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Umesh Modi is a chartered accountant, and Pamini Jatheeskumar is a chartered certified accountant at Silver Levene...
  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
More inWhite Papers  

nursing and pharmacyMarch 25 2015

Nurses and pharmacists can work together to help patients make the most of the medicines, a new report is recommending.

The report summarises drivers for improving patient care, reasons for patients not making the most of medicines and how the two professions can work together by overcoming barriers and sharing knowledge.

By working more closely together, the report says the potential benefits include:

•    improved patients’ health and adherence to their medicines
•    a reduction in the incidence of medication errors, allergic reactions to medicines and delayed/missed doses of medicines
•    a reduction in medicines wastage
•    more support for the fight against antimicrobial resistance (AMR)
•    optimised medicines for care home residents.

The report is the outcome of a discussion that took place between Royal Pharmaceutical Society and Royal College of Nursing representatives in December 2014. It summarises “drivers for improving patient care, reasons for patients not making the most of medicines and how the two professions can work together by overcoming barriers and sharing knowledge.”

Barriers to closer working between the professions can be overcome “primarily by understanding each of the professions’ roles and by sharing knowledge and good practice at local and national levels.”

One of the examples given is that “nurses and pharmacists can work with patients/carers and staff at a care home to review medicines eg timing administration that fits with the patient (rather than the system’s processes) – this improves adherence,” says the report. “Quality improvement tools such as mapping the patient journey and using plan-do-study-act to deliver better care also make a big difference.”

Among the ideas proposed to overcome the barriers are:

•    work-shadowing or spending time in each other’s work places, which will help with referrals and support
•    having a shared language about medicines and medicines optimisation, with better communication between organisations such as medicines safety bulletins produced jointly by nurses and pharmacists, and joint assessment of patients
•    learning from medicines incidents and near misses, along with monitoring prescribing and medicines administration
•    using technology including videoconferencing, telemedicine, summary care records and electronic prescribing to support handover of care between settings
•    employing nurses and pharmacists in shared teams in hospitals while community pharmacists building up strong relationships with nursing colleagues to create shared care pathways and joint involvement in service planning
•    shared education from undergraduate levels onwards throughout professional careers with joint learning events.

Introducing the report, Helen Gordon, Chief Executive of the RPS said that the NHS is at a crucial point with respect to interdisciplinary care. “The different treatment pathways across professions and care sectors must be joined up to deliver better outcomes for patients.

“This is particularly the case for medicines where most of the problems relating to adherence and safety occur at the boundaries of professions and care sectors. Integrated working across professions will release talent and help patients make the most of medicines.

“Much more needs to be done to optimise the use of medicines, tackle polypharmacy effectively and improve patient safety. Lessons must be learnt from patient experiences that have not gone well – the patient’s view is vital.”

Ms Gordon urged nurses and pharmacists to listen to patients and do things differently to move patient care forward. “Practical interventions that have made a difference for the patient must be incorporated into service redesign,” she said.

Links:

RPSGB announcement    

RPS and RCN joint report ‘Working together to help patients make the most of medicines’    

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