Emergency contraception - A CPPE workshop to support local public health services Pre-workshop book - Community Pharmacy Cumbria
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Emergency contraception A CPPE workshop to support local public health services Pre-workshop book PH/EHC18/PW August 2018
Content development
Emergency contraception – Pre-workshop book
This is a second edition of the CPPE Emergency contraception workshop resource. CPPE recognises
all those who helped and supported the development of the first edition of this resource including the
developer and reviewers, originally published in December 2009.
CPPE programme developer
Emma Anderson, regional tutor
Project team
Andrea Smith, community pharmacist
Sue Hagan, community pharmacist
Sally Greensmith, regional tutor and national lead, Medicines optimisation in care homes training
pathway, CPPE
Lesley Grimes, lead pharmacist, learning development, CPPE
Paula Higginson, lead pharmacist, learning development, CPPE
Kate Shakeshaft, nurse consultant, National Unplanned Pregnancy Advisory Service
Tracey Palmer, sexual health promotion locality coordinator, Derbyshire Community Health Services
NHS Trust
Reviewers
Dr Lucinda Farmer, chair of general training committee, Faculty of Sexual and Reproductive
Healthcare
Nick Theobald, executive lead, STI Foundation
CPPE reviewers
Caroline Barraclough, regional manager, East Midlands
Hayley Berry, regional manager, West Midlands
Piloted by
Hesham Abushena, locum specialist and community pharmacist, North West England
Olatilewa Adeyemi, community pharmacist
Rachel Airley, community locum pharmacist, Manchester
Sam Alshibani community pharmacist, Boots, Southport
Chui Ngo Cheung, community pharmacist, J Morris Pharmacy, Lancashire
Susan Johnston, pharmacy technician, Spire Cheshire Hospital
Catherine Lane, community pharmacist, Boots, Lancashire
Raisa Patel, community pharmacist, Boots, Lancashire
Nadiyah Razzaq, pre-registration pharmacist, Davey’s Chemist, Huyton
Johnathan Smith, community pharmacist
Catherine Thomas, locum community pharmacist, Derbyshire
Shuai Zheng, community pharmacist, Boots
Brand names and trademarks
CPPE acknowledges the following brand names and registered trademarks mentioned throughout this
programme: Blu-Tack®, ellaOne®, Levonelle® , Microgynon®, Micropore®, Lucette®, Cerazette®,
Rigevidon®
Disclaimer
We have developed this learning programme to support your practice in this topic area. We
recommend that you use it in combination with other established reference sources. If you are using it
significantly after the date of initial publication, then you should refer to current published evidence.
CPPE does not accept responsibility for any errors or omissions.
External websites
CPPE is not responsible for the content of any non-CPPE websites mentioned in this programme or
for the accuracy of any information to be found there.
All web links in this resource were accessed on 15 August 2018.
Published in August 2018 by the Centre for Pharmacy Postgraduate Education, Division of Pharmacy
and Optometry, The University of Manchester, Oxford Road, Manchester, M13 9PT.
www.cppe.ac.uk
Production
Hailsham Creative
© Copyright controller HMSO 2018
2Learning with CPPE
Emergency contraception – Pre-workshop book
The Centre for Pharmacy Postgraduate Education (CPPE) offers a wide
range of learning opportunities in a variety of formats for pharmacy
professionals from all sectors of practice. We are funded by Health Education
England to offer continuing professional development for all pharmacists
and pharmacy technicians providing NHS services in England. For further
information about our learning portfolio, visit: www.cppe.ac.uk
1 2 3
We recognise that people have different levels of knowledge and not every
CPPE programme is suitable for every pharmacist or pharmacy technician.
We have created three categories of learning to cater for these differing
needs:
Core learning (limited expectation of prior knowledge)
Application of knowledge (assumes prior learning)
3 Supporting specialties (CPPE may not be the provider and
will direct you to other appropriate learning providers).
This is a learning programme and assumes that you already
have some knowledge of the topic area.
