Addition of Pharmacists in Behaviours Of Concern response teams in the emergency department.

Addition of the Emergency Medicine (EM) pharmacist to behaviour of concern (BOC) response teams in the emergency department. This will be a randomised controlled trial comparing having an Emergency Medicine pharmacist versus standard care looking at enrolling 25 patients in each arm over a 6 month period. All patients being received after a “Behaviour of Concern” (BOC) call, initially assessed in the BOC room will be elligible for inclusion in the study if presenting during EM pharmacist working hours (7am-9pm Monday to Friday). Specific responsibilities of the EM pharmacist in the team will be to facilitate medication decision making after consultation with the medical team leader on previous allergies, known past medical history and current medications; prescribe and draw up medications where required for administration by a nurse, and obtain an accurate and efficient medication history on patient arrival, where possible. A medication treatment plan will be prescribed using both regular and as required medications. The use of chemical restraint will be minimised according to local guidelines and in accordance with the Mental Health and Wellbeing Act 2022. The EM pharmacist will also expedite prescribing and administration of other medications including home medications, nicotine replacement therapy, opioid agonist treatment and alcohol related withdrawal. Prescribing of medications by the EM pharmacist will occur prior to medication administration, directly into electronic medical records, utilising the Partnered Pharmacist Medication charting model (PPMC) previously evaluated.