Who should be involved?

We expect that the following people will be involved. If you are not sure who is involved, remember it is your professional responsibility to ask for support.

Your manager

Your chief pharmacist and/or line manager will identify you as a candidate for this learning package and endorse your participation.

They may ask you to provide a copy of your self-assessment against the Knowledge and Capability Guide prior to deployment to the critical care team to ensure that you are best placed to take on this role.

We recommend that you maintain contact with your usual line manager during your deployment.

Critical care tutor/clinical supervisor

You will need to work closely with an experienced critical care pharmacist, who will act as your ‘tutor’/‘clinical supervisor’ during this training. Their role will be to support you in your day-to-day practice as a pharmacist working in critical care, as well as in your learning and development in line with this training resource.

The supervision model in your hospital will depend on the availability of experienced critical care pharmacists and operational factors, however it is recommended that your tutor provide the following support:

• Provision of an induction into the critical care areas that you will be deployed in.
• Discussion about your self-assessment of the knowledge and capability guide, providing feedback where needed on areas requiring development.
• Provision of feedback on patient reviews that you have undertaken, either through direct observation or remotely/retrospectively, using the tools provided in this handbook.
• Meet with you to discuss your development, as well as any issues arising.

It is important that at your first meeting, you agree on expectations of each other, your ways of working and the frequency of your clinical supervision meetings.

This may vary depending on your level of previous critical care experience and your clinical background.

Critical care staff

The pharmacy and multidisciplinary team structure within the critical care areas in your hospital will be explained to you during your induction meeting with your tutor.

Your collaboration with the critical care staff will be central to your practice and a key avenue to support your development.

RCPharm

Access to our COVID-19 learning resources was free during the pandemic for the entire pharmacy profession, either by registering on our website, or using your RCPharm membership details.

UKCPA Critical Care Group

The UKCPA Critical Care Group hosted an online forum for UKCPA members working in this area. You can use this forum to pose questions to your peers working in critical care and share your experiences.

UKCPA also hosted an open-access COVID-19 Facebook group for pharmacists to share practice relating to the COVID-19 pandemic.

Mental health and wellbeing

Working in the critical care environment particularly during the COVID-19 pandemic can be very challenging. It is vitally important that you look after yourself with the same energy as you care for your patients.

Your critical care and pharmacy team will always be there to support you.

Upskilling guide

Step one: self-assess your knowledge

Go to the Knowledge and Capability Guide and review the topics listed under the four key themes.

Self-assess your confidence against each topic using the drop-down menu in the ‘self-assessment’ column.

Mark down where you have done previous learning against the topic by noting the approximate date of this in the ‘previous learning’ column (how recent is your experience or learning in this area).

Use the notes section to reflect on any specific questions or areas that you need to work on.

Step two: self-directed learning

We have signposted helpful learning resources in the Knowledge and Capability Guide to help you address specific learning needs from your self-assessment. If you are new to critical care, we recommend starting with the list of core reading/viewing listed on the overview page of the guide. 

Identify further reading to address specific learning gaps from the signposted resources next to the relevant topics – start with areas that are marked as high-priority, first.

Update the notes column when you have addressed learning gaps or if you have identified any further questions you need to follow up.

Step three: case studies

Test your application of knowledge by reviewing and answering the COVID-19 critical care training case study.

Once you have attempted the questions, compare your answers with the model answers provided by the Centre for Pharmacy and Postgraduate Education (CPPE) (found on the same page).

Consider the case mix of your ICU/critical care area that you will be servicing – you may need to find additional examples of cases that reflect this (with the support of your tutor).

Note down any further questions or areas to follow up in the notes section of your Knowledge and Capability Guide.

Step four: application to practice, with reflection and feedback

Meet with your assigned tutor/clinical supervisor.

Catch up with your tutor/clinical supervisor regularly as agreed at your initial meeting – see the development report template.

Find time with your tutor/clinical supervisor to provide feedback, ideally via direct observation if resources allow.

