South West Pharmacy Medicines Optimisation … West Medicines Information & Training South West Pharmacy Medicines Optimisation Training Programme Portfolio Templates: Unit 2.2 Discharge

South West Medicines Information & Training

South West Pharmacy

Medicines Optimisation

Training Programme Portfolio Templates: Unit 2.2 Discharge

Facilitation

Version 1 June 2016

SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME

© South West Pharmacy Medicines Optimisation Training Programme SWMIT, University Hospitals Bristol NHS Foundation Trust

v1 June 2016

Contents

REGULAR REVIEW – UNIT 2.2 ......................................................................................................................... 1

ACCURACY LOG - UNIT 2.2 .............................................................................................................................. 2

COMPETENCY BASED ASSESSMENT – UNIT 2.2................................................................................................ 5

COMPETENCY BASED ASSESSMENT FEEDBACK – UNIT 2.2 ............................................................................... 6

RANGE OF EXPERIENCES – UNIT 2.2 ................................................................................................................ 7

CLINICAL PHARMACY MANAGER ASSESSMENT – UNIT 2.2 .............................................................................. 8

CLINICAL PHARMACY MANAGER REVIEW ON TRAINEE’S PERFORMANCE IN FINAL ASSESSMENT – UNIT 2.2 ... 10

CHIEF PHARMACIST AUTHORISATION TO ACCREDIT – UNIT 2.2 ..................................................................... 11



v1 June 2016 1

Regular Review – Unit 2.2

Discharge Facilitation

Suggested discussion points: or X

1. How well is the trainee progressing through the programme?

2. What is going well for the trainee?

3. Are there any challenges and what support does the trainee need?

4. Has the trainee made any errors and what action has been taken?

5. Is the trainee’s level of confidence developing in the clinical environment?

6. Is the trainee confident with their information gathering processes?

7. Is the trainee getting the required time in the clinical area?

8. How has the trainee performed in busy clinical areas?

9. Does the trainee feel well supported?

10. What are the next steps for the trainee?

11. Are there any other comments that you feel may be relevant?

12. How well is the trainee progressing through the programme?

Trainee comments on review of performance: Educational Supervisor feedback:

Trainee Signature:

Educational Supervisor signature:

Trainee: Educational Supervisor:

Date:

Review No:



v1 June 2016 2

Accuracy Log - Unit 2.2


Trainee Name……………………………………..Trust………………………………………..

Date Patient

type No. of meds on Rx

Discharged to:

Comments (Note: Reflective diary logs can be used to provide more detail)

Information communicated effectively and

accurately? Y/N?

All referrals made

appropriately Y/N?

Signature of trainee

Signature of assessor

Errors found (See error

codes)

Error codes: 1. Prescription/assembly errors

a) Lack of clinical check

b) Incorrect /unsuitable medicines assembled

c) Label incorrect or inappropriate

d) Missing medicines e) Discrepancy between inpatient chart and

discharge prescription

f) Medicines that are not prescribed on the

discharge prescription

Referral error a) Lack of referral

b) Inappropriate referral

Communication a) Missing information

b) Incorrect information provided

c) Omitted follow up information, e.g. obtaining

further meds supplies in primary care/follow-up tests/NMS reviews etc.

There is no scope for error within this module

*The trainee should be observed accurately performing the process of discharge facilitation a minimum of 10 times

This sheet is page

…… of ……..

