Applying a Group Decision-Making Model within a Quality Program to Improve Medication Safety

To assess whether adherence to decisions made by professionals involved in the preparation and administration of orally administered medications via short-term enteral access could be enhanced through the implementation of a Group Decision-Making Model within a quality improvement program, comparing the third Plan-Do-Study-Act cycle with the fourth Plan-Do-Study-Act cycle with the Group Decision-Making Model.

This study outlines a quantitative research approach using the Standards for Quality Improvement Reporting Excellence (SQUIRE) model. The study was conducted between June 2018 and April 2019. A total of 16 nurses and 40 nursing assistants/technicians were working in the clinical medical ward at the moment of data collection. Group Decision-Making Model in conjunction with the PDSA cycle, as part of the Plan-Do-Study-Act cycle within a hospital in the State of São Paulo, Brazil, for supporting the hospital's nursing team in the preparation and administration of oral medicines via enteral access device for short-term use, including the washing of the equipment.

The findings, when compared to a prior Plan-Do-Study-Act cycle conducted without any involvement in decision-making, indicated that utilizing the Plan-Do-Study-Act cycle in conjunction with the Group Decision-Making Model method significantly improved the likelihood of successful implementation of quality improvement practices. This was especially noticeable in the case of the pill-crushing technique, where compliance increased from 5.3% in the Plan-Do-Study-Act cycle without the Group Decision Making Model to 100% in the Plan-Do-Study-Act cycle with the Group Decision-Making Model.

The Plan-Do-Study-Act cycle serves as a supportive tool for the management team. Nevertheless, its effectiveness may be constrained when final decisions follow a top-down approach. The incorporation of a participatory phase using the Group Decision-Making Model has demonstrated substantial potential to enhance the prospects of successfully implementing quality improvement practices regarding the preparation and administration of oral medications through enteral access device for short-term use.