A quality improvement project on nicotine replacement therapy in Shannon Clinic (Northern Ireland)

AimsThe aims of this quality improvement project were to determine if Nicotine Replacement Therapy was being prescribed correctly in Shannon Clinic in Northern Ireland and also to improve the rates of correct prescribing of Nicotine Replacement Therapy in the aforementioned unit.BackgroundThere are several different types of Nicotine Replacement Therapy currently available. Shannon Clinic is a smoke-free clinical environment therefore patients who smoke are offered Nicotine Replacement Therapy on admission. When I was working at Shannon Clinic I became aware that there was no clear guidance available to medical staff on the wards regarding prescribing Nicotine Replacement Therapy and therefore I decided to carry out this quality improvement project.MethodAn audit of drug charts was done on the patients who were under the care of the consultant that I worked with. In total nine drug charts were included in the audit. After the audit was complete, I produced a poster to show how to correctly prescribe Nicotine Replacement Therapy. A copy of this poster was placed on each ward in Shannon Clinic. After a period of time the drug charts were re-audited to see if there had been an improvement in the rates of correct prescribing of Nicotine Replacement Therapy.ResultIn total, 22% of the drug charts which were included in the audit had Nicotine Replacement Therapy prescribed incorrectly on them. After the inclusion of a poster outlining how to prescribe Nicotine correctly on each ward in Shannon Clinic, 0% of drug charts had Nicotine Replacement Therapy prescribed incorrectly on them. This was an improvement of 22%.ConclusionThis quality improvement project was successful at reducing the rates of incorrect Nicotine Replacement Therapy in Shannon Clinic. In the future it is my hope that this quality improvement project should lead to the correct prescribing of Nicotine Replacement Therapy for all patients in Shannon Clinic. It should also lead to an increased awareness regarding the different types of Nicotine Replacement Therapy for medical staff working in this clinical unit.

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274 Reducing Direct Infusion of Citrate in Continuous Renal Replacement Therapy: A Quality Improvement Project

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2019.03.276 ◽

2019 ◽

Vol 73 (5) ◽

pp. 714

Keyword(s):

Quality Improvement ◽

Renal Replacement Therapy ◽

Continuous Renal Replacement Therapy ◽

Replacement Therapy ◽

Quality Improvement Project ◽

Direct Infusion ◽

Improvement Project

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Winged Metal Needles versus Plastic Winged and Nonwinged Cannulae for Subcutaneous Infusions in Palliative Care: A Quality Improvement Project To Enhance Patient Care and Medical Staff Safety in a Singaporean Hospital

Journal of Palliative Medicine ◽

10.1089/jpm.2015.0085 ◽

2016 ◽

Vol 19 (3) ◽

pp. 318-322 ◽

Cited By ~ 1

Author(s):

Shirlyn Hui-Shan Neo ◽

Mansha Hari Khemlani ◽

Lai Kiow Sim ◽

Angeline Soek Tian Seah

Keyword(s):

Palliative Care ◽

Quality Improvement ◽

Patient Care ◽

Medical Staff ◽

Quality Improvement Project ◽

Improvement Project ◽

Enhance Patient Care

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55 Quality Improvement Project to Assess How Informed Patients are About do not Attempt Cardiopulmonary (DNACPR) Decisions?

Age and Ageing ◽

10.1093/ageing/afz186.09 ◽

2020 ◽

Vol 49 (Supplement_1) ◽

pp. i14-i17

Author(s):

P Jayasuriya ◽

Y Amanullah ◽

A Kumar ◽

C Hookey

Keyword(s):

Quality Improvement ◽

Medical Staff ◽

Quality Improvement Project ◽

Next Of Kin ◽

Geriatric Ward ◽

Improvement Project ◽

Information Leaflets ◽

Journal Clubs ◽

Weekly Journal

Abstract Introduction Despite growing evidence regarding DNACPR decisions, there is a paucity of information given to patients regarding resuscitation decisions. The main aim of this quality improvement project was to assess and improve patients’ and their relatives’ understanding about DNACPR decisions. Intervention We initially surveyed 30 inpatients or their next-of-kin (if the patient lacked capacity) in a geriatric ward who had DNACPR decisions in place. Although, 86% knew the implications of a DNACPR decision, only 50% knew that a DNACPR decision would not limit them from receiving other treatment. 66% reported that the information given by the healthcare professional is “too little”. 35 questionnaires were also given to doctors of all grades to assess their practice of DNACPR discussions and barriers for discussion. Majority (95%) of doctors knew what should be included in a DNACPR discussion. Medical staff not considering DNACPR discussions during assessment, medical staff not comfortable to make the DNACPR decision and the fear of distressing the patient are the three main issues that were highlighted as barriers. 17% of doctors reported that they would have attended a cardiac arrest at least on 2-5 occasions for a patient when resuscitation was futile. We presented this data and educated doctors on effective DNACPR discussions using video demonstrations in weekly journal clubs. All doctors were informed to distribute DNACPR Improvement After the intervention, only 80% understood the DNACPR discussion. 76% knew that DNACPR does not limit them from receiving other treatment. 73% reported that this was not stressful and 76% were satisfied with the discussion and reported that their questions were answered adequately. 11 out of 30 patients had received the information leaflets and all found it useful. Discussion Although after the intervention the percentage who understood the DNACPR decision had reduced compared to the initial audit, there was a 20% improvement in who knew that DNACPR decisions did not limit other treatment. We hope to extend this study by carrying out training sessions for doctors to improve the quality of these conversations and thereby enhance adherence to expected practice in DNACPR decision making.

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64 Improving the Monitoring and Awareness of Fluid Balance on A Hip Fracture Ward

Age and Ageing ◽

10.1093/ageing/afab030.25 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

pp. i12-i42

Author(s):

H Pickles ◽

V Addy

Keyword(s):

Quality Improvement ◽

Hip Fracture ◽

Fluid Balance ◽

Medical Staff ◽

Balance Training ◽

Quality Improvement Project ◽

Ward Staff ◽

Post Intervention ◽

Improvement Project

Abstract Introduction Fluid balance charts are frequently incomplete and inaccurate. At present our Trust does not offer fluid balance training to all ward staff. In addition, drinks given to patients by visitors are not usually documented on the fluid balance charts. The goals of this quality improvement project were therefore to: Methods Using the PDSA model a questionnaire was given to ward staff as a scoping exercise to identify the deficiencies in fluid balance education prior to the intervention and fluid balance charts were analyzed. The intervention involved: Results Pre-intervention questionnaires demonstrated that 31% of staff asked were not clear on the meaning of fluid balance and 88% felt that more fluid balance awareness was needed on the ward. In addition, 7/8 randomly selected fluid balance charts were incorrectly completed. Post intervention 87% understood the meaning of “fluid balance” monitoring and 7/8 fluid balance charts were correctly completed. Conclusion The intervention educated all ward staff and improved the accuracy of fluid balance monitoring. It also provided information and guidance to non-medical staff and visitors regarding fluid balance monitoring. Following the success of the project the intervention is being rolled out across the Trust alongside education sessions for staff.

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