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P-142 Identifying the challenges of introducing a hospice in-patient medicines self-administration scheme
  1. Colette Lehany
  1. Marie Curie West Midlands, Solihull, UK


Background/Introduction Medicines are administered to in-patients as default practice. This conflicts with principles of helping patients maintain independence. We have observed in practice that this led to loss of confidence and confusion with medicines when home, potentially causing medication errors. Evidence was needed to understand barriers and facilitators for a Medicines Self-Administration scheme.

Aims To establish:

  • Benefits and challenges of scheme development.

  • Process practicalities and training needs.

  • Patient choice.


  • Verbal screening survey of in-patients established how they manage their medication at home currently and whether they would like to self-administer.

  • Electronic survey (open-ended questions) emailed to RNs requesting their views on the scheme.

  • Multi-disciplinary working group established to steer and plan implementation.

Analysis Data analysed by working group. Common themes identified which guided a first proposal presented to the Senior Management Team.

Results 24 in-patients screened

  • 2 (8%) would like to self-medicate independently if offered.

  • 2 (8%) would require support in the hospice to self-medicate.

  • Only 4 (16%) patients would meet the proposed criteria to self-medicate.

12 out of 18 RNs responded. Themes emerging:

  • All fully supportive of the scheme but unclear how this would work in practice.

  • Concerned about professional nursing responsibilities.

  • Benefits to patients recognised.

Patients are often experts in their own medication. They should not be disempowered just because they are an in- patient!’ RN.

Conclusions This work provided evidence that ward staff would support a scheme to empower patients and maintain independence with their medicines. Patients would like to be offered the choice. The scheme could help identify problems before discharge and reduce risk of errors.


  • Procedure sign-off by hospice governance.

  • Training, implementation.

  • Re-audit after three months.

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