Background St Gemma’s Hospice recognises the national shortage of registered nurse (RN) recruitment with increasing dependency of patients (The Kings Fund. The NHS workforce: our position, 2021). As part of our ongoing development and cost effective use of resources, the nursing team are keen to use the existing RN resource as efficiently as possible. By moving to a workplace where it is usual practice for a single nurse to check and administer drugs (SNAD) would enable greater safety, more timely symptom management and more effective use of the workforce (Cross, Bennett, Ockerby C, 2017; Armitage, 2008).

Aim Inpatient unit (IPU) moves to single nurse administration of most drugs by June 2021.

1. Improve symptom management.

2. Reduce medicine administration errors.

3. Release RN time to care.

Method

• Literature review and pre- training questionnaire.

• SNAD group formed.

• Networking with other hospices.

• Create teaching package, provide study day including competency assessment.

• Devised competency tool and Standard Operating Procedure (SOP).

Results Pre-SNAD training timings were recorded with an average administration of medicine taking 15 minutes. The study day was evaluated well with RNs feeling empowered and confident. Evaluation of the project hasn’t taken place yet, as competency is ongoing, however, preliminary findings show more efficient symptom management, less interruptions and increased autonomy. We are hopeful that we will see a reduction in medication errors because of this. We have trained 75% of the RNs, those not trained do not meet the inclusion criteria but will be trained later in the year.

Conclusion Already we are finding that RN work has been interrupted less during the SNAD process. Medications have been administered more promptly therefore patients’ symptoms managed more efficiently. By utilising SNAD, time is used more efficiently in an environment that has a small number of staff and so limited workforce resilience.