An audit of drug shortages in a community pharmacy practice

Background: There are no firm data on drug shortages in Irish community pharmacy. This prospective observational study aimed to characterise the drug shortage problem in an Irish community pharmacy.
Aims: The primary aim was to determine numbers and durations of drug shortages. Secondary aims included comparing these shortages with Irish Pharmacy Union (IPU) drug shortage lists and determining the frequency with which notifications were received prior to shortages. Further secondary aims were to examine relationships between causes of drug shortages and drug costs and between causes of drug shortages and shortage durations.
Methods: The study took place in a community pharmacy in a Limerick City suburb between October 2012 and February 2013. Data were collected daily regarding drugs that were dispensed, but unavailable to purchase. Suppliers/manufacturers provided data on the reasons for shortages.
Results: 65/1,232 dispensed drugs (5.3 %) were in short supply over the study period. Median shortage duration was 13 days (interquartile range 4–32 days) and median cost was €8.10. Numbers of unavailable drugs by month varied from 13 to 38. Monthly IPU drug shortage lists identified between six and eight of these shortages depending on the month. Two notifications were received from suppliers/manufacturers regarding shortages. Parallel exports had the highest mean costs (mean €38.05) and manufacturing problems were associated with the longest durations (mean 57.44 days).
Conclusions: This study highlights the drug shortage problem in an Irish community pharmacy. We propose that enhanced communication between all stakeholders is the most worthwhile solution. Further studies are needed.

An Innovative Model for the Provision of Practice Learning Opportunities in Family and Child Care: Newry Student Unit, Southern Health and Social Care Trust.

This article describes the work of Newry Student Unit which operates in the Southern Health and Social Care Trust. The background to the unit is outlined and its development is discussed in the context of practice learning provision in Northern Ireland. The operation of the unit in providing Family and Child Care practice learning opportunities (PLOs) for student social workers is outlined and findings from evaluation questionnaires completed by students, college tutors and team leaders are presented. The paper highlights both the advantages and disadvantages of this model of PLO provision and concludes that it is a valuable resource for practice learning. Proposals for the development of the unit are discussed and it is suggested that the model has the potential be replicated in other areas of Northern Ireland.

A self-reported work sampling study in community pharmacy practice

Lack of time to implement pharmaceutical care has been cited as a barrier to the routine provision of this extended patient-care service. Using self-reported work sampling methodology, this study investigated how community pharmacists utilise their time. Pharmacists working in community pharmacies in the Greater Belfast area were found to spend approximately 49% of their time engaged in professional activities, 29% in semi-professional activities and 22% involved in non-professional activities. The activity to which pharmacists devoted the majority of their time was product assembly and labelling, this being a task which can be performed by trained technical staff. Only 9.5% of community pharmacists' time was devoted to counselling patients on their prescription medicines. Wide variation in the amount of time apportioned to each activity was observed between the participating community pharmacists (n=30). Staffing levels within the community pharmacy were found to significantly influence pharmacists' involvement in a number of activities, with pharmacists who worked in pharmacies employing multiple pharmacists devoting more time to the assembly and labelling of products and less time to administrative tasks, non-professional encounters and to miscellaneous professional activities. Pharmacists working in pharmacies with a high prescription turnover were found to devote significantly less time to counselling patients regarding OTC products and in responding to patient symptoms.

Participatory Action Research with and within community activist groups: capturing the collective experience of Ireland's Community and Voluntary Pillar

The inclusion of community activists in policy planning is increasingly recognized at the highest international level. This article shows how the use of Participatory Action Research (PAR) can present a deeper and more holistic picture of the experiences of Civil Society Organizations (CSOs) in shaping national-level social policy. By utilizing action-based research, the Community and Voluntary Pillar (CVP) of Ireland’s system of social partnership is shown to be an important agent in deliberating national bargaining outcomes (known as the Towards 2016 national agreement). The key contribution of this research is the reflective methodological considerations in terms of PAR design, execution and participant integration in the research process as a way to enrich and develop a deeper and more informed community of practice.

