Reducing Medication Administration Frequency in Veteran Community Living Centers

A quality improvement initiative of the Veterans Health Administration (VHA) aims to reduce frequency of medication administration to Veterans per day. Medication administration practices in our community living center (CLC) units are similar to an acute care medical unit versus a home environment. The objective of this project was to reduce medication administration frequency in order to minimize the number of interruptions to both Veterans and nurses.

A retrospective chart review was conducted for Veterans residing in a pilot CLC from January through March 2018. Electronic medical records and barcode medication administration (BCMA) logs were assessed. Data collected included demographic information and medication details (eg, drug name, frequency, administration time). Data were analyzed and pharmacist recommendations were documented into an Excel document, and then discussed with the pilot CLC unit medical provider in March 2018. The primary outcomes measured were the number and type of pharmacist recommendations, percent reduction in the average number of Veteran interruptions per day, and percent reduction in the average number of medication passes by nurse per day.

Thirty-one Veterans were identified with a range of 4 to 31 active prescription orders. Fifty-five pharmacist recommendations were made and 31 were implemented. The average number of Veteran interruptions per day was reduced by 13.9%. The average daily number of medication passes was reduced by 16.3%.

Both Veteran interruptions and nurse workload decreased due to the implemented pharmacist recommendations. Pharmacists will continue medication consolidation on a monthly basis and spread this project to other CLC units.