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Healthcare

Lessons from an onsite residential aged care pharmacist

14 May 2024, by Amy Sarcevic

In 2018, Goodwin Aged Care Services made history when it employed Australia’s first ever residential aged care pharmacist.

Since the deployment, Goodwin has achieved various quality measures, including faster medication rounds, and a reduction in medication errors.

Taking over the role in 2020, Kirolos Wasef, made further improvements, including lower antipsychotic usage, and a vaccination rate almost double the national average.

Ahead of the Pharmacy in Aged Care Forum, Mr Wasef discusses his approach, and why he believes onsite pharmacists are a necessary step forward for the sector.

Deeper resident relationships

Having worked as a community pharmacist for more than fifteen years, Mr Wasef has always understood the importance of consistency in the consumer/pharmacist relationship.

However, it wasn’t until he began seeing consumers daily that he recognised the role of more meaningful personal connections.

“Having more time and communication with the residents has really made a difference,” he said.

“The residents and I all know each other, which is important when it comes to discussing their medications.

“When you understand the resident’s individual health needs, you can become their advocate and more easily spot if their medication needs to be changed.”

As one example, Mr Wasef was able to help reduce medication – and the resulting GI side-effects – for a resident living with bowel issues.

In a medication review, it was revealed that the resident was consuming oxycodone for chronic pain, in addition to her daily laxatives.

Mr Wasef was able to suggest a gradual reduction of oxycodone and a replacement with oxycodone/naloxone formula, with fewer side effects.

“I followed up with the resident regularly during the process until the opioid had been ceased and laxatives reduced to one medication only,” he said.

Being a consistent presence has also helped Mr Wasef earn trust amongst the residents. He believes this may have boosted the facility’s medication compliancy rates.

To build on these strengths, Mr Wasef has taken the time to introduce himself to staff and residents.

“I go out of my way to talk to people – it’s not just a transactional relationship. And that is something that can really only be achieved when you are onsite and seeing people on a regular basis,” he said.

Training for aged care workers

A further advantage of being onsite is the relationships Mr Wasef has built with aged care workers. He believes these relationships have been beneficial in the context of training.

“Throughout my role, I’ve gotten to know staff quite well and have helped train them up on various topics. For example, the newer antivirals they were required to administer during the pandemic.

“Since then, we have expanded training and made sure all staff are confident handing out the full gamut of medications under their remit, to minimise the possibility of medication errors.

“Getting to know staff on a personal level over time has helped me to tailor this training to individual staff needs,” he said.

Medication management and audits

As a permanent onsite presence, Mr Wasef has also been in charge of the facility’s medication reviews and audits.

In 2020, he implemented the Electronic Medication Charts and, shortly after, an electronic S8 register for the facility.

He says both have made a positive impact on medication management and helped the facility meet national quality standards.

“Having an onsite pharmacist ensures good governance. You can easily spot where the gaps are and make necessary improvements. For example, the electronic medication charts have allowed fast and precise audits which have helped in analysing trends and reducing medication incidents.”

Advice to other residential aged care pharmacists

With the government soon to fund the deployment of residential aged care pharmacists, Mr Wasef extends some advice to those in this emerging profession.

“Be visible, useful and proactive,” he said.

“Make yourself known to staff and residents, attend meetings and clinical handovers, introduce yourself to GPs etc.

“Be on the lookout for issues and avenues for improvement always and measure yourself up against national quality indicators.

“But also, be flexible – it’s a new role and there is no set definition for it. So be someone who can cope with change and get the best out of anything thrown your way.”

Further insight

Talking more about his experience as a residential aged care pharmacist, Mr Wasef will present at the upcoming Pharmacy in Aged Care Forum.

This year’s event is collocated with the flagship National Dementia Forum – both held on 12 June 2024 at the Crowne Promenade Melbourne.

Learn more and register your place here.

About Kirolos Wasef

Kirolos is a credentialled geriatric pharmacist with more than twenty years experience in community pharmacy, consultancy, and aged care sectors.
Kirolos works as an in-house pharmacist across Goodwin’s residential care facilities. He is the chair of Goodwin’s Medication Advisory Committee (MAC), Antimicrobial Stewardship Committee (AMS) and Quality Care Advisory Body (QCAB).

Kirolos has a certificate in geriatric pharmacy. In 2023, he has completed his Graduate Certificate in Health Service Management (Safety and Quality), UTAS.

Kirolos has worked as a member of CHN Digital Health Steering Group and he was a member of the National Quality Use of Medicines Project Advisory Group.

 

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