Authors (including presenting author) :
Tang LN(1), Chan SW(1), Yue SS (1), Ng YB(1)
Affiliation :
(1)Department of Medicine and Geriatrics, United Christian Hospital
Introduction :
Safe and accurate medication administration is one of the core responsibilities and missions in nursing care. However, tremendous workload, jam-packed clinical environment and increasing proportion of inexperienced staff posed great challenges to uphold the standard in an acute geriatric ward (11B) in United Christian Hospital (UCH). Thus, preventive measures had been implemented to minimize the risk of MAEs in this persistently unpleasant working environment.
Objectives :
To minimize the number of Medication Administration Incidents (MAIs) in Ward 11B in UCH
Methodology :
1.Applying Authentic Leadership:
Supervised with Authentic leadership is a crucial on improving medication safety. Creation of supportive culture and enhancement of nurses’ creativity, motivation and ethical behavior were focused. Nurses especially the juniors would proactively ask for clarification while facing the unfamiliar medications or situations and speak up new ideas related to medication safety
2.Ensuring Good Compliance on Administration of Medication (AOM) Guidelines:
Even when using the In-patient Medication Order Entry (IPMOE) System for medication administration, a strong mindset of over-looking the whole drug profile of each patient according to the “Five-Right” principle was built in nurses especially the new comers. Regular on-site supervision, monitoring and audit were performed by clinical teachers, ward in-charges and advance practice nurses to ensure good compliance on AOM guideline.
3.Minimizing Distractions and Interruptions during Medication Round:
Avoidance of medication round during visiting hours was initiated to minimize distractions and interruptions by relatives. For dangerous drug checking, not only a quiet location with extra lighting support was set up but also a good practice of “Pointing and Calling” was applied during high-risk medications checking which greatly enhanced staff concentration.
4.Consolidating Nurses’ Pharmacological Knowledge:
Interactive educational talks on medication for the elderly comprising side effects, polypharmacy and medical interactions were held quarterly to ensure nurses’ competencies on pharmacological knowledge. Moreover, ad-hoc sharing on drug management of patients with unfamiliar diseases had also been conducted by other specialists.
Result & Outcome :
After the implementation of the strategies in the past 3 years, there was only 1 MAI occurred in Ward 11B compared with 71 MAIs in M&G department between OCT 2017 and SEP 2020.
