Published: 02/12/2004, Volume II4, No. 5934 Page 31
The AAH Hospital Service pharmacy technician of the year award shines a spotlight on a developing role in many hospitals, reports Martin Hedges.
Compliance with pharmaceuticals relies on a patient's understanding of supposedly simple instructions - the basis of the project by clinical award winner Nimla Soma, a community services co-ordinator at University Hospitals of Leicester trust.
Many patients from Leicester's Asian community, particularly the very elderly, could not understand even basic written or verbal instructions in English about their medicines. Patients either got imperfect translation services from family members, or pharmacy staff were called in to act as unofficial interpreters.
As a Gujarati speaker, Ms Soma was once called to translate for a patient who in the end turned down the offer of a rehabilitation course, simply because no-one could accompany her as translator.
First, she sent a questionnaire to 126 trusts that were identified as having a large Asian catchment population. Second, she interviewed 100 inpatients at Glenfield Hospital who were aged 18 or over and had Asian family names. Finally, she tried to measure the ad hoc translating already conducted by pharmacy staff.
The national survey showed that pharmacy staff were often relied upon as Asian language translators, but that no trust employed a full-time interpreter based in pharmacy. Of those replying, three-quarters said that a translator was required fewer than five times a month. Ms Soma felt this figure may have been underreporting the problem, however, due to the informality of the approaches to pharmacy staff.
Her own survey found that 72 per cent used Gujarati as their first language; 30 per cent spoke English with difficulty and 28 per cent could speak no English at all. An overwhelming majority of over-75s could not understand oral or written English.
Monitoring her own pharmacy department interpreting services, Ms Soma found that it amounted to about four hours each week.
She suggests trusts consider designating a translator within the pharmacy service so that the quality of service for non-English speakers on drug information was not left to family members.
The winner of the supply chain award has empowered technicians and dispensing assistants to do as much controlled drugs handling as regulations allow, giving back several working hours to nursing staff each week.
Judith Telford led the project, at Northumbria Healthcare trust, when she was dispensing and ward services manager at Hexham Hospital. Following the changes she instigated, waits for controlled drugs orders have diminished and ward stocks do not now run short.
Both technicians and assistants get greater job satisfaction with their extended role, while more pharmacist time is freed up for clinical duties.
Ms Telford began by writing nine 'standard operating procedures' and had them approved and implemented before staff training began. Technicians were trained to issue controlled drugs to wards and departments, while dispensing assistants were trained to handle frequent, regular top-ups of drugs stocks held on the wards.
The only serious problem that Ms Telford reports was a complaint that controlled drugs had been 'abandoned at an unattended nurses' duty station' by a pharmacy porter. Realising that the porters had no formal training in controlled drugs handling, she attempted to introduce a programme to address it.
A reluctant head porter initially took it as an indication that his staff were not to be trusted. 'Persistence' won him over, says Ms Telford.
At the start of the project in April 2003, pharmacist issues ran at 85 per cent. In the following months that figure was almost reversed, with technicians initiating more than 70 per cent of the issues on average, and in one month nearly 90 per cent.
For more information visit www. aah-hospitalservice. co. uk