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Hospital pharmacists association of ireland

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  • 17 Apr 2018 12:22 PM | Admin1 (Administrator)
    Webcasts giving both video and slides of presentations given during the 23rd EAHP Congress in Gothenburg, Sweden 21-23rd of March are now available on the link below

    https://events.eahp.eu/cmgateway/webcast.html#!sessionschedule

    Abstracts are available in the congress book

    http://www.eahp.eu/congresses/abstract#node_congress_abstract_page_group_abstract_books

    The links give a flavour of the high quality of lectures, workshops and seminars that were held. 


  • 25 Jan 2018 2:00 PM | Admin1 (Administrator)

    Which is the most valuable? 

    In their own way and dependant on the task in hand they are exactly the tool you need for the job. 

    If I had to  open 100 tins of beans the can opener would be my best friend. Refined over many years to be perfectly honed to deal with this specific task I could sail through opening the tins and prepare a banquet for a huge crowd (well I didn't promise a gourmet banquet!)

    If I had to cut out many items from pieces of paper, my can opener which previously saved the day would be cast aside for the scissors. Again a fine set of sharpened stainless steel scissors would allow me to accurately and comfortably cut out the items quickly and safely.

    But then there is the Swiss army knife. Often received as a gift and for some always found close at hand, it is not designed to do any one specific function better than a specialist tool could. Instead it has been exquisitely developed, refined and honed to be the answer to a multitude of tasks.  For that reason it can often be found carried by people who consider themselves ready for any eventuality. 

    "Where does this link back in to hospital pharmacists?" I hear a muffled cry.

    Well, in areas where you have a high volume of similar tasks a specialist tool is best placed to meet this demand. It has been developed to deal with a tight grouping of functions in the same way, quickly and safely. In the case above think scissors and can opener. 

    However in more unpredictable, general scenarios sometimes you need to hedge your bets and have a multi purpose tool that can cope with just about anything that is asked of it.  

    When we were asked to consider the career structure for Irish hospital pharmacists we recognised that being a generalist could be a speciality in itself.  It was no more or less specialised than working in a clinical niche for the majority of the day.

    The further training and development needed to cover several specialist clinical areas to a high level required training and development akin to that needed to work in depth in any single specialist medical area. Every department has a pharmacist that fits this bill. They can be dispatched to any far flung corner of a hospital and be relied upon. This is often down to skills developed through experience and blended training applied over time to a range of clinical areas. 

    It is for this reason that when job description reviews were conducted with the HSE in 2017 as part of the implementation meetings, discussions were tabled over the the meaning of "specialist" and "specialism" in Irish Hospital Pharmacy in order to acknowledge the diverse ways that hospital pharmacists have and continue to develop high level input to patient care. 


  • 18 Jan 2018 5:00 PM | Admin1 (Administrator)

    The IMPACT directive. It gets in the way, it frustrates. The limitations to practice, the feeling when another request comes through that will trigger a debate between the pharmacist, the requestor and if you are really luck hospital management.

     

    But if you look at the directive and what it is in response of and what goal it is intended for it becomes clear that often frustrations that should be brought to bear on a log jammed bureaucratic process are transferred to a piece of paper.

     

    There is (and was several years ago) consensus that the practice of hospital pharmacy has advanced to the point where the agreed employment structures for pharmacists within the HSE were no longer fit for purpose. Pharmacists in a significant number of hospitals were no longer confined to dispensaries, they were working closer to patients ensuring that all elements of medicines management were covered. Specialism was developed by pioneers in the profession and then became expected as the outcomes of this work filtered out. To this day a wide variation can be seen in the provision of clinical pharmacy services which is not linked to the size or complexity of the hospital covered.

    By virtue of being the largest employer this situation impacts the whole of the profession, as both legal, regulatory and market factors are hugely influenced by both the HSE and the Department of Health.

     

    The current career structure does not recognise the work of these pioneers, or give encouragement and support to those that today have the drive and commitment to improve the use of medicines for hospital patients in Ireland. Specialism is happening in a fragmented way, unsupported nationally and in many cases locally (without guidance and direction from national employers). In areas where specialism has occurred support for upgraded job descriptions has faltered once the operational necessity of having people in post has been satisfied. In the case of antimicrobial stewardship pharmacists, we have seen their work develop into a true speciality working as peers with Consultant and Registrar grade medical staff to ensure safe prescribing and monitoring is effective. Outcomes around antimicrobial stewardship have improved partly due to the work of this group of pharmacists. These pharmacists are not recognised by their employer as specialised. We have acted in good faith in the provision of new services but have waited for years for  agreed implementation of the career structure which has not been forthcoming from the HSE. In this way we devalue our contribution to Irish healthcare and our perceived value to the HSE.

      

    Compare where we are to the Medical and Nursing profession. We work collaboratively with Doctors and Nurses every day. We are used to seeing individuals in both groups take up opportunities for further training and development in order to specialise and to be recognised as such. They have the apparatus to achieve this which brings a benefit to patient care. The concept of a Senior doctor or nurse who would know everything about anything due to the amount of time they have practiced is inconceivable. Why is this the case for Pharmacy? Specialism is rightly difficult and hard work to achieve but with it should come recognition from colleagues, managers and patients alike.       

