576 ESTABLISHING VIRTUAL MULTIDISCIPLINARY ROUND IN BELFAST TRUST NURSING HOMES: PHARMACIST, NURSING & HEALTHCARE TEAM COLLABORATION

Abstract

IntroductionDuring the first covid surge, 25% of Belfast HSC Trust (BHSCT) care homes were affected, rising to 44% by surge 3, resulting in limited face to face access for healthcare professionals. Nursing home residents required medicine reviews post-covid infection to optimise medicines and reduce pill burden. MethodThe Care Home Nursing Support Team (CHNST), consultant pharmacist for older people and the lead care home pharmacist medicines optimisation older people (MOOP), rapidly established a multidisciplinary virtual round. Four main steps included: establishing Standard Operating Procedure (SOP)proforma template designinclusion of residentevaluation An SOP was established to ensure consistent pathway for nursing home inclusion criteria and team roles. The inclusion group included residents who were furthest from their baseline including weight loss, swallowing difficulties, decreased mobility, altered sitting balance and polypharmacy. The pharmacist developed a proforma template for completion by the nursing home staff to gather key information ahead of the round to improve efficiency eg swallow, renal function, pain, falls risk. The care home resident was included on video link by ipad following careful consent processes. Benefits included enhanced assessment of frailty, mobility, dexterity and adherence. Results 40% residents reviewed had increased Rockwood frailty score 50% residents reviewed had weight loss post-covid- average 4.8 kg Average 2.4 pharmacy medicines interventions per resident including: Reducing doses & nephrotoxic medicines due to poor renal function Deprescribing Onward referral to psychiatry for signs of depression Formulation changes due to swallowing difficulties Evaluation from the multidisciplinary team and nursing home staff was overwhelmingly positive, emphasising the opportunity for shared learning ConclusionThe multidisciplinary care home rounds provided an efficient means to collaborate with other professionals, while providing holistic & patient-focussed care. Plans are underway for development of an NI MOOP care home pathway.