Authors (including presenting author) :
Wong TC
Affiliation :
Medicine & Geriatrics, Our Lady of Maryknoll Hospital
Introduction :
Drug overstock has been found in patient’s medication drawers frequently. The drawers are congested by the overstocked medication which is not only disturb, confuse and prolong medication administration, but also might even resulting in medication incident.
Objectives :
Reinforcing medication safety by means of drugs’ storage in an orderly manner, and rectify the problem of drug overstock in patient’s medication drawers. Also, the “Five Rights” principle will be facilitated in medication administration as a result.
Methodology :
A hazard analysis was conducted on the current practice of nurse handling medication in ward by means of “Healthcare Failure Mode and Effect Analysis” (HFMEA). The possible potential failure modes, which may lead to drug overstock in patient’s medication drawers, in the processes which require further action were determined. A checklist for measuring the condition of drug overstock in the drawers was developed according to the HFMEA. According to the results of HFMEA and the 1st inspection round, strategies of workflow adjustments including ensure the practices of “First In, First Out” and minimize the unused leftover drugs in the drawers were established. Besides, the current practice of handling inter-hospital transfer medication from QEH was promoted. The strategies were shared to nursing staff together with the potential risks of drug overstock in patient’s medication drawers. The program was implemented after the sharing session and last for a month since August, 2018.
Result & Outcome :
Maintaining zero medication incident Medication trolley inspection round were conducted three times to measure the condition of drug overstock in patient’s medication drawers before, during and after the implementation. No drug overstock was found at the end of the program compare with 83.3% before the program. The practice of “first-in first-out” were performed in 29.2% of drawers before the program, then improved to 95.2% and 95.8%; discontinued drugs were found in 45.8% of drawers before the program, then improved to 19% and none. The average of overall compliance rate was raised from 65.4% to 94.2% and 99.6%. Nursing staff reflections were collected after the program, 91% of staff agree that medication administration is more efficiency; 73% of staff agree that the program reinforces medication safety; all staff agree that the workload of the program is acceptable; 61% of staff agree that the program is worth implementing in long run and the rest of staff no opinion in this issue.
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