Disaster definition


Firefighters battling flames. Source: NSW RFS

What roles can pharmacists play during a disaster? Researchers have outlined exactly what these should be

A new Australian research article ‘Defining pharmacists’ roles in disasters’ has outlined exactly what health sector experts say the profession should be doing before, during and after a disaster.

The article, published on the PLOS One website in late 2019, was undertaken because “currently there is no definition or acknowledgement of pharmacists’ roles in disasters”, the authors said, except for one’s defined by pharmacists’ themselves based on their experiences. 

Health researchers from the Queensland University of Technology conducted detailed interviews with 24 “key opinion leaders within the field of disaster health… on pharmacists’ roles throughout the four disaster phases – prevention, preparedness, response and recovery.”

The roles that were positively identified, listed by stage, were:

Prevention/Mitigation – reduce the health risks posed by hazards

  • Administer vaccinations
  • Educate the public on reducing the spread of communicable diseases/infections
  • Tailored ‘point of care’ messaging to chronic disease patients
  • Ensuring patients are aware of their increased risk of adverse health outcomes in a disaster
  • Optimising medication supplies for chronic disease management

Preparedness – ensure timely and effective response systems are in place

  • Ensuring uninterrupted supply of medications in a disaster
  • Knowing how to access national stockpiles if necessary
  • Develop business continuity plans that include disaster management to ensure sustainability of service
  • Developing drug algorithms and treatment guidelines to determine drug choice based on co-morbidities in the event of bio terrorism
  • Being a part of local/state/national disaster preparedness health meetings – providing medication management advice
  • Being a part of the local community disaster management teams to involve pharmacy in coordinated response
  • Maintain systems and process for the reconciliation and security of controlled drugs (e.g. morphine, oxycodone)
  • Have systems in place to secure cold chain lines
  • Develop a list of at-risk patients in their community

Response – action in disaster/emergency

  • Coordinating logistics of medications and medical supplies for patients with chronic diseases
  • Rationing limited supplies of medications
  • Assisting with the release and allocation of national stockpiles if required in pandemic or emergency
  • Triage of low-acuity patients. (e.g. medication reconciliation, patient medical history, referring to physician for further assessment or to pharmacist for refill of lost medications)
  • Institute cardiopulmonary resuscitation (CPR)
  • Provide wound care and first aid for minor ailments
  • Providing one off medication emergency supply refills for up to 30 days during the declared disaster
  • Continue provision of chronic disease medications
  • Dispense medications and other necessary medication-related items to affected members of the community (prescription, over-the-counter medications, inhalers)
  • Dispense general health pharmacy items to affected members of the community (toiletries, nappies, bandages, incontinence pads, water)
  • Making therapeutic substitutions for drugs available on limited formularies without prior authorization
  • Counselling patients on how to use and take medications
  • Prescribing and administering vaccinations (e.g. tetanus, antidote/prophylaxis to bio-terrorism agent following state public health disaster protocols)
  • Attend clinical ward rounds to provide pharmacist expertise on medical patients
  • Prescribe medication needs of low-acuity patients in hospital
  • Medication identification and safety assessment
  • Monitoring the chronic disease(s) of at-risk individuals to minimise exacerbation
  • Advocate pharmacy’s role during an event
  • Maintain media liaison on medication issues
  • Decide on the appropriateness of donated medications and other supplies

Recovery – returning to ‘normal’ business and beyond

  • Check on the health needs of the local community
  • Re-establish normal stock levels, destroy contaminated stock appropriately
  • Restock emergency/ disaster kits for next disaster event
  • Identify and prioritise vulnerable patients in local community
  • Restore order to patient records and drug records, if manually written due to power outages
  • Document what worked and what did not in the disaster response and change disaster plans accordingly
  • Participate in post-disaster research/reports
  • Inform local disaster management reports on pharmacy response improvements

 

 

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