Learning package designed to highlight best practice and excellence of service delivery, amongst pharmacy staff, during implementation of a community based needle exchange programme.
Please note that this example was originally submitted to demonstrate implementation of PH18 but remains consistent with the updated guidance PH52.
Guidance the shared learning relates to:
Does the example relate to a general implementation of all NICE guidance?
Does the example relate to a specific implementation of a specific piece of NICE guidance?
Aims and objectives
To deliver qualitative information to community-based pharmacists to enable them to commence operation of a needle exchange facility with confidence and insight.
To enhance their awareness of best practice policies and procedures, client focused empathy and basic harm reduction advice and safety measures.
Reasons for implementing your project
Currently the only needle exchange facility in Bedford is operated by The Can Partnership from their premises. The next possible exchange is some miles away in Kempston, Bedfordshire. The needle exchange experiences high volumes of people. There was an identified need to offer other 'gateways' into recovery services and external options to access Harm Reduction advice and self-care for those not yet willing to access Can Partnership.
How did you implement the project
I was asked to create a training package by the Operational Manager and the Director. I did not have access to look at other training packages as they charged fees to access resources. Other organisations did not have available documentation for me to view to ensure that my training package was suitable for Pharmacy staff. I felt that the package I had already put together for staff within my organisation assumed a certain level of expertise on the subject. This and the fact that it did not apply to a community pharmacy setting meant that it became apparent that it was not suitable. I resolved this by looking at the NICE guidance documents and working my way through this to demonstrate the guidance in a clear way to persons relatively new to the topic. This enabled me to ensure that the training package included essential areas of learning. The guidelines gave me the base lines for the content and the client base was drawn from reference groups such as adults over the age of 18yrs and steroid users.
Once I had written the training package I asked for this to be reviewed by the Service Manager, Operational manager and Service Director. I wanted to ensure that it was suitable and not too complex or simplified. The feedback from the Service Director was that it was pitched 'just right' for the purpose of community pharmacists however it would be beneficial to include a Q & A section at the end for any queries which I readily took on-board.
Initially, the Pharmacists seemed nervous about coming to the service, however, readily did so once reassured. They told me that nerves were due to total lack of experience in this area. I sat the chairs closely to me so as not to create a class-room atmosphere. This informal seating helped. Also helpful were the examples of equipment that would be found in the pharmacy packs to be dispensed. I ensured that there was adequate examples of each item eg; Myjectors, 2ml barrels, 0.45l bins, wipes, etc for everyone and handed them out as we discussed them. This really helped because the staff could look at them closely and grew accustomed to the packaging. They also asked me lots of questions as they viewed them and I was able to demonstrate things like the closure sound of the sharps bins.
Although simple, talking frankly about needle/ sharps safety and the practicalities of this helped address anxieties about personal staff safety.
Initially the training was provided to Superdrug Bedford pharmacists. This training is to be extended to other High Street Pharmacists in the future as the scheme is rolled out. For example Boots stores across the county have also agreed to participate. I hope that once validated the training can be accredited for training others in the Bedfordshire area for PBNX purpose.
By putting the NICE guidance into my work I was able to demonstrate that the advice and training was based on qualitative evidence, designed and contained high quality information and weighed up the cost and benefits of delivering this service. I requested that the Pharmacists complete an evaluation form for me. The results were collected and the averages are as follows:
Confidence before: 4/10
Confidence after: 8.2/10
100% would recommend
The evaluation feedback on the effect of the training on prescribing behaviour indicated that the pharmacists said that they found the informal discussions around this topic equally as insightful as the practical aspects. They told me that they would be mindful of the discussions during training when they dispensed and were more likely to be empathetic when dispensing. The average feedback score here was initially 2 out of 10 before the training and 8 out of 10 after the training
Key learning points
Key learning points were to have some of the operational aspects more clearly defined prior to training delivery. Many questions in the Q&A were regarding promotion of the service, HEP B vaccinations for staff and disposal arrangements of sharps bins. This is agreed at managerial levels and were still being finalised. In hindsight I would have liked to have delayed training to know about the operational practicalities so that I can respond. These questions were forwarded on and replied to later.
Another learning point was the timing, the pharmacists were at work for a full day and then attended the training from 18:15 hrs to 19:30. They were a little tired. In future I should like to deliver the training during the day - ideally morning time and deliver the training in two groups. The discussions were more important than I had realised and the pharmacists felt more at ease to discuss anxieties with me once we had talked.
The final learning point was not to expect 10 out of 10 on the feedback! they told me that despite the training being very good indeed they still felt they needed to commence operation to see for themselves and gain optimum confidence.
Is the example industry-sponsored in any way?