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WELCOME BACK

WELCOME BACK. Please switch off your mobile phones. A Medication Administration Training Tool in Care Homes. Sally Hall, Senior Pharmacy Technician, Gilbert Bain Hospital, Lerwick. Medicines management- audits and current practice in Care Homes.

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WELCOME BACK

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  1. WELCOMEBACK

  2. Please switch off your mobile phones

  3. A Medication Administration Training Tool in Care Homes Sally Hall, Senior Pharmacy Technician, Gilbert Bain Hospital, Lerwick

  4. Medicines management- audits and current practice in Care Homes Wendy Bagnall, Medicines Management Technician, Walsall CCG

  5. Walsall Medicines Medicines Management in Care Homes Wendy Bagnall Medicines Management Technician Walsall CCG

  6. Current service provision • Walsall CCG employs one Medicines Management Technician to undertake audits and provide help and support to care homes. • Community Pharmacists are contracted via a local enhanced service agreement to undertake quarterly audits and also to provide help and support to care homes. • Medicines Management support is provided to 70 care homes

  7. Service Aims • To improve safety by ensuring that care homes have policies in place for all aspects of medicines management. • To reduce potential patient harm as procedures for handling medication improve • To improve patient experience because medication will be handled safely and staff will have increased knowledge of medication

  8. Care Homes Use Of Medicines Study 2009 (N Barber et al.) Main findings of study were: • Residents (mean age 85 years) were taking 8 medicines each • On any one day 7 out of 10 patients experienced at least one medication error • Mean score for potential harm was low but results indicate opportunity for more serious harm

  9. Audits • A programme of audits for care homes began in April 2009 • All 70 care homes in Walsall, both nursing & residential are included • One audit is undertaken each quarter and of these: • 25% are undertaken by the MMT • 75% are undertaken by Community Pharmacists

  10. Training • Before undertaking the audits the Community Pharmacists are required to • Complete the CPPE Open Learning programme ‘Supporting People in Care Homes’ • Attend two training sessions provided by the Medicines Management Team.

  11. The service so far • Now been running for Four years • 16 audits have been undertaken so far • Improvements have been seen • Now able to re-visit some audits and compare results • Service is appreciated by care home staff

  12. Evaluation Survey 2012-13

  13. Previous Audits • Medicines Policies • Nutritional Supplements • Administration • Antibiotics & C-Difficile • High Risk Drugs • Specials • Asthma & Inhalers • Antipsychotics & Dementia

  14. Controlled Drugs Audit 2012 • First audited in 2009 • Good increase in compliance • Results show an increased awareness of the need for good policies and procedures for the management of Controlled Drugs

  15. Waste Medicines • Unused prescription medicines cost the NHS at least £300 million a year and of that £50 million worth of NHS supplied medicines are disposed of annually by care homes • 3025 items were included in the audit at a total cost of £12,570.52 • The annual figure for waste meds could be around £75,000.

  16. Results

  17. Working with others • Local Authority - if they have a contract with a local care home that is failing in some way and may need more support on medicines management issues. • Community Pharmacy- by undertaking audits they gain a better understanding of the problems faced by care homes and are better able to advise staff.

  18. Questions?

  19. Reducing the incidence of “Missed Doses” at North Bristol NHS Trust Sara Hobden, Pharmacy Technician, Medicines Management, Bristol

  20. Reducing the incidence of “Missed Doses” atNorth Bristol NHS Trust Sara Hobden, Pharmacy Technician, Medicines Management Pharmacy Department

  21. North Bristol NHS Trust (NBT) • Acute Teaching Trust: 2 sites • 1087 beds • 53 wards • 9100 staff • Safer Patients Initiative (SPI2): 2007 – 2009 • Southwest Quality and Patient Safety Improvement programme: 2009 – 2013 • New Hospital: May 2014

  22. Patient safety background Patient Safety – Medicines Management work stream • SPI2 project team • SWQPSI project team • Medicines Governance Group – Patients • NBT staff – Consultants; Other Doctors; Pharmacists; Nurses; Ward receptionists; Clinical Audit; etc.

  23. NBT Team

  24. Why is this important ? Nationally/Regionally • NPSA – guidance (2010) • SWQPSI target • NBT CQUIN target Patient Safety • Reduced harm • Reduce length of stay

  25. Definition: Missed doses occur when a medicine is not given to a patient when prescribed and may result in harm. There are variety of causes and our initial focus is drug unavailability code ‘6’

  26. Code ‘6’ – drug unavailable

  27. Aims and objectives To reduce the incidence of missed doses at NBT due to drug unavailability code ‘6’ Objectives • Reduce the number of missed doses • Raise awareness of effects on patients • Monitoring on a daily basis • Understand the reasons for missed doses • Introduce an e-tool for wards to audit themselves

  28. What have we done ? Phase 1: February 2010 – July 2010: • Determine criteria for a missed dose. • Using Plan Do Study Act (PDSA) cycles developed an e-audit tool.

  29. What have we done ? Phase 2: August 2010 – April 2011: • e-audit tool • Daily data collection • Emergency cupboards • Location of stock medication • Pharmacy staff awareness

  30. What have we done ? Phase 3: May 2011 – September 2011: • Training package • Posters displayed on wards • Ward handover sheet

  31. What have we done ? Phase 4: October 2011 – present day: • Monthly data shared • Missed dose order slip • Missed dose orange leaflet

  32. Pharmacy blue bag

  33. Orange leaflet

  34. Role of Medicines Management Technician • MM service • Medication lockers • One-stop dispensing • PODs

  35. Patient’s Own Drugs

  36. Patient’s Own Drugs

  37. Promoting Patients Own Drugs • Poster exhibited in the following areas: • GP surgeries • Community chemists • Hospital outpatients • Hospital wards

  38. Results

  39. Other / Future work • Maintain / improve results • Investigate ‘blanks’ • Alert for new medication • Parkinson's’ disease

  40. Summary 1.95%target: Achieved and maintained NPSA Alert: Compliant 2010/11 CQUIN target: Achieved 2011/12 CQUIN target: Achieved Posters:National Pharmacy Management Forum (London: Nov 2012) European Hospital Pharmacy Congress (Paris: March 2013)

  41. Any Questions ?

  42. Contact us Sara Hobden: Pharmacy Technician, Medicines Management • Direct line: 0117 323 2309 • Email: sara.hobden@nbt.nhs.uk Julie Hamer: Senior Pharmacy Technician, Medicines Management • Direct line: 0117 323 2309 • Email: julie.hamer@nbt.nhs.uk Jane Smith: Principal Pharmacist - Service Development & Governance • Direct line: 0117 323 2391 Mobile: 0788 443 7780 • Email: jane.smith@nbt.nhs.uk

  43. Lunch, exhibition and poster viewing Please by back by 13.20

  44. WELCOMEBACK

  45. Please switch off your mobile phones

  46. Annual General Meeting Fiona Price, Honorary Secretary, APTUK

  47. AHH Prize Winners

  48. 12 years of a wandering soul, the good and bad parts of life as a Locum Carole Tilbrook, Locum Pharmacy

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