Bernice West

Pharmacist prescribing in the UK – a literature review of current practice and research

Objective:  To review the research literature to date on pharmacist prescribing in the United Kingdom (UK) and to explore the main areas of care and practice settings including any benefits and limitations.

Antimicrobial optimisation in secondary care : the pharmacist as part of a multidisciplinary antimicrobial programme-a literature review

The aims of this literature review were: (i) to determine what roles have been supported by evidence for the pharmacist in optimising antimicrobial treatment as part of an antimicrobial multidisciplinary team (AMDT) in secondary care; and (ii) to describe the outcomes of interventions of an AMDT in secondary care with pharmacy involvement. Both descriptive and primary research reports were identified and included. The hospital pharmacist emerged as a key member of the AMDT. The dispensary pharmacist was mainly involved in the screening processes and was crucial in implementing restriction policies. The general ward-based clinical pharmacist was involved in guideline development, formulary management, intravenous-to-oral conversions and evaluations of programme outcomes through monitoring of drug usage, and also facilitated identification of patients with specific needs who could be referred to the specialist pharmacist. A role emerged for the specialist pharmacist who was an integral part of the AMDT and was involved in activities including reviewing of more complex patients, attending ward rounds and streamlining of initial empirical antimicrobial treatment. Outcomes of interventions reported in primary research have been classified into: drug outcomes, where most trials measured and reported an increase in adherence to guidelines; microbiological outcomes, only considered in a few trials; clinical outcomes, with different parameters measured and a maintenance or improvement reported; and financial outcomes. The latter were reported in all trials with numerous cost savings, although not all were statistically significant. Moreover, the cost of the intervention was not always considered.

London Patels: Caste and commerce

Abstract The Patels in many ways provide an ideal case for studying caste and commerce in Britain. They have originated from Chantar in the rural heartland of Gujarat. For many decades, the community has defied Indian traditional caste expectations of behaviour. Furthermore, as twice migrants, the Patels have retained a strong sense of identity and have entered into the business worlds of East Africa and the United Kingdom. This article addresses two key aspects of the Patel migratory experience and business achievement. Firstly, caste organisation in Charotar and London is explored through a discussion of field data from each context. This analysis not only demonstrates a complex system of differentiation within the caste but also provides an insight into the economic potentials within certain aspects of Hindu culture. Secondly, the business activities and acumen of the Patels are considered on the basis of a range of data sources. By analysing official records and interview data the article shows the ma...

Work life and psychological health: the experiences of Thai women in deprived communities.

I discuss womens work life and the psychological health of women in low-income communities in Northeast Thailand. Previous research has shown that low-income women are part of a disadvantaged group who struggle against several problems in their everyday life, and who work hard to survive. These women worked as either manual laborers in agriculture or factories or as self-employed vendors, and were busy Ha Yoo Ha Kin (working and earning a living). The womens way of life was complex and involved being responsible for their children, husband, extended family, work, and themselves. Understanding womens beliefs and practice relating to work life and health is essential in designing effective intervention programmes to promote the health and well-being of low-income women in Thailand.

Role development in acute nursing in Scotland.

Aim This research was designed to evaluate innovative roles underpinning successful nurse-led services in nursing and midwifery in Scotland. Method A dual methodological approach encompassing a national survey and detailed case studies was adopted. The survey of all NHS trusts in Scotland was designed to profile role developments and extended practices in nursing and midwifery practice. The survey data were used to identify case studies that reflected innovative roles within nursing and midwifery. Twenty semi-structured interviews were undertaken with clinical nurse specialists and analysed using the constant comparative approach of grounded theory. Results Three case studies in acute care were identified for in-depth study. The key themes to emerge were the specific nature of the work, the professional merit associated with each role, benefits to patients and the importance of objective evaluation of the role. Conclusion The findings from the acute care case studies strongly support the importance of nurses promoting and developing patient-focused initiatives in acute care.

Evaluation of a national educational programme for healthcare workers on prevention and control of healthcare associated infections

This paper presents an overview of key findings from an evaluation of a national educational programme that aims to provide healthcare staff with the skills and knowledge necessary to ensure good practice in preventing healthcare associated infections. The research methods comprised literature review, large-scale questionnaire surveys of students and mentors on the Cleanliness Champions Programme, and 20 key-informant interviews. The educational programme was found to be fit for purpose, but there was a need for some restructuring and modifications. Nurses were found to comprise around two-thirds of all registrants on the programme. The study also provided some illumination of initial integration into practice. Cleanliness Champions typically reported substantial impact on their personal practice and many cited examples of influence on colleagues’ practice. However there is an urgent need to ensure that other occupational groups join with nursing by enrolling on the programme in much greater numbers. If this is accompanied by further investment, a critical mass may form that has sufficient multidisciplinary momentum to make good infection prevention and control practices more embedded clinical realities within Scotland. Key lessons from the evaluation are identified that may usefully inform similar initiatives and/or other national healthcare education programmes.