Please reconcile, not wait a while

2019 ◽  
Vol 105 (2) ◽  
pp. 122-126
Author(s):  
Ashifa Trivedi ◽  
Sadhna Sharma ◽  
Richa Ajitsaria ◽  
Nicola J Davey
Keyword(s):  
Quality Improvement ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Acute Setting ◽  
Paediatric Department ◽  
Medicines Reconciliation ◽  
The Mean ◽  
Patient Safety Incidents ◽  
Main Factor

A quality improvement project to increase the rate of paediatric medicines reconciliation was carried out in a district general hospital between April and July 2018. Baseline data collected from our paediatric ward shows that medicines reconciliation by doctors is only accurately completed 50% of the time. Evidence shows that medicines-related patient safety incidents are more likely when medicines reconciliation happens more than 24 hours after a person is admitted to an acute setting. The aim of this quality improvement project was therefore to ensure that 100% of paediatric patients have their regular medications prescribed by mid-day the day after admission. The paediatric pharmacy team reviewed all paediatric inpatient drug charts from Monday to Friday for 12 weeks. The number of regular medications and the number of medicines reconciled was recorded each day. The effectiveness of various interventions were reviewed using Plan–Do–Study–Act cycles. On average, 40 patients were reviewed each week. The mean reconciliation rate was 79%, and the worst rate was 0%. 100% reconciliation was achieved on 34 occasions and was achieved continuously for the last 3 weeks of data collection. A repeat audit carried out in September 2018 found the reconciliation rate was maintained at 100%. Multiple interventions occurred during this quality improvement project: teaching sessions for doctors, posters to raise awareness and questionnaires for parents/children to complete about their regular medications. The main factor for success in this project has been involving all members of the paediatric department including children and their parents.

scholarly journals Nurse’s Knowledge of Early Ambulation of the Post Operative Patient and Complication Prevention: A Quality Improvement Project

2021 ◽  
Author(s):  
Meghan Carides
Keyword(s):  
Quality Improvement ◽  
Patient Outcomes ◽  
Nursing Intervention ◽  
Educational Programs ◽  
Quality Improvement Project ◽  
Complication Rates ◽  
Improvement Project ◽  
Nursing Knowledge ◽  
Early Ambulation ◽  
The Mean

Ambulation is the single most important nursing intervention in the prevention of postoperative complications. It is also a key component in maintaining optimal patient outcomes. Current literature has revealed that when ambulation is initiated early there is a marked decrease in pain, length of hospital admission, and overall complication rates. However, even with this depth of evidence early postoperative ambulation on the two surgical units at a teaching hospital in Rhode Island, patient ambulation continues to be inconsistent. The purpose of this quality improvement project is to improve nursing knowledge regarding early ambulation after surgery for the prevention of post-operative complications. This project utilized a pretest, educational in-service intervention, and posttest design. Seventeen out of a possible 22 surgical nurses participated in this project (N= 17, 77%). The educational in-service sessions combined information from an extensive literature review in the form of a 10-minute Power Point presentation. Pre and post tests were made up of 5 knowledge-based and 5 opinion-based questions. The mean scores for the pretest were 74% while the mean scores for the posttest were 95.2%. There was a 35% increase in overall scores following the educational intervention. APRNs play a pivotal role in establishing and implementing educational programs. This project aimed to recognize a need for ongoing education about postoperative ambulation for the surgical unit nurses. Educational programs about postoperative ambulation and complication prevention should be routinely incorporated in future trainings to ensure improved nursing knowledge and patient outcomes.

scholarly journals 1473 Urology Consent Forms at a District General Hospital – a Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D Bernstein ◽  
A West ◽  
E Preston ◽  
P Premakumaran ◽  
N Suleyman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
General Hospital ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Consent Form ◽  
National Guidelines ◽  
Improvement Project ◽  
Consent Forms ◽  
Carbon Copy

Abstract Aim Consent is a core component of interaction between patients and healthcare professionals. Prior to surgery, forms are completed to record patient consent. As well as containing risks and benefits of the procedure, the consent form, as per guidelines1,2, must be legible and suitable to a patient’s capacity. To evaluate compliance with local and national guidelines, a quality improvement project was undertaken at a district general hospital. Method Over a three-week period 30 urology consent forms were selected to assess adherence to local and national guidelines. The appropriateness of consent form, patient signature, legibility, acronym use and whether the patient was offered a carbon copy were assessed. After initial data collection, all urology staff consenting patients were notified of the findings and how best to improve guideline adherence. A further three-week data collection was undertaken, though the sample set was small due to Coronavirus and Christmas. Results The results confirmed that patients had appropriate consent forms filled out and were signed appropriately. After intervention, there was clear improvement in legibility, with no low legibility consent forms, and 100% vs 83% high or moderate legibility between data sets. Intervention also resulted in significant reduction of acronym use; 33% vs 60%. More patients were also offered to retain a carbon copy; 89% vs 40%. Conclusions Through this intervention of highlighting local and national guidance as compared to current practice, compliance drastically improved. As the pandemic subsides, we hope regular emails to surgical teams will improve consent form completion to better patient care.

Medicines reconciliation of biologics on a primary care clinical system

2021 ◽  
Vol 3 (7) ◽  
pp. 274-280
Author(s):  
Sam Appiah-Anane
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Secondary Care ◽  
Care Setting ◽  
Quality Improvement Project ◽  
Care Providers ◽  
Snomed Ct ◽  
Improvement Project ◽  
Medicines Reconciliation ◽  
Clinical Systems

With increasing number of biologics gaining approval from the National Institute for Health and Care Excellence for a wide variety of both cancer and non-cancer clinical indications in secondary care, the need for accurate medicines reconciliation in primary care also increases. The risk of patient harm from incomplete medicines reconciliation is a consideration, particularly when patient data is transferred from a secondary care setting to a primary care setting. As part of a prescribing quality improvement project, a list of biologics prescribed by secondary care providers were reconciled on to patients' primary care clinical systems (EMIS) by clinical pharmacists and pharmacy technicians at a Clinical Commissioning Groups. Patients were identified by cross-referencing high cost drug reports with clinical diagnostic codes (a mixture of READ codes and SNOMED-CT terms) on primary care clinical systems. In total, 192 medicines were reconciled safely on the relevant patients' notes across 16 different GP practices A further 81 medicines had already been reconciled at the start of the quality improvement project. The purpose of this article is three-fold; to expand the awareness of biologics in the context of medicines optimisation in the primary care arena, to discuss medicines reconciliations of biologics in primary care, including the role(s) of pharmacy professionals, and to discuss the wider implications of prescribing biologics in the light of ethical considerations such as veganism.

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