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Published on: June 11, 2012
A quality improvement project to increase self-administration of medicines in an acute hospital
S Garfield1,2, H Bell1, C Nathan1
1Charing Cross Hospital, Imperial College Healthcare NHS Trust, Fulham Palace Rd, Hammersmith, London, UK.
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.
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