Pandemic position

What roles can a specialised COVID pharmacist play? One Australian hospital found out

The deployment of a specialised COVID pharmacist position has “proven a key and responsive member of the front-line COVID-19 team” at Fiona Stanley Hospital in Perth, WA, say hospital team members.

In a new research paper, members of the hospital’s Department of Pharmacy, and other members of the Fiona Stanley Hospital team said the role was “necessary for facing the challenges posed by this pandemic”.

“The deployment of a specialized ‘COVID pharmacist’ within our institution has demonstrated that the skills of the pharmacist can be adapted, expanded and utilised to alleviate the pressure of doctor shortages, reduce healthcare worker exposure to infected patients, contribute to therapeutic decisions and work collaboratively to tackle the challenges faced during this pandemic,” the pharmacists wrote.

The hospital formed a new ‘COVID team’ to specifically manage inpatients with suspected or confirmed COVID-19 on 23rd March.

The team comprised a respiratory consultant, two registrars, one junior doctor, a medical assistant, and a dedicated clinical pharmacist (COVID pharmacist).

The pharmacist position – taken from a pool of 4 trained pharmacists – works 38 hours per week on weekdays, plus provides a limited after-hours service on weeknights and weekends.

“The COVID pharmacist attends ward rounds, practices partnered charting and has faced challenges such as anticipated medical staff shortages, the storage of medications bought in by COVID-19 infected patients, the limited availability of clinical trial medications, intentionally limiting contact between infected, or potentially infected patients, and clinical healthcare workers and significant language barriers,” the pharmacists said.

The COVID pharmacist completes medication reconciliation and counselling using remote communication strategies, such as tablet devices, cameras and institutional patient entertainment systems, avoiding direct patient contact.

In contrast to regular inpatient practices at the hospital, COVID-19 confirmed or suspected patients are advised to leave their medications at home.

“If brought in, they are stored in locked bedside drawers in the patients’ room to prevent contamination of clean areas whilst providing medication security and preventing medication self-administration,” the pharmacists said.

“This allows continued medication reconciliation on discussion with the patient, although the
containers cannot be physically inspected”.

The COVID pharmacist also modifed usual clinical pharmacist processes to obtain an accurate medication history and make medication adjustments via non-contact strategies, including use of the individual’s electronic health records (MyHealth records), they added.

The role has potential application in other Australian healthcare institutions, the Fiona Stanley team believe. However, they highlighted the need for proper planning and preparation.

“Implementing this new role requires appropriate training and planning. It requires management to allocate resources to accommodate a new full-time role in these unique times.

Staff who are vulnerable to the effects of COVID-19 due to existing health or personal conditions – such as pregnant women, workers with chronic respiratory conditions, workers who are morbidly obese or are immunosuppressed – should be identifed,” they said.

“Contingency planning in the event that the dedicated COVID ward reaches capacity is critical and ensure the COVID pharmacist undergoes partnered medication charting training and credentialing”.

However, they concluded that the position could be successfully expanded to other institutions.

The analysis was published recently in the International Journal of Clinical Pharmacy

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