     

    The IMPACT directive is borne out of the HSE’s failure to implement what it agreed upon. An agreement that was made, based on the principle of providing a structure to enable modern pharmaceutical care for patients. A principle that holds just as true today. Hospital pharmacists are competent and confident that their roles could be expanded, with the underpinning support to drive better patient outcomes. Pharmacists are part of the solution to the question of how to manage increasing complexity in healthcare coupled to an ageing population with the corresponding increase in co-morbidity and polypharmacy.

     

    The HPAI continues to represent Hospital Pharmacists at national industrial relations meetings in an effort to ensure the implementation of the Hospital Pharmacist career structure. The addition of a reference to the implementation of this structure in the HSE Operating plan for 2018 is welcomed by the HPAI. However the sustained support of the membership of the association and for the IMPACT directive is critical to ensure that Hospital Pharmacy is transformed, making it fit for the present and future.

  • 12 Jan 2018 1:45 PM | Admin1 (Administrator)

    There has been recent interest shown by the HSE in the consideration of the adoption of modern IT facilities both within hospital pharmacy dispensaries and on the wards in the form of prescribing software. The benefits of these systems are huge in several outcome areas. 

    One of the few advantages of finding yourself behind the curve of adoption of technology is that others have had the chance to test and fix what was once novel and now mainstream pieces of software.  The HSE can, as a result look to a developed market and select a product that offers the best balance of features, safety, usability and value. 

    In other health systems the adoption of this type of technology has empowered hospital pharmacy practice and has led to increased time at the patient's bedside for clinical work. The ability to alert pharmacists to new patients, dose changes, delayed administration or supply requirements all result in the work coming to the pharmacist rather than the pharmacist hunting for work amongst the drug kardexes.

    The correct adoption of technology allows for seamless connection of dispensary  automation and drug storage units along with procurement to smooth logistics. 

    To achieve these benefits, there needs to be a realisation that the adoption of technology is only a catalyst to drive changes in processes. Simply  buying the best software and hardware doesn't guarantee the best outcome. This is greatly swayed by the implementation, system administration and ongoing support for medicines management processes at ward and pharmacy level.

    Pharmacists have proven that they are integral to the successful deployment of e-prescribing. However the disparity in the level of clinical pharmacy provision within HSE hospitals risks any implementation of such systems. 

    In order to underpin the modernisation of processes, a modernisation of the Hospital Pharmacist profession is required. Without structures that can cope with taking the lead on all aspects of medicines management, the large investment required in infrastructure will be at risk. 

    It is for this reason that the HPAI continues to work to ensure the implementation of the Hospital Pharmacist career structure, to ensure that Pharmacy is represented at senior levels to ensure medicines management related projects are expert led within all hospitals. 


  • 17 Nov 2017 1:35 PM | Admin1 (Administrator)

    Standard membership works out at approximately €6.90 per week with subscriptions this is reduced for Hospital Pharmacists earning less than €44,880

    Example approximate costs are given below (although this is intended only as an indicative guide based on subscriptions in March 2017 - more information is available from IMPACT direct here)

    Basic salary

    Impact subscription cost

    Cost per week

    €44,880

    €359.04

    €6.90

    €43,799

    €350.39

    €6.74

    €41,016

    €328.13

    €6.31

    €38,265

    €306.12

    €5.89

    €35,368

    €282.95

    €5.44

    €34,438

    €275.50

    €5.30

    €31,831

    €254.65

    €4.90



  • 16 Nov 2017 12:28 AM | Admin1 (Administrator)

    The Medical Council and the PSI, the pharmacy regulator, have launched a joint initiative aimed at doctors and pharmacists, entitled ‘Safe Prescribing and Dispensing of Controlled Drugs’

  • 16 Nov 2017 12:24 AM | Admin1 (Administrator)

    European legislation for aseptic manufacturing is developed with a particular focus on the pharmaceutical industry. With certain exceptions, manufacturers of human medicines are required to hold a Manufacturer’s Authorisation. To obtain an authorisation to manufacture medicinal product, compliance with the principles of Good Manufacturing Practice (GMP) must be demonstrated.

    Aseptic compounding in Irish hospital pharmacy is exempt from holding a Manufacturer’s Authorisation provided certain criteria are met (Medicinal Products (Control of Manufacture) Regulations, 2007. Section 5 – S.I. No. 539 of 2007). However, the ethos of GMP is equally paramount to ensure that all products compounded are of high quality, safe and effective. It is important, therefore, that the underpinning principals of GMP can be translated transparently and safely into the hospital pharmacy aseptic compounding unit.

