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Queen’s University
          Belfast




  Supporting safe use of medicines


               Colin G Adair
NI Centre for Pharmacy Learning and Development
 School of Pharmacy, Queen’s University, Belfast
Medicines safety
• Shipman
  – Murdered 15 patients
  – Possibly 214 others
• Adverse incidents
  – £290,000 per event
  – 1,100 deaths annually
  – 11% of in-patients
  – 8.5 additional days
Medicines safety
• Shipman
  – Murdered 15 patients
  – Possibly 214 others
• Adverse incidents
  – £290,000 per event
  – 1,100 deaths annually
  – 11% of in-patients
  – 8.5 additional days
• Final Shipman report
Education support - 2006
NI Response to the
Recommendations of
the Shipman Inquiry
  – GPs
  – Pharmacists
  – Nurse prescribers
  – Foundation doctors
  – Other trainees

   Sustainable
Learning
methods
eLearning
•   Why incidents occur
•   Learning from incidents
•   Prescribing safely
•   High-risk medicines
•   Drug calculations

                              • CD legislation
                              • Commonly made errors
                              • Safer medical and non-
                                medical prescribing
                              • Records and disposal
Comparison of methods
• NI response to the Shipman Inquiry
  – Controlled drugs
  – Medicines safety
• Identical content as:
  – Workshop
  – Print-based distance learning
  – Online course
• Measurement
  – Course evaluation
  – Post-course assessment
Comparison of methods
                          course evaluation (2007)


Descriptor                       Live     Printed*   eLearning*

Objectives (1-5)                 4.64       4.47        4.46

Relevance (1-5)                  4.73       4.50        4.49

Content (1-5)                    4.67       4.28        3.93

Presentation (1-5)               4.62       4.25        3.93

Stimulus (1-4)                   3.75       3.50        3.70

Overall (0-9)                    8.09       7.81        7.58
*significantly lower than live
Comparison of methods
                         course evaluation (2011)


Descriptor                          Live       Printed*   eLearning

Objectives (1-5)                    4.64         4.47       4.68

Relevance (1-5)                     4.73         4.50       4.75

Content (1-5)                       4.67         4.28       4.65

Presentation (1-5)                  4.62         4.25       4.70

Stimulus (1-4)                      3.75         3.50       3.70

Overall (0-9)                       8.09         7.81       7.99
*significantly lower than live and eLearning
Feedback
“First time I have used elearning and was pleased I could use it
successfully”

“I will be in an environment where the particular errors mentioned
could occur and I feel that the added awareness I now have after the
course should help me in my daily practice.”
Comparison of methods
     post-course assessment




 Live        Printed    eLearning

87±8%        85±5%       84±7%

Six month post-course test: 83±7%
Programme costs

Overall NICPLD costs: £9.65/hour

  Daytime    Evening   Distance   Vocational
 workshop   workshop   learning    training

  £15.10     £10.10     £6.49       £6.30
Programme costs

Overall NICPLD costs: £9.65/hour

  Daytime    Evening   Distance   Vocational
 workshop   workshop   learning    training

  £15.10     £10.10                 £6.30
Conclusion
• MedicinesNI
  – 2917 users
  – 2495 courses completed
• NICPLD
  – 350/95 hours eLearning
  – 2010: assessment online-only
  – 2011: evaluation, application online-only
• Costs
• Responsiveness
  – Responsible pharmacist regulations
Professional pharmacy
Professional pharmacy education
                     education
          • NES


      • NICPLD
                      • CPPE

      • ICCPE

                 • WCPPE
Fran Lloyd
    Michael Mawhinney
    Maureen McCann
     Suzanne Murray
      Gillian Redpath


