A quality improvement project to increase self-administration of medicines in an acute hospital. (24th March 2018)

• Record Type: Journal Article
• Authors: Garfield, S; Bell, H; Nathan, C; Randall, S; Husson, F; Boucher, C; Taylor, A; Lloyd, J; Backhouse, A; Ritchie, L; Franklin, B D
• Is Part Of: International journal for quality in health care. Volume 30:Number 5(2018:Jul.)
• Page Start: 396
• Page End: 407
• Publication Date: 2018-03-24
• Subjects: Self-administration -- quality improvement -- medicines -- hospital -- patient involvement; Medical care -- Quality control -- Periodicals; 362.1068
• DOI: 10.1093/intqhc/mzy035
• Languages: English
• ISSNs: 1353-4505

Abstract

Abstract: Quality problem or issue: A patient survey found significantly fewer patients reported they had self-administered their medicines while in hospital (20% of 100 patients) than reported that they would like to (44% of 100). We aimed to make self-administration more easily available to patients who wanted it. Initial assessment: We conducted a failure, modes and effects analysis, collected baseline data on four wards and carried out observations. Choice of solution: Our initial assessment suggested that the main areas we should focus on were raising patient awareness of self-administration, changing the patient assessment process and creating a storage solution for medicines being self-administered. We developed new patient information leaflets and posters and a doctor's assessment form using Plan–Do–Study–Act cycles. We developed initial designs for a storage solution. Implementation: We piloted the new materials on three wards; the fourth withdrew due to staff shortages. Evaluation: Following collection of baseline data, we continued to collect weekly data. We found that the proportion of patients who wished to self-administer who reported that they were able to do so, significantly increased from 41% (of 155 patients) to 66% (of 118 patients) during the study, despite a period when the hospital was over capacity. Lessons learned: Raising and maintaining healthcare professionals' awareness of self-administration can greatly increase the proportion of patients who wish to self-administer who actually do so. Healthcare professionals prefer multi-disciplinary input into the assessment process.