Article type
Abstract
Background: Medication errors are common in the intensive care unit (ICU), which can lead to adverse events. A significant proportion of personnel time in the ICU is devoted to medication-related processes.
Objectives: we designed a best practice implementation study to improve medication management and storage in an ICU.
Methods: A prospective study was conducted from November 2023 to January 2024 in the medical ICU of a general private hospital. In this study we integrated an implementation science approach of the Joanna Briggs Institute (JBI) with health care quality improvement through a clinical audit. Three audit criteria representing the best practice recommendations for medication management and storage were used including existence of an organizational policy, medication storage in accordance with manufacture’s recommendations, and limited access to stored medication. A baseline audit was conducted, followed by identifying barriers and the implementation of multiple strategies. The project was finalized with a follow-up audit to determine change in practice. Twenty eight nurses participated in the current study. We followed the instructions of the JBI and used software of JBI Practical Application of Clinical Evidence System (PACES) and situational analysis software Getting Research into Practice (GRiP) to support data collection and implementation planning.
Results: The results of this implementation study showed that the compliance rate improved from 7.14% in the baseline to 100% in the follow-up audit for criterion 1, 75% to 100% for criterion 2, and remained 100% at the follow-up audit as the baseline audit for criterion 3. Barriers and strategies to improve non-compliant criteria were identified and implemented. The main barrier was lack of an organizational policy/guideline on medication management and storage. The strategies to be implemented include holding a one-day conference on medication management and storage, holding a training workshop on medication management and storage and adapting and using clinical guidelines in the department.
Conclusions: The implementation of the evidence-based quality improvement project improved the status of medication management and storage by nurses in ICU. It can be concluded that guideline adherence, educational programs and tools, such as face-to-face training can facilitate the implementation of evidence into practice.
Objectives: we designed a best practice implementation study to improve medication management and storage in an ICU.
Methods: A prospective study was conducted from November 2023 to January 2024 in the medical ICU of a general private hospital. In this study we integrated an implementation science approach of the Joanna Briggs Institute (JBI) with health care quality improvement through a clinical audit. Three audit criteria representing the best practice recommendations for medication management and storage were used including existence of an organizational policy, medication storage in accordance with manufacture’s recommendations, and limited access to stored medication. A baseline audit was conducted, followed by identifying barriers and the implementation of multiple strategies. The project was finalized with a follow-up audit to determine change in practice. Twenty eight nurses participated in the current study. We followed the instructions of the JBI and used software of JBI Practical Application of Clinical Evidence System (PACES) and situational analysis software Getting Research into Practice (GRiP) to support data collection and implementation planning.
Results: The results of this implementation study showed that the compliance rate improved from 7.14% in the baseline to 100% in the follow-up audit for criterion 1, 75% to 100% for criterion 2, and remained 100% at the follow-up audit as the baseline audit for criterion 3. Barriers and strategies to improve non-compliant criteria were identified and implemented. The main barrier was lack of an organizational policy/guideline on medication management and storage. The strategies to be implemented include holding a one-day conference on medication management and storage, holding a training workshop on medication management and storage and adapting and using clinical guidelines in the department.
Conclusions: The implementation of the evidence-based quality improvement project improved the status of medication management and storage by nurses in ICU. It can be concluded that guideline adherence, educational programs and tools, such as face-to-face training can facilitate the implementation of evidence into practice.