Implementation of bedside medication preparation in intensive care: post-improvement cycle

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Clinical Pharmacy Practice

Background:

• Bedside medication preparation is crucial for patient safety in Intensive Care Units (ICUs).
• Previous assessments indicated suboptimal adherence to best practices in medication preparation within this ICU setting.

Purpose of the Study:

• To evaluate the effectiveness of a quality improvement (QI) cycle in optimizing the bedside medication preparation process.
• To enhance patient safety by improving adherence to medication preparation protocols in an ICU.

Main Methods:

• A quasi-experimental, pre- and post-implementation study design was employed in a public hospital ICU.
• Data were collected through audits assessing adherence, interruptions, medication storage, and temperature control, analyzed using Shapiro-Wilk and Mann-Whitney U tests.
• Carter's Positivity Index was utilized to quantify compliance with observed practices.

Main Results:

• Overall compliance with bedside medication preparation increased significantly from 46% to 80% post-intervention.
• All evaluated variables, including adherence, storage, and temperature monitoring, demonstrated substantial improvements.
• The transition from an "undesirable" to a "safe" care stratum was observed, indicating enhanced medication safety.

Conclusions:

• The implementation of a quality improvement cycle positively impacted bedside medication preparation processes.
• QI initiatives are effective in improving patient safety within the critical care environment.
• Sustained focus on medication preparation protocols can lead to safer patient care outcomes.