally, shared decision-making protected pharmacies' finances (p = 0.040). Crisis teams or collaboration with social and healthcare operators did not provide advantage to pharmacies. However, pre-existing pandemic plans associated with reduction of pharmacies' resources (p = 0.006).

CONCLUSIONS

Community pharmacies responded to the COVID-19 pandemic with several measures to ensure the continuity of pharmaceutical services and care and the availability of medicines, disinfectants and personal protective equipment. Developing shared decision-making in pharmacies and active collaboration with peers and supply-chain stakeholders could improve pharmacies' finances and their owners' resilience in future crises.

Development of a Pharmacy Point-of-Dispensing Toolkit for Anthrax Post-Exposure Prophylaxis for Allegheny County Postal Workers

CONTEXT

The Centers for Disease Control and Prevention (CDC) and the US Postal Service (USPS) consider anthrax to be a potential threat to USPS workers. A county health department-owned pharmacy supports local USPS response in the event of an exposure. The pharmacy team identified the need to review and update the local anthrax response plan.

PROGRAM/POLICY

A Pharmacy Point-of-Dispensing Toolkit and response plan for initial 10-day post-exposure antibiotic prophylaxis was developed for use by a local health department in the event of a mass anthrax exposure at a US Post Office sorting facility. The pharmacist's role in medical countermeasures planning for anthrax exposure is also discussed to illustrate how pharmacists' medication expertise can be utilized.

EVALUATION

The CDC's Public Health Preparedness Capabilities: National Standards for State and Local Planning framework and inputs from an interprofessional stakeholder team were used to develop a Medical Countermeasures Response Plan and Implementation Toolkit for mass point-of-dispensing (POD) in the event of an anthrax exposure.

IMPLEMENTATION AND DISSEMINATION

Stakeholders attended a USPS Community Partner Training event where additional revisions to the toolkit were made. The toolkit and standing order are now implemented at the local health department to be reviewed and updated on a yearly basis by health department leadership.

DISCUSSION

Pharmacists can use their medication expertise and experience with patient education to design emergency response plans focused on increasing patient safety and medication adherence. Pharmacists should be involved in emergency response and medical countermeasures planning that involve medications.

Factors Associated with the Implementation of Pediatric Immunization Services: A Survey of Community Pharmacies

Pharmacists are well-positioned to help increase pediatric immunization rates. This study assessed the types of pediatric vaccines offered in community pharmacies, compared participant/pharmacy characteristics and participants' perceptions of barriers and pharmacists' role in providing pediatric immunizations between pharmacy-based providers and non-providers, and assessed factors associated with pharmacy-based pediatric immunization provision. A cross-sectional survey was sent to Alabama community pharmacies from February to April 2023, of which 240 responded (20.5% response rate). Measures included whether they offered childhood vaccines in 2022 and the types of vaccines administered, participants' perceptions of pharmacists' role in pediatric immunization, and perceived barriers to providing pharmacy-based pediatric immunizations. Roughly half of pharmacies (50.8%) provided pediatric immunization services with influenza vaccines (91.0%) the most commonly provided vaccines and poliovirus-inactivated vaccines (4.9%) the least. Pharmacies providing pediatric immunization services significantly differed from non-providers. That is, the majority of providers practiced within a grocery or retail store; they were younger and practiced in a pharmacy with higher average daily prescription volume and a higher average pharmacy practice full-time equivalent; and they perceived lower implementation logistics barriers and a lower role of pharmacists regarding pediatric immunization. Multivariable logistic regression analysis indicated that implementation logistics is significantly associated with pharmacies offering pediatric immunization services after controlling for pharmacy/participant characteristics (p = 0.01). Therefore, ameliorating implementation logistics barriers should be considered when devising strategies to promote pediatric immunization services in community pharmacies.

An evidence-led review of the FIP global competency framework for early career pharmacists training and development

BACKGROUND

The International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) for early career pharmacists is an evidence-driven guide for pharmacist professional development. First published in 2012, the FIP GbCFv1 contains a structured assembly of competencies for pharmacists in four broad areas: pharmaceutical public health; pharmaceutical care; organisation and management; and professional/personal. FIP is committed to support the advancement of pharmacy around the world, and in light with the expansion of the type of services that pharmacists may provide to their patients and the advances in technology and therapeutics, revising and updating the GbCF is imperative.

OBJECTIVE

The aim of this project was to revise and update the first published iteration of the FIP GbCFv1 (2012) to ensure currency and continued relevance.

METHODS

This is a qualitative study that employed four rounds E-Delphi method. A group of international experts (n = 29) was convened to revise the GbCFv1 through an iterative approach with repeated and synchronised rounds of analysis and revision focusing on the currency of the competency areas and associated behavioural statements. The revision was conducted between January to August 2020.

RESULTS

The number of behavioural statements increased from 100 to 124 behavioural statements, with 23 competency domains, but remain structured within the competency clusters. Three new competencies were added to the GbCF (emergency response, digital literacy, and interprofessional collaboration) and one competency was renamed from self-management to leadership and self-regulation.

CONCLUSIONS

The process undertaken to revise the GbCFv1 are described, resulting in a valid and transnationally relevant GbCFv2. In the GbCFv2, the number of competencies and associated behavioural statements increased due to important additions including emergency response, digital literacy, interprofessional collaboration and an expansion of leadership and self-regulation. This process provides an assurance of relevancy and currency for a 'fit for purpose' early career competency development framework for global implementation.

