Background Syringe drivers are integral part to palliative care practice. The most widely used model, McKinley T34, is used to administer controlled drugs including opioids. As a result the documentation and monitoring of the use of syringe drivers is vital for ensuring safe treatment and in prevention or detection of potential adverse events.
Aim The aim of this audit was to review how effectively syringe driver checks and the subsequent documentation of such checks were carried out for patients in hospital, community and hospice settings.
Method Standards were set using current guidance and safety information. Patients were systematically identified through the help of the transform team (a palliative care liaison team), contacting the medical equipment library responsible for issuing the syringe drivers and by systematically going round the wards in the hospital setting. The checklists were analysed using a predetermined spreadsheet. A second improved checklist was introduced and the process repeated.
Results Data from the first cycle indicated the frequency of syringe driver checks was half that of the required 6 per day. A number of important safety parameters were under recorded and reasons identified included misleading questions and poor formatting of the syringe driver checklist (eg, questions on the reverse side of the page). After implementing the new sheet some modest improvements were made, most notably the documentation of syringe volume and syringe brand improved. Hospice and community data checklists were completed more accurately in accordance with clinical guidelines, compared to the hospital setting.
Conclusion The implementation of a checklist with clearer questions and an improved format resulted in some improvement. However the discrepancy between the hospital and community/hospice setting, where staff are more experienced with the use of syringe drivers, indicates the potential need for more training amongst hospital staff.
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