Introduction of Drug Round Tabard and Checklist to Reduce Interruptions and Error in Medication Administration.
Medication administration errors are common, costly and the cause of adverse events in clinical practice. Interruptions during medication administration rounds are thought to be a prominent causative factor of these errors. The change chosen for this project was the introduction of drug round tabards in a long term care facility for the elderly. The aim was to reduce non-urgent interruptions during drug rounds, reduce the incidents of medication errors, enhance patient safety, safe time and promote compliance with professional and national standards on medication management. Disposable red tabards embroidered front and back with ‘Drug round in progress, do not disturb’ and checklist were introduced. The HSE change model was applied as a framework for the design and implementation of the change project. A total of 66(n=66) drug rounds- 33 pre-implementation and 33 post-implementation were observed for 2 weeks each. The sources of interruptions were recorded using the Medication Administration Distraction Observation Sheet (MADOS). Nurses’ compliance to medication administration policy was evaluated using observational checklist that included 30 criteria. Medication administration errors were captured through direct observation and retrospective chart review. All staff were adequately trained, and nurses’ satisfaction with the change project was measured in a survey. Quantitative evaluation method was used. There was an 85% decrease in interruptions (125 to 19), and larger decreases in medication errors (91%; 46 to 4) and non-compliance to policy (98%; 125 to 3). The average medication time saved was 9minutes. The result from the nurses’ survey and verbal feedback on the project showed satisfaction with the use of drug round tabard and checklist. These results will be used as evidence to roll out these strategies to other units in the hospital.