Educational Supervisors initials…………….



v1 June 2016 3

Error Analysis Record – Unit 2.2

To be completed for all errors made or missed by the trainee

Trainee name: Educational Supervisor name:

Date: Error reference number (Item log sheets – page and item number)

Brief description of error

Corrective actions taken

Potential impact of the error to the patient (trainee assessment)

Root cause of trainee’s error (trainee assessment)



v1 June 2016 4

Preventative actions / Learning objectives

Root cause of initial error

Potential outcome (Educational Supervisor’s assessment) None / Minor / Major / Critical

Comments

Assessment of next steps / ability of the trainee to continue with assessment programme / restart the programme

Trainee signature:………………………………………… Educational Supervisor signature:……………………………………………………….



v1 June 2016 5

Competency Based Assessment – Unit 2.2


Trainee:

Educational Supervisor: Date: Assessment number: 1/2/3/4

Number of patients seen during observation (must include minimum of 3):

The trainee must always: Achieved /

Knowledge

question

used

/

1. Communicate with relevant healthcare professionals to establish any issues affecting patient’s discharge to be aware of, e.g. swallowing difficulties

2. Ensure Medicines Reconciliation was carried out on admission and check any information regarding the patients discharge needs in the admission notes

3. Take any relevant action and liaise with the discharge facilitator and on-going care team e.g. traffic lights drugs/specials prescribed

4. Ensure discharge prescription has been clinically checked as per local protocol

5. Reconcile and assemble all required medication according to the discharge prescription

6. Before the patient is discharged: i. Explain the treatment and potential side effects and their management to the individual

and/or carer and accurately answer any questions at a level and pace that is appropriate to their:

1. level of understanding 2. culture and background 3. preferred ways of communicating 4. needs

ii. Check that the individual and/or carer understands the medication and monitoring regime and any potential side effects together with their management

iii. Ensure that the individual is given written information and instructions regarding their medication

iv. Support the individual to take their medication as prescribed v. Reaffirm the benefits of adhering to the medication regime and the potential consequences

of non-compliance on their health

7. Complete all records according to SOPs

8. Refer any issues outside personal limitations as appropriate i. To the pharmacist

ii. To another member of the multidisciplinary team

9. Ensure they work in accordance with the Standard Operating Procedures and within the scope of your responsibility and practice at all times

10. Comply with legal, professional and organisational policies at all times

Educational Supervisor’s signature:

o Each criteria can only be covered with a knowledge question on one occasion. o No more than three knowledge questions can be used during one assessment. o All questions and a description of how well the trainee has answered the question must be documented in the

feedback. o Each of the competency-based criteria must be achieved on at least 3 out of 4 assessments.



v1 June 2016 6

Competency Based Assessment Feedback – Unit 2.2


Trainee:

Educational Supervisor: Date: Assessment number: 1/2/3/4

Assessment Feedback

Trainee Signature:

Educational Supervisor

Signature:



v1 June 2016 7

Range of Experiences – Unit 2.2


Range of situations the trainee must reflect on in their case studies:

Note: All essential ranges must be covered The trainee must demonstrate that they have sufficiently covered a wide range of experiences throughout their assessment period by reflecting on these experiences and recording their reflection as CPD case study entries starting at ‘action’.

Range 1. Patient types 2. Information provided verbally

3. Non-verbal information sources

4. Situations you should reflect on

Essential Min of 2 from the list below a) Patient b) Patient’s carer/relative c) Care/Nursing home

a) Patient’s Own Drugs (PODs) Min of 3 from the list below

Optional Must

include a

min of 2

from each

category

unless

otherwise

stated

a) Surgical b) Medical c) Elderly d) Psychiatry e) Others (e.g. Paediatrics)

d) GP Surgery e) Community pharmacy f) Interim care team

b) Repeat prescription request c) MARS sheet, compliance

device d) Nursing notes e) Medical notes, clerking sheet,

discharge letters, clinic letters f) GP letter/GP patient summary g) Summary Care Record or

equivalent

a) Patient going to respite care on discharge and potential changes to the supply requirements

b) Patient going to a nursing / residential home on discharge and potential changes to the supply requirements

c) Patient newly started on a compliance device on discharge and potential changes to the supply requirements communicated to the GP and chemist

d) Palliative care discharge e) Patients with swallowing difficulties: NG / PEG etc. f) Changes to the discharge letter after it has been processed g) Discharge medication left behind: patient either choosing