Isotopic variation complicates analysis of trophic relations within the fish community of Plußsee: a small, deep, stratifying lake

Analysis of carbon and nitrogen stable isotopes has allowed freshwater ecologists to examine lake food webs in increasing detail. Many such studies have highlighted the existence of separate within-lake pelagic and benthic-littoral food webs but are typically conducted on large (> 10 km2) lakes, whereas the majority of lakes are actually relatively small. We used stable isotope analysis (δ13C & δ15N) to examine trophic interactions between fish and their prey in Plu�see, as an example of a small, stratifying lake, and to determine whether separate pelagic/benthic-littoral food webs could be distinguished in such systems. Our results indicate that the Plu�see food web was complicated, and due to extensive intra-annual isotopic variation in zooplankton (e.g. cladoceran δ13C annual range = 25.6�), it may be impossible to definitively assign consumers from small, eutrophic stratified lakes to pelagic or benthic-littoral food webs. We present evidence that some components of the Plu�see food web (large bream) may be subsidised by carbon of methanogenic origin.

Exploring Innovative Methodologies in time and place to analyze child protection documents as elements of practice

This paper aims to demonstrate how a derived approach to case file analysis, influenced by the work of Michel Foucault and Dorothy E.Smith, can offer innovative means by which to study the relations between discourse and practices in child welfare. The article explores text-based forms of organization in histories of child protection in Finland and in Northern Ireland. It is focused on case file records in different organizational child protection contexts in two jurisdictions. Building on a previous article (Author 1 & 2: 2011), we attempt to demonstrate the potential of how the relations between practices and discourses –a majorly important theme for understanding child welfare social work – can be effectively analysed using a combination of two approaches This article is based on three different empirical studies from our two jurisdictions Northern Ireland (UK) and Finland; one study used Foucault; the other Smith and the third study sought to combine the methods. This article seeks to report on ongoing work in developing, for child welfare studies, ‘a history that speaks back’ as we have described it.

‘Reforming Social Work Education: Some Reflections on the Contribution of Practice Learning’

Social work in the UK is currently undergoing a process of major reform and a wide range of recommendations have been made aimed at improving practice and education. This paper focuses on the Social Work Reform Board's proposals for improving practice learning in qualifying level social work education. It examines how recommendations for better partnership working between Higher Education Institutions and employers and developing critical reflection in agencies are likely to impact on student learning. Drawing on experience of social work education in Northern Ireland it considers the potential of the Reform Board's proposals for improving the quality of practice learning and enhancing students' preparedness for employment. The paper concludes that differences in educational aims and priorities, resistant practice cultures and cut-backs in resourcing could present major obstacles that must be overcome if this potential is to be realised.

A Case Study in Policy Delivery:Examining Social Inclusion through Interpretation and Practice

The current body of literature regarding social inclusion and the arts tends to focus
on two areas: the lack of clear or common understanding of the terminology involved
(GLLAM, 2000) and the difficulty in measuring impact (Newman 2001). Further, much
of the literature traces the historical evolution of social inclusion policy within the arts
from a political and social perspective (Belfiore & Bennett, 2007), whilst others
examine the situation in the context of the museum as an institution more generally
(Sandell, 2002b). Such studies are essential; however they only touch on the
importance of understanding the context of social inclusion programmes. As each
individual’s experience of exclusion (or inclusion) is argued to be different (Newman
et al., 2005) and any experience is also process-based (SEU 2001), there is a need
for more thorough examination of the processes underpinning project delivery
(Butterfoss, 2006), particularly within a field that has its own issues of exclusion, such
as the arts (Bourdieu & Darbel, 1991). This paper presents case study findings of a
programme of contemporary arts participation for adults with learning difficulties
based at an arts centre in Liverpool. By focusing on practice, the paper applies
Wenger’s (1998) social theory of learning in order to assert that rather than search
for measurable impacts, examining the delivery of programmes within their individual
contexts will provide the basis for a more reflective practice and thus more effective
policy making.