Revalidation
You can use this programme to support revalidation and your continuing
professional development (CPD). Consider what your learning needs are in
this area.
Consider why you have chosen to participate in this learning programme.
Why is it relevant to you in your role as a pharmacy professional? What new
skills, knowledge or approach are you hoping to learn? How will it benefit
the people using your services? These reflections will help you with your
revalidation records.
For more information about revalidation and to enter your records, visit:
www.mygphc.org
Keeping up to date
To ensure this learning resource is up to date we will review it every year.
A CPPE programme manager will check through the material to ensure
the content is current and relevant, and that the quality of the learning
experience is maintained. You will find the latest version of this resource on
the CPPE website.
3Feedback
Emergency contraception – Pre-workshop book
We hope you find this learning resource useful for your practice. Please help
us to assess its value and effectiveness by completing the feedback form at
your event, or by emailing us at: feedback@cppe.ac.uk
4About this CPPE workshop resource
Emergency contraception – Pre-workshop book
The overall aim of this programme is to acquire the knowledge, develop
the skills and demonstrate the behaviours needed to provide high-quality
emergency contraception services as part of your pharmacy practice.
There are two parts to this CPPE workshop resource, both of which must be
completed in order to achieve the learning objectives:
n this pre-workshop book, which may include reading, information
searches and tasks that you need to complete before you attend the
workshop
n the workshop itself, which is focused on the knowledge, skills and
behaviours which will help you manage and optimise care for patients.
This book gets you started. It provides key information and tasks to help
you meet the learning objectives, but it also encourages you to identify your
own learning needs. It then challenges you to relate what you have learnt to
your own practice and professional development. We have included tasks to
stimulate your thinking and we will refer to these again at the workshop, so
please ensure you complete them in advance.
We estimate it will take you up to four hours to complete the tasks in this
book, depending on your prior knowledge and learning.
It may help to allocate some time to download the Declaration of
Competence (DoC) for this service now and work through the DoC
framework as you do your learning. This may involve undertaking some
other additional CPPE learning programmes and linked e-assessments. To
access the DoC framework and find out more about the DoC system visit:
www.cppe.ac.uk/services/declaration-of-competence
A note about web links
Where we think it will be helpful we have provided web links to take you
directly to an article or specific part of a website. However, we are aware
that web links can change. If you have difficulty accessing any web links we
provide, please go to the organisation’s home page or your preferred internet
search engine and use appropriate key words to search for the relevant item.
5Declaration of Competence
Emergency contraception – Pre-workshop book
The Declaration of Competence (DoC) system, hosted by CPPE, allows
pharmacy professionals to reflect on their learning and practice and to
record evidence of competence. The system is supported for use across
England by Health Education England, and endorsed by NHS England
and Public Health England. The system is intended to support pharmacy
professionals and employers in assuring the delivery of high-quality services
for patients.
As a pharmacy professional you are responsible for keeping your knowledge
and skills up to date. Completing the CPPE learning and assessments
suggested in the DoC framework for this service, carrying out the pre-
workshop reading and tasks and attending the workshop will support you in
meeting specific competencies within the DoC self-assessment framework
for this service.
If the service is not currently commissioned locally, then working through
the learning programme will enable you to be service-ready, or support you
in maintaining competence in your everyday practice.
If you are completing this learning in order to deliver a commissioned
service, you must first check that the service commissioner has approved the
use of the Declaration of Competence system within the service specification
and/or patient group direction. Alternatively, commissioners may specify
their own routes of training for service delivery (which may also meet
specific competencies within the DoC).
To access the DoC framework and find out more about the DoC system,
visit: www.cppe.ac.uk/services/declaration-of-competence
Some of the tasks in this book could be used to support you in working
towards your personal declaration to provide an emergency contraception
service. If you plan to complete a declaration, we recommend that you
have a copy of the Declaration of Competence framework to hand as you
work through this material.
You can access a copy of the DoC framework for emergency
contraception services at: www.cppe.ac.uk/doc
If you are new to DoC then please be aware of your responsibilities
to meet the core competencies relating to consultation skills and
safeguarding, which we look at in Tasks 1 and 2 below.