not to wait or to come back later h) No medication required on discharge: ward TTA packs

available / no changes to medication /Trust policy regarding time since admission

i) No discharge letter written j) Discharge letter written but no pharmacist clinical screen k) Patients with changes to an existing compliance aid l) Patient needing to be discharged urgently



v1 June 2016 8

Clinical Pharmacy Manager Assessment – Unit 2.2

Trainee name………………………………………. Date…………………………

The trainee must demonstrate that they have the following skills: Competent = C

Not competent = NC

Comments

Communication skills

The trainee must:

o Demonstrate a range of communication skills

o Demonstrate empathy and developing a rapport with the individual/carer

o Demonstrate that their beliefs, attitudes, feelings and values do not affect their

communication with others

o Demonstrate an awareness of the referral process for patients with a range of

needs

o Liaise effectively within the multidisciplinary team

o Communicate the outcome of activities undertaken to the appropriate person

o Demonstrate an understanding of equality and diversity

Problem Solving Skills

The trainee must:

o Identify and prioritise problems within scope of own competence and practice

o Collect and evaluate relevant information

o Appraise available options for resolution of identified problems

o Demonstrate clear decision making



v1 June 2016 9

The trainee must demonstrate that they have the following skills: Competent = C

Not competent = NC

Comments

Professional skills and attitude

The trainee must :

o Comply with relevant and current legislation, policy, good practice, organisa-

tional and professional codes of conduct, practice and ethical standards

o Provide accurate information whilst working within own knowledge base and

operating within the scope of the job role

o Demonstrate an understanding of clinical governance issues

o Demonstrate knowledge and understanding of additional precautions required

for high risk medicines, in accordance with organisational procedure

o Demonstrate a working knowledge of risk management, incident management

and error reporting systems

o Demonstrate an awareness of issues relevant to clinical areas

o Manage their time effectively

o Refer appropriately when required to do so

Documentation/transcription skills The trainee must :

o Use the appropriate approved documentation

o Demonstrate accurate and legible transcription skills

o Ensure information is recorded in the appropriate records and that documenta-

tion is filed in the correct location (medical notes for example)



v1 June 2016 10

Clinical Pharmacy Manager Review on Trainee’s Performance in Final Assessment – Unit 2.2

Clinical Pharmacy Manager’s Review on Trainee’s Performance in Final Assessment/Reference for Assessment Panel

The trainee has*/has not yet* met all of the above criteria and has*/has not yet* demonstrated an appropriate level of competence and confidence to become accredited in Unit 2.2 of the South West Pharmacy Medicines Optimisation Training Programme. PASS Trainee should proceed to the external assessment * REFER Trainee is not yet at a suitable standard to be accredited * FAIL Trainee is not of a suitable standard to become accredited and should not continue *

* delete as appropriate

Signature of Clinical Pharmacy Manager

Name Date

Name Date

SOUTH WEST TRAINING PROGRAMME FOR PHARMACY LED MEDICINES OPTIMISATION SOUTH WEST PHARMACY MEDICINES OPTIMISATION TRAINING PROGRAMME


v1 June 2016 11

Chief Pharmacist Authorisation to Accredit – Unit 2.2

Please retain original

Upon satisfactorily meeting the requirements for accreditation set by the South West Pharmacy Medicines Optimisation Training Programme, this trainee has demonstrated that they are competent to carry out the following aspects of the medicines optimisation role:

Unit 2.2 Discharge Facilitation

I hereby authorise the South West Medicines Information & Training department to proceed with the accreditation and certification of this trainee.

Trainee name............................................................

Approved for certification Signature of Chief Pharmacist (or approved designated deputy)

Name Date

Documents

South West Pharmacy Medicines Optimisation … West Medicines Information & Training South West Pharmacy Medicines Optimisation Training Programme Portfolio Templates: Unit 2.2 Discharge