Within NHS Greater Glasgow and Clyde, pharmacists and nursing staff were concerned. The vancomycin guidelines, which required maintenance doses to be administered during the night, were leaving patients exhausted. As part of my Pre-registration research project, I was tasked with performing a pharmacokinetic analysis to test different times post-loading dose and gauge if there was any flexibility in the guideline, so that patients could either have their first maintenance dose early or delayed, while still remaining therapeutic.
I originally thought this project would be fairly straight forward, as I have a keen interest in pharmacokinetics and my fourth year dissertation project at university involved a pharmacokinetic analysis, and adjustment, to a paediatric vancomycin guideline. This project was extremely successful and resulted in a change of practice of which I am incredibly proud. However, my new project contained complex pharmacokinetic principles, some familiar to me, but many not. As my last project was focused on paediatric pharmacokinetics, some of the principles I had learned were not applicable. As my pharmacokinetics lecturer’s mantra went: “Children are NOT small adults”.
Ultimately, the project was a great success: I quantified the concerns of nursing staff and did find a tendency for patients to receive dosing in the night. I was also able to come up with recommendations on the timing of the first maintenance dose to overcome this. I now have plans to report my findings to the Antimicrobial Utilisation Committee for review.
For future hospital pre-registration pharmacists I have bit of advice – find something that interests you and do not be afraid to make it known. Had I not told my tutor where my interests lay then I would not have had this opportunity. If something does not interest you, then you will struggle to put in the extra work that makes a good project great! I would also set your objectives early on and confirm them with your project tutor. These projects have a tendency to grow arms and legs and become much bigger than can be done in the time-frame. This can be very exciting, but there is limited time and a lot to do in your pre-registration year. You could note any extra objectives asked of you then follow them up once qualified and spend the time they require to be done right.
My project has solidified my interest in pharmacokinetics, where I hope to pursue a career, but has also sparked an interest in research. Being able to recommend solutions to an identified problem is extremely satisfying and rewarding. I hope, once qualified, to conduct more research that has an impact in improving patient care.