george eliot hospital nhs trust medication safety thermometer elizabeth holland clinical audit &...
Post on 03-Jan-2016
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George Eliot Hospital NHS Trust
Medication Safety Thermometer
Elizabeth HollandClinical Audit & Effectiveness Nurse
George Eliot Hospital NHS Trust is a District General Hospital in Nuneaton
320 Beds including Maternity
Took part in the testing of Safety Thermometer
Started M.S.T in September on one medical ward Elizabeth 27 beds
December 2 medical wards Melly & Elizabeth 2 surgical wards Victoria & Alexandra
January 1 medical ward Bob Jakin
September we used the 3 page tool from HaeloOctober I adapted the input sheet from Haelo to test
Version 1 same method as GEH Safety Thermometer
Found it over complicated even using the 3 page guide as reference
I decided to go back to one form per patientPrinted double sided to cut down on paper
Tested in November on 3 wards 5 patientsUsed 3 page tool as reference guide
General comments from ward manager, sister & pharmacist were positive
Amendments have been made to Version 2 after discussions at the Webex & with Haelo
Ward: Hospital Number:GenderPatient's genderMFAgePatient's age70Is the allergy status documented?Inc NKDA on kardexYNWas medicine reconciliation for all medicines started within 24 hrs of admissionPharmacist has been involvedYNo - patient within 24hrsNHow many regular medicine are prescribed?Not inc PRN, Stat doses, IV fluids, O2, food supplements or devices. Different doses of the same medicine count as one medicine01-45-15>15Omitted dose of regular medication in the last 24hrs?Exclude Food supplements & O2 insert number of omissions using available info e.g. 3 omissions as pt refused & 2 route not availableInsert number Reason for omissionOmitted doses a critical medicineNumber of omissions of a critical medicineAnticoagOpiateInsulinAnti-effectivesHas the patient received any of the following medicines in the last 24hrsAnticoags (Heparin, LMWH [excluding VTE proph], Warfarin & NOAC's) Opiates (exclude oral codeine & dihydrocodeine IV or SC sedatives, Insulin) AnticoagWarfarinOpiatesIV/SC SedativesInsulinIf YES proceed to Section 2AnticoagHeparin, LMWH, Warfarin & NOACsYAny bleed or any kind of VTEAdministration of Vit K, Protamine or clotting factors e.g. OctaplexPotential for bleed, interactions with other medicinesNINR greater than 6 or APTT ration greater than 4Opiates Common complications of Opiates include sedation, respiratory depression & confusionYAdmin of NaloxoneReps rate below 12bpmNInjectable SedativesMidazolam, Lorazepam,, diazepam, clonazepamYCommon complications Admin of FlumazenilCommon complications of over sedation include hypotension, delirium, respiratory depression, reduced GCSNInsulinSymptoms of hypocaemia including anxiety confusion, extreme hunger, fatigue, irritability, sweating or clammy skin, trembling handsYCommon complications (capillary blood sugar
Version 4!Collection form Libby Style!
Alterations to make it suitable for other organisations
The collection form has now been developed into a tool for the Acute and community to test in January 14Next steps?
Sharing resultsThe Band 7 on Elizabeth observed the first collection and asked to see their results. Pharmacist assisting the collection also interested in findings.
Ward DashboardsTo make the data look the same as classic Safety Thermometer I have put ward level data in a dashboard to share