Pharmacists in the emergency department play a crucial role in upfront decision making around medicines for patients presenting with various medical conditions.
Cristina Roman, is the Lead Pharmacist at Alfred Emergency Trauma Centre. In her 12 years working in the Emergency Department, Cristina has established pharmacy services, and filled gaps in patient care with new models of care.
One of those models of care adopted by the US and other countries, is involving pharmacists for critically unwell patients that present to the emergency department.
Through her investigations, Cristina has considered how pharmacy services can impact stroke care, sepsis and trauma outcomes.
Thrombolytic therapy is crucial in ischaemic strokes, as every minute with a blood clot in the brain increases the risk of permanent disability for the patient.
Pharmacists can play a crucial role in identifying patients appropriate for thrombolysis and assisting with the administration of high-risk medications like thrombolysis for stroke patients. This can mean faster thrombolysis to eligible patients, shaping the scope of practice for the emergency medicine pharmacist.
In addition, her studies have also shown the involvement of pharmacists in sepsis calls improves time to antibiotic administration, particularly for patients in ICU care. The evidence has shown better outcomes for the most unwell patients.
Nurses and medical staff at Alfred Hospital are now actively pulling pharmacists into scenarios, highlighting the value and benefit of their involvement in patient care.
This model of care for emergency departments involving pharmacists has gained international interest and is continuing to expand.
Australian Health Journal spoke with Cristina Roman and Lisa Bremner, Advanced Training Resident Pharmacist at Alfred Hospital Emergency Trauma Centre.
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HIGHLIGHTS The power of social determinants of health, panel discussion
Clinicians and consumers know only too well that life circumstances such as poor housing, income and food insecurity can have a negative impact on health outcomes. Conversely, participation in community activities, social connection and access to nature parks and leisure facilities can help maintain health and wellbeing.
More recent phenomena in public health have also focused us on the health and social care connection. Stress factors such as the sudden loss of employment and social interaction, moving to remote work or schooling, and the impacts of sudden, localised COVID-19 ‘lockdowns’ to prevent further outbreaks were triggers of increased psychological distress.
And loneliness is being described as our latest epidemic with chronic loneliness inked to a myriad of health problems and earlier death. A recent report found one in four Australians say they feel persistently lonely, and that loneliness costs $2.7 bn a year in health costs alone.
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Value-Based Health Care : Dental Health Services Victoria Case Study
Dental Health Services Victoria has implemented a value based health model for oral health, around the patient and the clinician that included both during co-design. This has been possible with a single oral health data system for the state of Victoria and staff keeping in mind the value and outcomes that patients seek.
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The Case for Embedded Pharmacy in Residential Aged Care
Embedded pharmacy in residential aged care has been successful in South Australia at the Tanunda Lutheran Home in the Barossa Valley. Julian Soriano talks about his pharmacy role in medication management and medication safety to deliver the best clinical care for residents.
In this segment, Julian talks about the traditional pharmacy model serving residential aged care and the limitations of the imprest process for dispensing medication. Soon into the project he saw the collaboration required with GPs and onsite nurses in dispensing medication for residents in end-of-life or palliative care. Julian sees the imprest process unable to support end-of-life residents, even being able to check the availability of medication.
But what most may not be aware of, is his rapid growth since starting the business in 2013 having just been in health care a few years earlier. Being part of a 2nd generation health care family, Shawn learnt from his father on site and at trade show visits overseas. Prior to HPA, he spent 2 years working in fit-outs of operating theatres, neo-natal and general population ICU, throughout being more fascinated with what he saw.
