Hospital Pharmacist
Vol 11 No 4 p165-166
April 2004

Letting us all know about good practice

By Debbie Andalo

Pharmacy technician Marie-Louise Lewis is starting to be accustomed to the spot light. She was named technician of the year in 2003 and has just celebrated seeing her first article published in Hospital Pharamcist. Mrs Lewis is among a growing number of technicians who are beginning to realise that they have a story to tell about the changes in pharmacy practice and the profession. She said: “Getting published made me aware that we should share the work we are doing with everybody. I realised that the publicity might help other technicians by giving them an insight into the way they are doing things and help them become more effective. I really feel we should be sharing this information.”

Mrs Lewis was encouraged to publish after her paper, which looked at whether a technician-led medicines management service could reduce clinical error on the wards, won her the technician of the year title in the annual AAH competition last October. The 2,000-word article gave details of the initiative she had been involved in at the Glan Clwyd Hospital in Denbighshire, Wales, where she works as a senior pharmacy technician. She admitted starting the article was difficult. She said: “I started off by linking the initiative to the Audit Commission’s report “A Spoonful of Sugar” and other recent government reports because what we were doing at Glan Clwyd tied in with the government target to reduce medication errors by 2005.” Once she had the introduction she then spent the following weeks on the detail and finding the research references she needed to give her article a stamp of authority. She said: “Over all it took me a couple of months to write but I didn’t count the hours. I must admit I didn’t expect it to take the time that it did but you have to remember that I was working at the time as well and trying to implement the new service.”

The greatest difficulty she faced was finding the correct terminology, she admitted. “I hadn’t done anything like that before. I had to know all about the background to the scheme, then write about the method used, what I found out and then had to put together a conclusion. I’d never had to use references before but somebody taught me how to do that,” she said. The thrill of seeing her own words in print has given her the confidence she needed to try and write other articles for publication and she is already thinking of her next idea. “I am currently part of a team project, involving pharmacists and technicians at ward level, which allows technicians at MTO 2 to be team leaders triaging drug history on the wards.”

The initiative is being piloted at the moment and she is considering if the scheme works that it might make an interesting feature for other technicians to read about. “Getting my first article published has given me a lot of confidence to do this again and I think other technicians should put their ideas down on paper and share them.”

Pharmacy technician Jayne Parkinson, admitted she could not believe it when she saw her first article published in a prescribing magazine last month. The two-page feature gave details of the medicines management collaborative minor ailment initiative which had been introduced at her primary care trust where she works as its medicines management facilitator. Ms Parkinson was encouraged to put pen to paper by leaders of the medicines management collaborative at the National Prescribing Centre.

The collaborative has, until recently, been restricted to primary care but has now been extended to hospital pharmacy. The deadline for applications to become part of the collaborative was earlier this year and twenty trusts have now been chosen to test out their new ideas in secondary care. Extending the collaborative into secondary care creates an ideal opportunity for technicians involved in the successful bids, to write about the part they are playing. But Ms Parkinson agreed that historically technicians have been reluctant to put their thoughts down on paper for public scrutiny.

She said: “I think there is the feeling that what you are doing isn’t new and that somebody else has probably done this before. But I think technicians should remember that even if something has been done before everybody works in a different way so you still have something new to say. I think one of the problems we have is that we are happy to share information on a small scale, such as within our primary care trust, but we just don’t think of sharing beyond that.” Ms Parkinson found writing the article straightforward. A lot of the information had already appeared in reports she had been involved in. She said: “It was really all about cutting and pasting and telling the story again rather than putting it into a report format. It didn’t take longer than a couple of hours.”

Her advice to other technicians who are interested in publishing is to read as many articles as possible in the specialist professional journals to discover how other people write. She said: “They have to keep their eyes open and find a style which they like. They have to think about what it was that grabbed then and then to try and copy that approach.”

She said articles were also more interesting to read if they included not only background information but also pointed out some of the problems which the project faced and how they were overcome. Technicians must also feel confident about writing. She said: “They mustn’t think they are the only technician ever to have written an article. If they know anybody who has written before then get some tips from them too.”

Pharmacy technicians’ lack of confidence in writing articles for publication is not surprising, according to Lesley Morgan who until last year was president of the Association of Pharmacy Technicians UK (APTUK). Mrs Morgan, who is also assistant director of support staff at the Welsh Postgraduate Centre for Pharmaceutical Education in Cardiff, said: “Unlike pharmacists, technicians are not taught to write to that sort of level when they are doing their training. Technicians are very much ‘doers’ and they aren’t trained to write. I am not suggesting they are illiterate but rather that they often don’t know what to include and what to leave out.”

Another problem they have, according to Mrs Morgan, is they have difficulty identifying the significance of the work they are involved in. At the same time they may be under the illusion that articles are only of any value to the reader if they are based on research, rather than on day-to-day changes in practice. She said: “I think they sometimes think that what they do isn’t worth writing about. That what they do is normal practice. But I think we are slowly getting the message across that there are a lot of things they are involved in which are worth writing about.”

Chief pharmacists, according to Mrs Morgan, have a role in offering technicians support and encouragement in achieving publication. She said: “I think some chief pharmacists may be willing to help but then the technicians don’t ask them.” She was also confident that as technicians increasingly take part in continuing professional education, which in the future will be linked to registration, they will become more confident in writing articles for publication. She added: “There are a lot of really good things going on which pharmacy technicians are involved in and it would be really good if we could get some of them to write them up.”

This is a view shared by editor of Hospital Pharmacist Gareth Jones. For the past 14 months the journal has run a section which highlights the practice and professional developments of pharmacy technicians. Six of the features have been written by practicing technicians. He said: “We are aware that there is a lot of work which technicians are involved in but they don’t seem to have the confidence to write it up for publication. I think another issue is that if you put your name to an article you are putting yourself on a pedestal and a lot of people don’t have the confidence to do that. But we are aware that there is a lot of interesting work that the technicians are involved in and publication gives them the opportunity to share that with other people.”

Technicians may be reluctant writers but, in the current climate of new skill mix and regulation, if they want to enhance their status within pharmacy and help develop and roll out best practice it is a skill they would be wise to learn. Mrs Morgan said: “Technicians need to demonstrate that they are part of the higher profile being given to pharmacy as a whole and being able to write articles for publication is an important part of that. I think it’s about technicians being able to develop a learning organisation so that we can all learn from each other.”

President of the APTUK Darren Leech agreed. He said technicians were good at speaking at conferences and seminars but froze when it came to writing. He warned it is a hurdle they are going to have to learn to over come. “Things are improving slowly because quite a number of senior technicians are now studying for postgraduate certificates and diplomas. It is extremely important that technicians develop these writing skills because if they don’t, it will slow up the pace of change. Writing about innovation and ways of developing services is the way that best ideas are shared.”