    In the absence of nationally agreed guidelines for aseptic compounding in Irish hospital pharmacy the Hospital Pharmacist Association of Ireland (HPAI) submitted a project to develop guidelines to the Medication Safety Forum in 2010. All pharmacy departments with compounding facilities were invited to contribute. Through consultation with the Health Information and Quality Authority (HIQA) and the Irish Medicines Board (IMB), the Pharmaceutical Inspection Convention and Pharmaceutical Inspection Co-operation Scheme (PIC/S) Guide to Good Practices for the Preparation of Medicinal Products in Healthcare Establishments (PE 010/3) was chosen as the most appropriate guidance to apply to aseptic compounding in Irish hospitals.

     

    These guidelines were written by pharmacists working in aseptic compounding and reflect a consensus of the combined knowledge of these pharmacists. They are guidelines of professional practice as developed by practitioners and have been endorsed by Chief Pharmacists (Head of Departments) on 7th March 2013 and by the HPAI Executive on 7th November 2013.

    HPICS-complete.pdf

  • 16 Nov 2017 12:23 AM | Admin1 (Administrator)

    Chief I Pharmacist/ Pharmacy Manager

    The role of Pharmacy Manager has changed measurably since the 1978 job descriptions were implemented. Hospital Pharmacy practise is more complex and pharmacy departments now provide


    many additional services apart from the traditional dispensary based operations. The advent of the Pharmacy Act has added additional pressure for Pharmacy Managers as they are


    now deemed to be Superintendent Pharmacists operating a retail pharmacy business.


    There are few (if any) other departments operating in hospitals that face as much regulatory pressure as Hospital Pharmacies. The complexity of the Superintendent Pharmacy and Pharmacy Owner relationship


    must be negotiated by Pharmacy Managers; this is not helped by reporting structures which often mean the “owner” is many steps away in a complex management chain.


     


    It is welcoming to see the development of pharmacy services and regulation to improve the breadth and quality of services we provide to our patients. However Pharmacy Managers should not be expected to operate in an environment where they are unsupported and unrecognised by management.


     


    The implementation of the Review of Hospital Pharmacy will create the Director of Hospital Pharmacy and Director of Medicines Management role,


    Hospital CEO or General Manager, thus facilitating meaningful engagement between superintendent and owner.


     


    The Review also provides for a rotational Area Director role, platform for Pharmacy Managers in different hospitals to work collaboratively for the betterment of patient care. As noted above the development of Deputy Director will relieve some of the operational pressures faced by Pharmacy Managers.








  • 16 Nov 2017 12:20 AM | Admin1 (Administrator)

    Chief II Pharmacist

    Chief II Pharmacists currently operate in a variety of roles including clinical specialities, service managers and heads of departments. The role varies considerably between and within hospitals; often these posts have grown organically out of the 1978 job description, and the roles currently undertaken are far more complex and nuanced than when they were first established.


    For example an Aseptics Chief II is tasked with managing an Aseptic Unit, which in itself carries considerable responsibility, but they may also have responsibility for clinical trials, cancer clinical services, cancer drug procurement and reimbursement, protocol development and electronic prescribing.


    Medication Safety Pharmacists are tasked with managing their hospitals medication safety programmes but are usually involved in much broader aspects of medicines management, and are often expected to operate at a Regional and National level.


    The Hospital Pharmacy Review will better define the role of Pharmacists working at Chief II level. It will establish Pharmacy Service Managers in areas such as Dispensary, Aseptics and Clinical Services; these posts will provide appropriate recognition for the considerable responsibility associated with these roles.


    The establishment of the Deputy Director of Hospital Pharmacy post will allow Pharmacy Service Managers to focus their attention on the operational needs of their service rather than being pulled to cover administrative and management functions outside their remits. Chief II Pharmacists have been expected to operate in an ever expanding and complex health service without any progression in their job description or definition of their responsibilities.


    The Hospital Pharmacy Review must be implemented so Chief II pharmacists receive the due recognition they deserve and are given the operational freedom they need to manage their service with the patient as their primary focus.


  • 16 Nov 2017 12:15 AM | Admin1 (Administrator)

    Basic and Senior Grade Pharmacists

    At present there is no formal route to specialisation in Hospital Pharmacy; this is in contrast to many of our professional colleagues in Dietetics and Physiotherapy for example who have a clinical specialist grade.


    This means that many highly qualified (77% of hospital pharmacists hold a related post graduate qualification) and experienced pharmacists are working as unrecognised, and often underutilised, specialists in clinical areas.


    The Hospital Pharmacy Review recommends the establishment of a Clinical Specialist Pharmacist grade; this reflects the contribution Hospital Pharmacists make to patient care in complex and key specialities.








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About the association

The Hospital Pharmacists Association of Ireland (HPAI) is a voluntary organisation that represents it members on issues relevant to hospital pharmacists.

Mission Statement

The hospital Pharmacists Association of Ireland exists to:

  • further the development of hospital pharmacy practices.
  • assist in the provision of continuing pharmaceutical education.
  • represent the views of the hospital pharmacist on issues of relevance to hospital pharmacy.
  • advance the professional welfare of our members

Contacts

MembershipHPAI@gmail.com


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