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PAEDIATRIC SIMULATION—A NEW ROLE FOR PHARMACISTS IN IMPROVING PATIENT SAFETY
  1. S Jarvis
  1. Bristol Royal Hospital for Children

Abstract

Aim Simulation has become an important resource in patient safety and education. Senior pharmacist involvement in high fidelity simulations began through regional educational “road shows” in referring hospitals which identified areas of concern in medication safety. This led to working with the simulation team with the aim of assessing the place of pharmacy in this relatively new methodology.

Method Scenarios were planned based on situations involving clinical pharmacists. A group of paediatric pharmacists working locally observed and assessed a simulated incident involving a heparin overdose. The same scenario was repeated as a workshop at a national conference. This introduced a variety of pharmacists to simulation who were then offered the opportunity to attend a study day.

Two scenarios were run using child and baby manikins. The first introduced a protocol for the treatment of hyperammonaemia requiring complex calculations in a stressful situation. The second concerned a collapsed neonate requiring drugs urgently from pharmacy to replace expired stock. At the end of the sessions the pharmacists discussed how the scenarios might affect their practice and in which situations they felt the use of simulation would improve patient safety and reduce risk.

Local pharmacists reviewed practice and developed a programme of high and low fidelity scenarios which could be used to improve education and patient safety within pharmacy and to assess the introduction of protocols and systems. This included scenarios to develop and assess the prioritization of tasks within chart screening in a busy dispensary and plans to use simulation for critical medicine provision, ‘SBAR’ implementation and “on call' training.

Results From the initial meetings the pharmacists identified that by observing the simulation of a stressful situation they appreciated that errors were not the result of lack of knowledge or care but were much more complex. Discussions at the completion of the study day resulted in a list of suggestions for the development of simulation to improve medication safety and the role of pharmacy in improving patient care. These ranged from low fidelity simulations of processes involved in drug recalls, shortages and major incidents to more complex simulations to test new protocols before introduction and to improve education for all pharmacy staff to increase the understanding of the development of medication related incidents.

Conclusion Members of the pharmacy staff have a role which runs parallel to the rest of the multi-professional team. Within the UK it is unusual for pharmacists to be directly involved in the prescribing and administration of drugs in acute situations but they have a governance role in ensuring that medication is prescribed, supplied and administered in a timely and safe way. This series of simulations introduced a novel and informative way of improving patient care and enhancing the role of pharmacy within the clinical team.

  • Neonatology
  • Pharmacology

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