Abstract

Medication for hospice inpatients is prescribed by doctors, dispensed by pharmacists and administered by nurses. A clearly designed drug chart is central to this process. Changing the drug chart needs careful management, to avoid staff discontent and procedural errors. Improvements were required to the design of the drug chart at the Marie Curie Hospice, Solihull, which was identified as being difficult to work with. The aim was to design a new drug chart, which was clear and user-friendly for the clinical team, and which would reduce error. A drug chart working group was established in September 2009, consisting of a pharmacist, two nurses and a doctor. Issues for improvement were identified by means of a staff questionnaire. It was suggested that the spaces for writing controlled drug prescriptions were too scattered, the syringe-driver section was unclear, printed ‘as required’ prescriptions were illogically arranged, and there were too many separate sheets of paper for fluid and warfarin prescriptions. Allergy warnings did not stand out, and insufficient space meant that patients frequently needed two charts. The best features were taken from a number of hospice drug charts, and combined to reflect these issues. Several prototypes were evaluated, and the final version was tested over a 3 month period. In September 2011, the new drug chart was launched. The process of implementation of the newly designed drug chart has led to a user-friendly clinical tool. Three months into its establishment on the inpatient unit, feedback has been constructive and positive. On-going audit of the implementation of the newly designed drug chart will be carried out.