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    18 views13 pages

    Presentation1 - Copy2 - Copy3

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    of 13

    Re-Audit on Are routine Medications prescribed routinely?

    Hardwick Timothy
    Alhashash Mohammad
    Aizaz Khalid
    Perera Hector
    Wusu, Adedoyin

    Clinical Governance meeting 23 November 2023​


    St Richard’s Hospital, Chichester
    Outline

    • Background ​
    • Objectives ​
    • Methods​
    • Results​
    • Summary​
    • Recommendations
    Background
    Patients being caught in the middle where there is lack of agreement over prescribing responsibilities and the risk
    that they might be left without the medication they need.

    There was an obvious lack of communication between healthcare professionals over the transferring of prescribing
    responsibilities.

    As per guidance "Responsibility for prescribing between Primary & Secondary/Tertiary Care":
    1.1 Patients should never be placed in a position where they are unable to obtain the medicines they need, when
    they need them.
    1.4 Patients have the right to be treated with a professional standard of care.
    2.6.1 Shared care: This includes patients, carers and all clinicians involved in their care.
    Background

    • Summary of the first cycle of the audit:

    • First cycle time frame – 15th May to 15th June 2023

    • Serious delay and/or no prescription signed for patients who underwent Elective surgeries under T&O.

    • Serious complications occurred due to missing regular doses.

    • ERP prescription signed in all patients


    Background

    • Interventions carried out

    Ø Print out Poster and place it in surgeons room to remind/ push on Surgeons and assistants to insure that
    regular medications are prescribed.
    Ø Spread the ward locally to junior Doctors who covers Elective ward, to check post operative patients routine
    medications.

    • Why Re-Audit?

    Ø To see if any improvement has occurred in the prescribing process

    Ø To close the audit loop/ Third cycle


    Objectives

    • To assess if any improvements in comparison to first cycle


    • Is there still a delay in prescribing routine medications
    • If any delay, does this delay leads to missing doses?
    Method

    • Retrospective review of all patients who underwent elective procedures on


    T&O list from 18th Oct to 18th Nov 2023

    • Time of ERP prescription was chosen at point reference point.

    • Records were assessed till time of discharge for prescription of routine


    medications.

    • Data collection: Bluespier, EPMA

    • 96 Patients evaluated
    Results

    1st Cycle 2nd Cycle

    Total patients Evaluated 118 96

    Patients who normally have prescribed medication 82 72

    Patient who did not need regular medication or were discharged the same day, 25 37
    hence excluded

    Patients who needed regular medication , hence included in study 57 59


    Results

    1st Cycle 2nd Cycle

    Number (n) Percentage (%) Number(n) Percentage(%)

    Missed at least one dose 50 87% 26 44%

    Got their routine medications 16 28% 41 71%


    prescribed within 24 hours
    Average delay in hours 42h - 18h -

    Prescribed on time 6 13% 12 20%


    Summary

    • Less proportion of patients have missed routine medications doses while IP (44%) compared to
    the 1st Cycle (87%)

    • Average delay 18h way less compared to first cycle 48h

    • Overall, Significant improvements were noted in prescribing regular medications for Elective
    patients.

    • However we still have an issue as almost half of elective patients who undergo an operation
    under T&O have missed their routine medications while IP
    Recommendations

    1- New design poster and poster will be publicized in Surgeons Room, Trauma room, Apuldrahm
    ward. (Elective T&O ward), and this aim to increase awareness among all healthcare practicians who
    get in contact with patient including nurses.
    2- To include in the post operative plan '' please insure routine medications are prescribed", an
    email will be sent to consultants with abstract and recommendation.
    3-Re-audit in 30 days.
    4- Conduct similar audit in other surgical specialities.
    5-Conduct similar audit in other Hospitals in Trust .
    6- ? Any suggestions
    Thank you for listening!

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