Thanks to Norman Morrow and
  Diane Taylor, DHSSPSNI

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Safe use of medicines

  • 1. Queen’s University Belfast Supporting safe use of medicines Colin G Adair NI Centre for Pharmacy Learning and Development School of Pharmacy, Queen’s University, Belfast
  • 2. Medicines safety • Shipman – Murdered 15 patients – Possibly 214 others • Adverse incidents – £290,000 per event – 1,100 deaths annually – 11% of in-patients – 8.5 additional days
  • 3. Medicines safety • Shipman – Murdered 15 patients – Possibly 214 others • Adverse incidents – £290,000 per event – 1,100 deaths annually – 11% of in-patients – 8.5 additional days • Final Shipman report
  • 4. Education support - 2006 NI Response to the Recommendations of the Shipman Inquiry – GPs – Pharmacists – Nurse prescribers – Foundation doctors – Other trainees Sustainable
  • 6. eLearning • Why incidents occur • Learning from incidents • Prescribing safely • High-risk medicines • Drug calculations • CD legislation • Commonly made errors • Safer medical and non- medical prescribing • Records and disposal
  • 7.
  • 8. Comparison of methods • NI response to the Shipman Inquiry – Controlled drugs – Medicines safety • Identical content as: – Workshop – Print-based distance learning – Online course • Measurement – Course evaluation – Post-course assessment
  • 9. Comparison of methods course evaluation (2007) Descriptor Live Printed* eLearning* Objectives (1-5) 4.64 4.47 4.46 Relevance (1-5) 4.73 4.50 4.49 Content (1-5) 4.67 4.28 3.93 Presentation (1-5) 4.62 4.25 3.93 Stimulus (1-4) 3.75 3.50 3.70 Overall (0-9) 8.09 7.81 7.58 *significantly lower than live
  • 10. Comparison of methods course evaluation (2011) Descriptor Live Printed* eLearning Objectives (1-5) 4.64 4.47 4.68 Relevance (1-5) 4.73 4.50 4.75 Content (1-5) 4.67 4.28 4.65 Presentation (1-5) 4.62 4.25 4.70 Stimulus (1-4) 3.75 3.50 3.70 Overall (0-9) 8.09 7.81 7.99 *significantly lower than live and eLearning
  • 11. Feedback “First time I have used elearning and was pleased I could use it successfully” “I will be in an environment where the particular errors mentioned could occur and I feel that the added awareness I now have after the course should help me in my daily practice.”
  • 12. Comparison of methods post-course assessment Live Printed eLearning 87±8% 85±5% 84±7% Six month post-course test: 83±7%
  • 13. Programme costs Overall NICPLD costs: £9.65/hour Daytime Evening Distance Vocational workshop workshop learning training £15.10 £10.10 £6.49 £6.30
  • 14. Programme costs Overall NICPLD costs: £9.65/hour Daytime Evening Distance Vocational workshop workshop learning training £15.10 £10.10 £6.30
  • 15. Conclusion • MedicinesNI – 2917 users – 2495 courses completed • NICPLD – 350/95 hours eLearning – 2010: assessment online-only – 2011: evaluation, application online-only • Costs • Responsiveness – Responsible pharmacist regulations
  • 16. Professional pharmacy Professional pharmacy education education • NES • NICPLD • CPPE • ICCPE • WCPPE
  • 17. Fran Lloyd Michael Mawhinney Maureen McCann Suzanne Murray Gillian Redpath Thanks to Norman Morrow and Diane Taylor, DHSSPSNI

Editor's Notes

  1. Harold Shipman was convicted in January 2000 of the murder of 15 patients, the subsequent inquiry concluded that it was highly probably that he had murdered a further 214 patients.There seems to be an erosion in trust in the professions by Government and the public. There also is a loss of deference. i.e. doctor knows best.
  2. Harold Shipman was convicted in January 2000 of the murder of 15 patients, the subsequent inquiry concluded that it was highly probably that he had murdered a further 214 patients.Adverse events – unintendedPublication of the 6th and final Shipman report on 27th January 2005
  3. Harold Shipman was convicted in January 2000 of the murder of 15 patients, the subsequent inquiry concluded that it was highly probably that he had murdered a further 214 patients.Adverse events – unintendedPublication of the 6th and final Shipman report on 27th January 2005
  4. AMEE Interest in eLearningMuch of learning in medicine has been didacticInterest in is eLearning better than lectureNo comparators
  5. AMEE Interest in eLearningMuch of learning in medicine has been didacticInterest in is eLearning better than lectureNo comparators
  6. 2006 NICPLD asked to develop learning programmes to support the NI ….
  7. In summary While live was consistently better none of the methods were poor and we were happy with the evaluations.We can look at this in two ways. (a) either we should devote more resources to live or (b) we can pursue eLearning for a number of reasons.
  8. In summary While live was consistently better none of the methods were poor and we were happy with the evaluations.We can look at this in two ways. (a) either we should devote more resources to live or (b) we can pursue eLearning for a number of reasons.
  9. Costs include:SalariesTutors honorariumVenue + cateringPrintAdmin – photocopyRental and overhead
  10. Costs include:SalariesTutors honorariumVenue + cateringPrintAdmin – photocopyRental and overhead
  11. A surface approach is common with education that has an excessive amount of course material, little choice over study topics, little opportunity to pursue subjects in depth and an assessment system that rewards the reproduction of factual information. Education thatOur aim is to avoid the surface approach to learning that does lead to a change in practice for the professional. Rather it is to develop education programmes that foster deep learning that bring about change in practice.
  12. A surface approach is common with education that has an excessive amount of course material, little choice over study topics, little opportunity to pursue subjects in depth and an assessment system that rewards the reproduction of factual information. Education thatOur aim is to avoid the surface approach to learning that does lead to a change in practice for the professional. Rather it is to develop education programmes that foster deep learning that bring about change in practice.