What was the aim?
Optimising and preventing harm from medication on admission and discharge in an acute trust can be complex. The trust wanted to improve the medicines management pathway for patients receiving acute, unplanned episodes of care.
What was the solution?
Northern Devon Healthcare NHS Trust’s pharmacy and medical assessment unit (MAU) teams identified opportunities to improve the medicines management pathway. As a result, South Western Ambulance Service NHS Foundation Trust’s paramedic crews agreed to prompt patients being taken to Northern Devon District Hospital to bring their medicines with them. This triggered other initiatives within Northern Devon Healthcare to improve medicines management.
enhanced recovery team was briefed on the importance of ‘getting medicines right’,
and new questions on medication were added to the trust’s discharge planning
information booklet to make referral to a pharmacist easier following admission.
therapists agreed to ask patients about their medicines when preparing for
MAU team educated each new intake of junior doctors in the importance of ‘getting
medicines right’ on admission.
hospital pharmacy team made sure it was ready to answer patients’ questions
about their medicines.
trust runs an annual public awareness campaign, ‘Talk About Your Medicines’, to
encourage patients to ask questions about their medicines and be referred to
the pharmacy team for advice if needed.
trust worked with the local pharmaceutical committee to signpost patients to
community pharmacy medicines support services following discharge.
What were the results?
number of patients bringing their medicines into hospital rose from 7% in July
2017 to 67% in February 2018.
use patients’ own medicines as an information source when completing medicines
reconciliation on admission. This encourages patients to talk about their medicines
and whether they are experiencing any problems.
number of unintended omissions of medication reduced from 11 high risk and 32
other medicines in 2015/16 to two high risk and 20 other medicines in 2017/18.
number of patients able to administer their own medication has increased, which
saves nursing time and reduces the risk of unintended omissions of medication
on busy wards.
patients’ own medicines has reduced medicines waste and time taken dispensing
medication that patients already have and do not need.
What were the learning points?
procedures for ‘getting medicines right’, teamwork and effective communication
- Measurement and feedback to staff are important for checking that you are ‘getting medicines right’ for your patients.
The trust plans to develop a patient experience questionnaire on medicines.
Want to know more?
Joy Davey, Medicines Safety and Governance Pharmacist, Joy.firstname.lastname@example.org