| Popis: |
This audit shows that the prevalence of missed doses is still high at IH as none of the standards have been met. Blank spaces at drug administration times are still frequent and this may be due to distractions during drug rounds. MDs arising from unavailable drugs are regular; this shows that non-pharmacy staff are not accustomed to assessing drug availability, thus not notifying pharmacy for timely ordering. Consecutive MDs for critical drugs were only observed in temporary escalation wards, while the permanent wards met the standard. It was also apparent that critical drug MDs were from different therapeutic areas to that of the respective. Bias was not eliminated as some wards were fully audited while others partly; some proformas were incomplete or filled incorrectly. A large portion of the MDs were ‘Refused’ doses which may skew the results. The classification of drug availability and the type of communication to pharmacy were not documented adequately probably due to the complexity of the proforma. The data for nil-by-mouth/ swallowing difficulties MDs were also reported as this was identified as an area for pharmacy intervention. Unclear documentation on both drug charts and the proformas made it difficult to identify whether the doses were given promptly after dispensing, as ‘checking’ and delivery of a medicine cannot be tracked easily. Drug charts could be amended to include a reminder for drugs not available and a summarised list of critical medicines for staff. Nurses can also be reminded of incorporating MMCBs in their drug rounds and have a brief training session on critical medicines and MDs. A re-audit comparing the same standards and examining the trends of MDs and dispensing time throughout the time of day and week could highlight areas for improvement. |
