Aim To gain consensus on the content required to develop a training plan and competency assessment tool for pharmacists to undertake systemic anti-cancer therapy (SACT) verification for paediatric haematology oncology patients; a high risk clinical pharmacy area.1
Method A two-stage Delphi style questionnaire, using a five point Likert scale, was distributed to pharmacists in the UK and Ireland.2 The extent to which they agreed or disagreed with a series of statements was rated. These statements covered seven key elements3:
essential requirements for pharmacists working in cancer care areas;
governance and patient safety;
cancer biology and SACT;
initiation of treatment;
toxicity and oncological emergencies;
prescription verification; and
clinical application and assessment.
Consensus of opinion with each statement was set at ≥70% agreement.4 Where there was failure of agreement in round one, this was reassessed in round two.
Results The majority of respondents operated in principal treatment centres and had >5 years work experience. Consensus was reached in 80.3% of the statements asked in round one.
Consensus was not reached on whether a pharmacist would be required to be aware of the Lanksy and Karnofsky performance scales, whether they would be required to explain how to manage some oncological emergencies and how it was best to assess competence for the pharmacist’s clinical application of knowledge. These areas were further explored in round two and consensus was reached in 66.7% of the statements. Consensus was reached on how best to assess the competence of a pharmacist new to this high-risk area and advanced level pharmacist would need to demonstrate awareness of the Lanksy and Karnosfky performance scales. However, consensus was not reached on whether they would be able to explain and how to manage superior vena cava obstruction and increased intracranial pressure.
Conclusion A strong consensus was reached on the competency assessment required for pharmacists to undertake SACT verification in paediatric haematology oncology, and how best to conduct this assessment. These findings will be used to develop a training framework and evidence pack to traininexperienced pharmacists entering this high-risk clinical area. It will be distributed to the Children’s Cancer and Leukaemia Group principal treatment centres and members of Neonatal Paediatric Pharmacy Group – Paediatric Oncology Pharmacists sub-group.
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