Ensuring Doctor of Pharmacy Graduates Have the Essential Competencies for Innovative Practice

As the pharmacy profession continues to evolve from product oriented to patient centered, pharmacy programs have been transitioning from a traditional pharmacy curriculum to a competency-based education pedagogy. Competency-based education has been developed to instill the required clinical competencies in graduates to better meet the contemporary role of pharmacists in accordance with the latest scientific knowledge and evidence-based practices in an ever-evolving health care landscape. While these ideas have helped shape the new Accreditation Council for Pharmacy Education (ACPE) Standards and Center for the Advancement of Pharmacy Education (CAPE) Educational Outcome domains, recent publications have indicated that it is integral for these Standards to include public health emergency preparedness and response. Updated Standards and Educational Outcomes must be integrated longitudinally in pharmacy curricula to ensure that graduates will be practice-ready health care professionals. This commentary highlights the strategic use of workforce development of population health based on two perspectives: emergency preparedness and response and digital health.

Emergency Preparedness for the COVID-19 Pandemic: Social Determinants Predicting the Community Pharmacists’ Preparedness and Perceived Response in Malaysia

Background: Pandemic preparedness of healthcare providers helps to mitigate future threats such as spread and fatality rates, as well as the management of the disease. Pharmacists are key partners with public health agencies, and the role of community pharmacists is becoming increasingly recognised in this COVID-19 pandemic. The study aimed to explore the emergency preparedness of community pharmacists (CPs) for COVID-19. Methods: A cross-sectional study was performed among community pharmacists using cluster sampling followed by convenient sampling. A self-administered questionnaire was formulated using references from the previous literature and the WHO preparedness checklist. Descriptive analysis was undertaken for the participants’ socio-demographic characteristics. All the data collected were entered into the Statistical Package for Social Sciences version 24 (SPSS V.24), (IBM SPSS Statistics for Windows, Version 24.0. Armonk, NY: IBM Corp.) for analysis. Results: Most of the CPs had five or fewer years of practice experience, and they had all the mandatory information relating to the needs of their communities regarding the disease. The participants knew where to acquire these resources whenever needed. They were able to recognise the signs and symptoms of the disease. Most participants felt that they were confident to provide patient education and carry out their duties during these challenging times. There was a strong position correlation between preparedness and the perceived response of the participants. Conclusion: The community pharmacists in Malaysia are prepared enough for COVID-19 pandemic management and perceive that they can respond during any unprecedented situations, such as COVID-19. Community pharmacists were aware of the challenges that they need to face in their community regarding COVID-19.

Building a pharmacy workforce from the ground up to support the COVID ‐19 vaccine rollout: lessons learned and recommendations

The COVID‐19 pandemic has required an unprecedented surge in the pharmacy workforce to support mass vaccination hubs. This review discusses the challenges faced while training and credentialing a surge pharmacy workforce and how these challenges were overcome. The process used for training and credentialing new employees has been described and recommendations and insights have been provided based on the lessons learned at two COVID‐19 mass vaccination hubs in New South Wales. Operationalising one of the largest mass vaccination hubs in Australia required efficient training and credentialing of the pharmacy workforce. This process included the use of pharmacist‐extenders such as students, assistants, and those from other healthcare and non‐healthcare backgrounds. Training was optimised by using a flipped classroom model, so that the vaccine preparation process was provided via asynchronous online videos. The videos covered each step of vaccine dose preparation with visual cues to guide appropriate technique. On‐site training involved use of simulation and checklists for credentialing. Many factors contributed to the success of this process, including the use of triaging and the re‐allocation of personnel based on skill level, collaboration with the Sydney Pharmacy School to train and support a surge workforce involving students, initial on‐site information technology support in the form of pharmacy superusers, the use of checklists and guides for troubleshooting, and assigned pharmacy educators to train new employees. The public health response to the COVID‐19 pandemic forced us to rapidly adapt to build a pharmacy workforce in record time to support mass vaccination hubs. The recommendations and insights provided from our experience can guide future surges. Some of these concepts may also be applied to pharmacy practice in hospitals when resources are constrained.

Hospital Pharmacy Preparedness and Pharmacist Role During Disaster in Saudi Arabia

Background

In case of emergencies, the number and severity of mass casualties may exceed medical services resources. Saudi Arabia is prone to different disasters, and all medical resources should be ready and prepared to serve during disasters. Pharmacists are essential during disasters; however, their roles have not been well studied during disasters in Saudi Arabia.

Methods

An observational cross-sectional study targeted tertiary hospitals in Jeddah. An electronic survey, consisting of 34 questions, was developed and distributed to pharmacy directors or their representatives to investigate the hospital pharmacies’ preparedness and pharmacist roles during disasters in the city of Jeddah.

Results

Six hospitals participated in the survey, with a 100% response rate. All respondents confirmed the presence of disaster plans involving pharmacy departments. Hospital committee consensuses determined which medication to stock in five hospitals (83.3%). All six respondents (100%) agreed that the following medication supplies were adequate in the event of disasters: analgesics, rapid sequence intubation medications (ie, sedatives and paralytics), respiratory medications, antimicrobials, and maintenance intravenous (IV) fluids. There was disagreement on the adequacy of wound infection prophylaxis, vasopressors/inotropes, antiemetic medications, ophthalmic medications, and antidotes for chemical weapons. There were discrepancies on pharmacist roles during disaster, but hospitals agreed on the following roles: maintain effective distribution and control, collaborate on medication management, and develop and maintain first-aid skills.

Conclusion

All included facilities have emergency preparedness plans for the hospitals and the pharmacy departments. However, the type and quantities of stocked medications, as well as pharmacist roles, are not well recognized. The results highlight the need for national guidance to enhance and support the preparedness of healthcare facilities.