Greenwood D, Tully M P, Martin S, Steinke D
Division of Pharmacy and Optometry, University of Manchester, Oxford Road, Manchester, M13 9PT, UK.
Int J Clin Pharm. 2019 Apr;41(2):434-444. doi: 10.1007/s11096-019-00799-2. Epub 2019 Mar 16.
Background Due to a shortage of emergency department doctors and nurses, hospitals have started to employ pharmacists who have additional clinical skills, known as Emergency Department Pharmacist Practitioners, to help deliver services. Objective To describe, compare and define the Emergency Department Pharmacist Practitioner role. Setting UK emergency departments. Method Using a purpose developed questionnaire hosted on a tablet computer, Emergency Department Pharmacist Practitioners were asked to report their contribution to patient care and the wider emergency department over 10 work days. Main outcome measure Emergency Department Pharmacist Practitioners' work. Results Twenty Emergency Department Pharmacist Practitioners from 15 UK hospitals were recruited. Of 682 patients cared for, 4.8% (n=33) were of blue triage category (least urgent) and 4.1% (n=28) red (immediate need). Specific activities to inform patient diagnosis included clinical examinations (264/682 patients, 38.7%) and the review of investigation/test/procedure results (270, 39.6%). For treatment, EDPPs prescribed a total of 603 medicines (for administration in the ED) to 266 patients (39.0%) and performed procedures for 63 (9.2%). Eleven of the practitioners also took on the role of designated care provider (i.e. the healthcare professional with overall clinical responsibility) for at least some of their patients. From application of the care typology, all 20 practitioners carried out both 'traditional' and 'practitioner' activity and 9/20 of them sometimes provided more 'practitioner' than 'traditional' care to individual patients. Seven key role attributes were identified including how these pharmacists support patients with medical complaints and injuries of any severity and at any stage of their visit. Conclusion Emergency Department Pharmacist Practitioners combine traditional clinical pharmacy activities with more hands-on medical practise including being designated care provider. The role is versatile in that care and support provided to patients and the wider emergency department professional team is varied and therefore somewhat adaptable to situations which present.
背景 由于急诊科医生和护士短缺，医院已开始雇佣具备额外临床技能的药剂师，即急诊科药剂师从业者，以协助提供服务。目的 描述、比较并界定急诊科药剂师从业者的角色。地点 英国急诊科。方法 使用在平板电脑上专门设计的问卷，要求急诊科药剂师从业者报告他们在10个工作日内对患者护理及更广泛的急诊科工作的贡献。主要结局指标 急诊科药剂师从业者的工作。结果 招募了来自英国15家医院的20名急诊科药剂师从业者。在他们护理的682名患者中，4.8%（n = 33）属于蓝色分诊类别（最不紧急），4.1%（n = 28）属于红色（急需）。有助于患者诊断的具体活动包括临床检查（264/682名患者，38.7%）和对检查/检验/操作结果的审查（270名，39.6%）。在治疗方面，急诊科药剂师从业者共为266名患者（39.0%）开具了603种药物（供在急诊科使用），并为63名患者（9.2%）实施了操作。其中11名从业者还至少为部分患者承担了指定护理提供者的角色（即承担总体临床责任的医疗保健专业人员）。根据护理类型学的应用，所有20名从业者都开展了“传统”和“从业者”活动，其中9/20的从业者有时为个别患者提供的“从业者”护理多于“传统”护理。确定了七个关键角色属性，包括这些药剂师如何在患者就诊的任何严重程度和任何阶段为有医疗投诉和受伤的患者提供支持。结论 急诊科药剂师从业者将传统临床药学活动与更多实际操作的医疗实践相结合，包括担任指定护理提供者。该角色具有多样性，因为为患者和更广泛的急诊科专业团队提供的护理和支持各不相同，因此在一定程度上能够适应出现的各种情况。
