Reducing missed medications in surgical patients.

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Surgical Nursing

Background:

• Accurate drug charts are crucial for elective surgical patients to prevent missed medication doses and peri-operative complications.
• Existing medication management systems may have inefficiencies leading to medication errors.
• Multidisciplinary team collaboration is essential for optimizing patient care.

Purpose of the Study:

• To implement and evaluate interventions aimed at reducing missed medication doses in elective surgical patients.
• To improve the accuracy and timeliness of medication administration in the peri-operative period.
• To assess the sustainability of implemented changes in clinical practice.

Main Methods:

• A quality improvement project utilizing a driver diagram to identify key areas for intervention.
• Implementation of four interventions: changes to elective proformas, initial clerking process, and nurse-based prescribing.
• Utilized a plan-do-study-act (PDSA) cycle following NHS Improvement guidelines for iterative assessment and refinement.

Main Results:

• The percentage of missed medication doses decreased from 9.8% to 0% following the intervention implementation.
• Two key interventions were identified as sustainable and integrated into routine elective patient pathways.
• Demonstrated a significant improvement in medication administration accuracy and patient safety.

Conclusions:

• Targeted quality improvement initiatives, including nurse-based prescribing, can effectively eliminate missed medication doses in elective surgical settings.
• Empowering nursing staff in medication management enhances patient safety and reduces adverse outcomes.
• Sustainable changes to established systems can improve both patient care and operational efficiency in surgical services.