1254 / Monitoring and review of the medication management procedure

ITALY
Classification of the PSP
Type of Patient Safety Practice Not Evaluated
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Implementation of Patient Safety initiatives / Activities
There is no specified text here There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
One of the main goals achieved by the Risk Management unit of the University Hospital of Sassari was to define a procedure for the medication therapy.
Description of the Patient Safety Practice
 
In accordance with the recommendations of the Italian Ministry of Health, a procedure has been drafted to regulate the whole process of prescribing, preparing, administering and interrupting medication therapy, to try to prevent or at least reduce the possibility that errors occur. The procedure has been helpful to define roles and responsibilities of the different professionals involved in medication management. It aims to standardize behaviors and tools, therapeutical single data sheed, that are very useful for the prevention / reduction of errors related to treatment in the hospital setting. The procedure was developed by a working group made up by physician and nursing coordinators of the different units, coordinated by the Head of Risk Management unit. The procedure was shared with the Head of Pharmacy, validated by the Health Department and adopted by Resolution of the General Directorate of the University Hospital of Sassari. Subsequent to the implementation of the procedure a training course divided into two editions has been organized, which involved health personnel, in particular representatives of Risk Management units, on the issues of Clinical Risk Management (Methods and Tools for risk reduction) and it has been very helpful in supporting the implementation of Ministerial Recommendations. After the training course, the Risk Management unit, in the frame of monitoring the application of the procedure in order to verify compliance in view of possible review, on September 1, 2015, a questionnaire has been administered to all Coordinators Nursing of the Operating Units.
After one year from the implementation of the procedure, the different professionals (physicians, nurses, nursing coordinators), have expressed the need to try to redefine the stages of medication management, based on the initial application and adaptation to the characteristics of each operating units. It has been highlighted that the methods for automatic and routine behavior during the different phases of the therapeutic process, at times, may be the cause of error. Drafting a procedure is necessary to define and standardize behaviors and tools useful for the prevention / reduction of errors during prescribing, preparation, administration and interruption of therapy. Physicians, pharmacists, nurses are the actors involved in the delicate process of management of drug therapy and each one may run into an error if the features of the system is not put constraints to avoid wrong actions both invitations to follow the steps right . The error can occur at all stages of the process: in the prescription, in the preparation (eg. Dilutions), in the administration, in the suspension. The procedure has been described in detail the process from prescribing, medication preparation, administration, suspension of the drug at the end of therapy. Each phase has been identified and the responsible parties involved through a matrix of responsibilities. It 'was drawn single data sheet as the standard model to be adapted and implemented within the units, which enables the entire process is tracked, with signature / initials of who performs the action. The questionnaire distributed to one year from implementation, involving all operating units aims to verify the degree of implementation of the procedure, analyzing any critical issues that have emerged from the analysis.
Responses to the questionnaire highlight:
1.    50% of respondents fully comply with the medication management procedure
2.    100% of respondents: the procedure is available for consultation
3.    83% of respondents state the single data sheet they use comply with the one proposed by the procedure
4.    83% of respondents do not wear safety vest; 16% do wear it.
5.    77% do not wear safety vest when administering medicines; 23% do wear it.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
No
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
Effect not known or the intervention has not yet been evaluated
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
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Involved health care staff
 
Physicians
Nurses
Pharmacists
Therapists
Administrative support (secretary, clerk, receptionist etc.)
Clinical manager
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
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Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/questionnaire.aspx?id=5367
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Motivated staff
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Antonella Virdis
Country: ITALY
Organisation: AOU SASSARI
E-mail: a.virdis@aousassari.it
Phone: There is no specified text here
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