Use the following tools to structure the feedback:

• Critical care clinical feedback tool: use to structure dedicated learning discussions.
• RCPharm case-based discussion tool: use to structure quick and timely feedback – can be used as a precursor to a more in-depth discussion with the tool above.

Knowledge and capability guide

This guide has been extracted from the UKCPA Expert Practice Critical Care Curriculum. It is focused on developing knowledge and understanding aligned to the Expert Professional Practice cluster of the Advanced Pharmacy Framework. There are other domains of practice that are also critical when practising effectively at Foundation and Advanced levels. These are set out in the respective clusters of the RCPharm Foundation and Advanced
Pharmacy Frameworks.

Acknowledgements

Acknowledgements

This training resource has benefitted from stakeholder input from a wide variety of pharmacy experts as indicated below. 

We are exceptionally grateful to all of those involved for giving up their time freely when time is more precious than ever. 

RCPharm reserves the right to change and update this guidance as the pandemic progresses.

RCPharm COVID-19 Critical Care Training Resource Short Life Working Group:

• Darrell Baker, director of pharmacy and medicines management, Dragon’s Heart Hospital Wales.
• Timothy Banner, consultant pharmacist, Dragon’s Heart Hospital Wales.
• Clare Barton, senior clinical pharmacist, Northumbria Healthcare NHS Foundation Trust.
• Greg Barton, specialist pharmacist – burns and critical care – St Helens and Knowsley Teaching Hospitals Trust.
• Nisha Bhudia, specialist pharmacist – critical care, Royal Brompton and Harefield NHS Foundation Trust (supporting NHS London Nightingale Hospital).
• Mark Borthwick, consultant pharmacist – critical care – Oxford University Hospitals NHS Foundation Trust.
• Emma Boxall, specialist critical care pharmacist, Salford Royal Foundation Trust.
• Emily Bushnell, senior clinical pharmacist, Royal Free London NHS Foundation Trust (supporting NHS London Nightingale Hospital).
• David Campbell, chief pharmacist – medicines optimisation – Northumbria Healthcare NHS Foundation Trust.
• Sarah Carter, CEO, UKCPA.
• Ruth Edwards, head of professional experience and senior lecturer, Aston Pharmacy School.
• Roger Fernandez, chief pharmacist, King’s College Hospital NHS Foundation Trust.
• Sadeer Fhadil, senior cardiovascular pharmacist, Barts Health NHS Trust (supporting NHS London Nightingale Hospital).
• Gail Fleming, RCPharm director of education and professional development.
• Jatinder Harchowal, chief pharmacist, Medicines Management & Clinical Support Services Business Unit, The Royal Marsden NHS Foundation Trust (supporting NHS London Nightingale Hospital).
• Peter Kopelman, emeritus professor of medicine, University of London.
• Cathy McKenzie, clinical academic pharmacist, King’s College Hospital NHS Foundation Trust.
• Vincent Ng, RCPharm professional development pharmacist.
• Debra Roberts, associate dean – pharmacy – Health Education and Improvement Wales.
• Susan Roberts, associate postgraduate pharmacy dean, NHS Education for Scotland.
• David Sapsford, consultant pharmacist – critical care – Cambridge University Hospitals NHS Foundation Trust. 
• Matthew Shaw, director, CPPE.
• Rob Shulman, consultant pharmacist – critical care – University College London Hospitals.
• Rahul Singal, chief pharmacist, North East London NHS Foundation Trust (supporting NHS London Nightingale Hospital).
• Beth Ward, RCPharm head of education.
• Ben Waters, senior cardiovascular pharmacist, Guy’s and St Thomas’ NHS Foundation Trust (supporting NHS London Nightingale Hospital).
• Janice Watt, lead pharmacist – acute services – NHS Greater Glasgow and Clyde.

RCPharm would also like to acknowledge and thank the following groups for supporting the development of this resource:

• RCPharm Education Standards Committee
• RCPharm Hospital Expert Advisory Group
• UKCPA Critical Care Pharmacy Community

Related resources

• Critical care pharmacist development report template
• COVID-19 critical care training case study
• Critical care clinical feedback tool
• Case based discussion tool