6Learning objectives
Emergency contraception – Pre-workshop book
You can use our programmes to support you in building the evidence that
you need for the different competency frameworks that apply across your
career. These will include building evidence for your Foundation pharmacy
framework (FPF) and supporting your progression through the membership
stages of the Royal Pharmaceutical Society (RPS) Faculty.
As you work through the programme consider which competencies you are
meeting and the level at which you meet these. What extra steps could you
take to extend your learning in these key areas?
After completing all aspects of this programme, you should be able to:
n escribe the aims of an emergency contraceptive service and its place in
d
contraception and sexual health services
n escribe the principles of confidentiality and appropriate safeguarding
d
work to emergency contraception consultations
n se the patient group direction appropriately to ensure that medico-legal
u
aspects are balanced with the woman’s safety and preferences
n a pply current clinical guidance to emergency contraception consultations
to provide safe and effective care
n emonstrate a person-centred approach to the discussion being sensitive
d
to the needs and preferences of the woman
n e xplain how and when you would refer or signpost a woman to a further
service and how you would access further support and advice from local
sexual health services if needed.
7Emergency contraception service
Emergency contraception – Pre-workshop book
Everybody has a part to play
Everybody in the pharmacy team has a role to play. Pharmacy technicians’
and pre-registration trainees’ roles may include providing women and other
members of the team with information about the service. They might also
undertake tasks associated with providing the service. Only pharmacists are
allowed to use patient group directions (PGDs) under current legislation.
Personal values and beliefs
You will be attending this workshop with colleagues and peers, and many
of you will hold our own personal values and beliefs about emergency
contraception. Please be reassured that the workshop facilitator, the sexual
health expert and the other participants will not discuss personal values
or beliefs at this event. If you do not feel sure that you are able to provide
emergency contraception on the grounds of personal values or beliefs, you
may find it helpful to come along to the workshop to find out more. You may
also find it helpful to read more about your professional obligations in the
General Pharmaceutical Council’s In practice: Guidance on religion, personal
values and beliefs, available at: www.pharmacyregulation.org/sites/
default/files/in_practice-_guidance_on_religion_personal_values_
and_beliefs.pdf
How will you provide emergency contraception in your
practice?
Prior to attending the emergency contraception workshop, you will need
to consider how you provide emergency contraception in your practice.
You may use a PGD, sell emergency contraception over the counter or
prescribe it. If you are using a PGD, please ensure that you have read this as
part of your pre-workshop preparation and bring this, and any consultation
recording forms or consultation questions, along with you to the event. We
will refer back to this during some of the workshop activities. If you are
selling or prescribing emergency contraception, you will find it useful to have
a copy of your consultation questions at the workshop.
Before attending the CPPE workshop you need to complete the tasks set out
below.
The workshop is a practical learning session, designed to give you local
information on emergency contraception and to build your confidence
through role play.
8Task 1 – Effective and sensitive
Emergency contraception – Pre-workshop book
communication
We expect that you will have some prior knowledge of consultation skills;
for example, you might have completed the CPPE Consultation skills for
pharmacy practice e-assessment. If you have not already done this, then
you can find out more about CPPE resources to support foundation level
consultation skills on our gateway page: www.cppe.ac.uk/gateway/
consultfound
Women may find it difficult and embarrassing to talk to you about
emergency contraception. Therefore, you will need to communicate with
them sensitively. If you plan to complete a Declaration of Competence to
provide this service, then you will need to state what activities you have
undertaken to ‘apply effective consultation skills to communicate with clients
appropriately and sensitively when dealing with sexual health’.
