Our first pharmacist vaccinators
Pharmacists may soon be providing flu jabs as routine. In Hamilton, at least.
Three pharmacists from Pharmacy 547 have successfully completed the necessary vaccinator training and resuscitation course and are on their way to provide immunisation as part of their suite of value-added pharmacy services.
Pharmacy 547 already provides a Medication Management Service, INR testing and warfarin management, a quit smoking service, blood pressure testing, diabetes screening, robotic compliance packaging, a weight management service and emergency contraception.
For the past two years, flu jabs have also been provided through the pharmacy’s on site nurses mainly to the clients of Mental Health and Care of the Elderly services. The nurses are employed by the pharmacy to deliver a range of services under contracts with the Waikato DHB.
Pharmacist and owner Ian McMichael, along with colleagues Alice Littlewood and Michael Taylor, underwent the two-day training delivered by the Immunisation Advisory Council in March, followed by an advanced resuscitation course in April.
The training included instruction on everything from the history of vaccination to immunity, the cold chain, possible adverse effects, contraindications, handling of vaccines and the National Immunisation Schedule.
The subsequent assessment involved going through the whole process with the invigilators and doing practical vaccinations by giving intra-muscular flu injections to patients. The airways management and resuscitation course is mandatory for accredited vaccinators in case a patient has an anaphylactic reaction to the vaccine.
Unusual group
The three pharmacists were part of a larger group that included more than 20 nurses.
“It was quite unusual, not just for us but also for other participants because pharmacists have not been a part of this training before,” Mr McMichael says.
The trio are now awaiting Pharmacy Council’s clarification of their scope of practice before they can start providing flu jabs. Once their scope of practice becomes clear, he says they will simply take over the task of immunisation from nurses, making them the country’s first pharmacist vaccinators.
The pharmacist scope of practice needs to be clarified since administering drugs or vaccines is currently not explicitly mentioned in it.
The development is heartening news for pharmacy leaders who have been campaigning for pharmacy’s greater role in the New Zealand health sector. Vaccination is one such service some pharmacies would like to provide, much like their Australian counterparts.
Mixed views
Incidentally, a preliminary survey by Otago University School of Pharmacy lecturer Sarah Hook several years ago revealed mixed views to the idea of pharmacy vaccinators. Some pharmacists were concerned about time and legal issues and were wary of encroaching on GPs’ territory.
However, Mr McMichael says his pharmacy has been targeting only those who are not getting their free jabs at the GP surgeries. The uptake of the free vaccination in those with chronic health conditions, such as diabetes, is low and Dr Hook feels pharmacists could play a role in improving the situation.
During 2009, nurses at Pharmacy 547 provided 200 jabs mainly to fully funded patients who also receive medication management services. There is scope for a walk-in flu jab service as well, since some of those 200 customers were healthy, unfunded clients who paid for their jab.
Take the plunge
Earlier this year, the National Immunisation Programme manager David Wansbrough said the Government “doesn’t see a need to provide flu immunisation in pharmacies at this stage”.
Mr McMichael has addressed that by first establishing the service, using qualified nurses, creating a track record of success for it and then upskilling pharmacists to take over.
“My approach is to first demonstrate our capability, collect robust data and patient satisfaction surveys and take them to the DHBs to convince them we are able to deliver such healthcare services,” he says.
“You have to have the courage, and take the plunge.”
Indemnity
Meanwhile, the Pharmacy Defence Association says their insurers, QBE, have confirmed vaccinator pharmacists will be covered for indemnity under their PDA membership. Initially it will be on a case by case basis and then automatically, if the Pharmacy Council adds influenza vaccination to the pharmacist scope of practice.
“This is a positive way forward,” PDA executive officer Carolyn Hooper says.
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