Background Controlled drugs (CDs) are used extensively in end of life care and need to be administered in a timely way. Two staff nurses to check and administer CDs has implications on time, autonomy and person-centred care.
Aims To empower staff to work autonomously in the administration of oral CDs, reduce CD incidents, free nursing time to care and prevent delay in the administration of medication.
Methods SNA would be considered a significant change to process therefore the first step was to introduce this proposed change as part of staff’s annual medications training. This consisted of revisiting;
policy and procedure for CDs
mapping the process using a medications incident to demonstrate the risk of a two– nurse process.
Root Cause Analysis and human factors were considered. A phased approach was utilised to role out this innovative change over a six months period. Phase 1 consisted of Band 6 staff and nurses that had volunteered to participate. Phase 2 were staff who were initially reserved regarding the SNA but encouraged by the initial success of Phase 1. Phase 3 took longer as this was a fluid group of staff who were new and lacked experience, had confidence issues due to a previous drug error or needed additional support due to concerns.
Results SNA of CDs showed a reduction in incidents from 72.7% with two nurses administering to 28.5% with SNA. Staff reported more autonomy, release of time to care and speed of reaction to patient need.
Conclusion SNA demonstrated a positive impact on person-centred care for all.
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