Read You’re welcome, the Department of Health’s quality criteria for young
people friendly health services, and make notes on how you could make
your service even more friendly to young people in the text box below. This
document is available at: www.gov.uk/government/publications/quality-
criteria-for-young-people-friendly-health-services
Optional additional activity: If you want to do more work on this area,
you could choose to look at the CPPE Dealing with difficult discussions
e-learning programme. Section 4 contains information that specifically
relates to consultations around sexual health. This is available at:
www.cppe.ac.uk/programmes/l/diffdisc-e-01 9Task 2 – Safeguarding
Emergency contraception – Pre-workshop book
As a pharmacy professional, you have a responsibility to remain confident
and current in safeguarding. Make sure that you know who to contact if you
need to raise or discuss a safeguarding concern. This information will usually
be on the website of the local authority for your area.
If you plan to complete a Declaration of Competence, you will need to state
how you ‘have met the competencies expected of all healthcare professionals
with regard to safeguarding children and vulnerable adults’. If you have
not undertaken any education in safeguarding in the last two years, we
recommend that you do this now. For more information about the options
open to you, visit the CPPE Safeguarding gateway page: www.cppe.ac.uk/
gateway/safegrding
When focusing on safeguarding, you will need to determine if the woman
consented to have sexual intercourse. Watch the following light-hearted
Thames Valley Police video entitled Tea and Consent and make notes in the
boxes below on the following questions. You can find this video here:
www.youtube.com/watch?v=pZwvrxVavnQ
1. If a person consents to have sex once, does this mean that we can
assume that they have consented to sex that they will have with that
person in future?
2. If a person consents to have sex and then changes their mind, does
this still count as consent?
10Emergency contraception – Pre-workshop book
3. Can an unconscious person consent to have sex?
4. If a person consents to have sex and then becomes unconscious,
does this still count as consent?
11Task 3 – When is emergency
Emergency contraception – Pre-workshop book
contraception needed?
This workshop assumes that you will have prior knowledge on the basics of
different methods of contraception. If you need to find out more about this,
work through the CPPE Contraception e-learning programme and associated
e-assessment.
One of the things that you will need to ascertain when providing an
emergency contraception service is when emergency contraception is
needed. Women may come to see you if they have not used contraception
optimally, and you will need to advise them if they need emergency
contraception.
Use Section 4 of the Faculty of Sexual and Reproductive Healthcare’s
guidance on Emergency contraception to decide if you think that emergency
contraception is needed in the following circumstances. This guidance can be
accessed at: www.fsrh.org/standards-and-guidance/
12The expert speaker will discuss these scenarios at your event.
Emergency contraception – Pre-workshop book
Emergency contraception
needed
Scenario Yes No Unsure
Libby comes to see you with a packet of
Microgynon 30 to discuss the pills that
she has missed. You can see from the
packet that Libby is currently on day 13
and has missed days 10 and 11. Libby
tells you that she had sex last night.
Sara tells you: “I took my pill six hours
later than I usually do yesterday; I had
sex last night, does it matter? The label
says I should take it at the same time
every day.” When you look at Sara’s
Summary Care Record, you can see that
she has been prescribed Cerazette.
Alisha comes to see you; she had sex
last night but is not sure if the condom
came off or not.
Kaela is using a contraceptive patch,
which fell off yesterday. She stuck it
back on with Micropore tape and had
intercourse last night.
Ellie tells you that she had sex last night;
she is taking Lucette. She looked in her
diary and realised that she should have
started her next packet three days ago.
Nasia used the withdrawal method and
thinks she might have got ejaculate on
her external genitalia – it definitely went
on the top of her legs
13Task 4 – What type of emergency
Emergency contraception – Pre-workshop book
contraception will you recommend?
This workshop assumes some prior knowledge of the different types of
emergency contraception and the information that you will need to discuss
with women requesting emergency contraception. If you need find out
more about this before your workshop, you should work through the CPPE
Emergency contraception e-learning and associated e-assessment.
Use the Faculty of Sexual and Reproductive Healthcare’s guidance on
emergency contraception – available at www.fsrh.org/standards-and-
guidance/ – to find out the following information about each type of
emergency contraception:
n The efficacy of each method
n The advantages and disadvantages for each method
n How soon after unprotected sexual intercourse each method needs to be
used
n Contraindications for each method
n Information to discuss with the patient for each method
n The incidence of common side effects of each method
Make notes in the table below. Take this to the event with you so that you can
fill in any gaps that you have during the expert presentation.
14Levenorgestrel Ulipristal Copper IUD
Efficacy
Advantages and
disadvantages
How soon after
unprotected sexual
intercourse does it need to
be used?
Contraindications
Counselling points
The incidence of common
side effects
15
Emergency contraception – Pre-workshop bookNow that you have looked at the different types of emergency contraception,
Emergency contraception – Pre-workshop book
you need to decide which will be most appropriate in different situations.
Make a list of your top six questions that you will ask women, in order to
decide which form of emergency contraception might be appropriate in a
given situation. You will get a chance to try your questions out in the role
play section of your event.
1.
2.
3.
4.
5.
6.
16Emergency contraception – Pre-workshop book
Optional additional reading: If you want to find out more about different
types of emergency contraception before your workshop, we recommend
the following resources:
n Your local PGD and service details
n SPCs for the products that you intend to sell or provide
n Patient information on the FPA website: www.fpa.org.uk/ – search
for patient information on ’emergency contraception’
n Patient information on emergency contraception on the NHS Choices
website, available at: www.nhs.uk/conditions/contraception/
emergency-contraception/
If you want to find out more about the questions to ask in an emergency
contraception consultation, have a look at the CPPE Emergency
contraception e-learning programme.
17Task 5 – Engaging your team
Emergency contraception – Pre-workshop book
You will need to support the team that you work with in order to deliver a
safe and effective emergency contraception service. Often, support staff will
be the first people that women will see when they walk into the pharmacy. If
you complete a Declaration of Competence to provide this service, you will
need to state how you can support and develop the pharmacy team when
providing the emergency contraception service.
Watch the following CPPE video with your team: www.youtube.com/
watch?v=RWxz1bQ4ESI
This video is about consultation where the patient would like a contraceptive
pill, rather than emergency contraception. However, it shows the impact
that interruptions, and struggling to manage consultations among a heavy
workload, can cause.
Discuss how, as a team, you can provide a welcoming and uninterrupted
service and make a note of your ideas in the box below. At the workshop,
you will share these ideas with your colleagues during the
ice-breaker activity.
Ideas generated from your team discussion
If you would like more materials for support staff, CPPE has a series of
videos entitled Consultation skills for support staff on its YouTube channel.
These videos deal with embarrassing health problems, difficult discussions
and awareness of a non-judgmental approach. These videos are available at:
www.youtube.com/user/YouCPPETube/videos
18Checklist for action
Emergency contraception – Pre-workshop book
Now that you have worked through this pre-workshop book, take a moment
to run through this checklist to make sure you are well prepared for the
workshop.
Actions I completed this on:
I have started to prepare for the workshop by
downloading the Declaration of Competence
for emergency contraception and assessing my
own competence and learning needs.
I have considered how I will provide emergency
contraception in my practice. If relevant, I have
read a copy of the PGD(s) that I will be using
and I have ensured that I will have access to
this at the workshop.
I have prior knowledge on foundation level
consultation skills.
I have met the competencies expected of
all healthcare professionals with regard to
safeguarding children and vulnerable adults.
I have prior knowledge on the basics of
different methods of contraception.
I have completed Tasks 1-5.
Signed:
Date:
Take this book with you to your local workshop. Make sure that you know
when and where it is and what time it starts.
Enjoy your learning.
19Contacting CPPE For information on your orders or bookings, or any general enquiries, please contact us by email, telephone or post. A member of our customer services team will be happy to help you with your enquiry. Email info@cppe.ac.uk Telephone 0161 778 4000 By post Centre for Pharmacy Postgraduate Education (CPPE) Division of Pharmacy and Optometry 1st Floor, Stopford Building The University of Manchester Oxford Road Manchester M13 9PT Share your learning For information on all our experience with us: programmes and events: email us at feedback@cppe.ac.uk visit our website www.cppe.ac.uk Funded by: Developed by:
You can also read
