Going Beyond the Task Bringing Medication Safety Alive

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Going Beyond the Task Bringing Medication
Safety Alive

• Jean Benton PHC-NP, CGN(C), BSc.N, NCA
• Elizabeth Fletcher B Sc N (M Sc N student)
• January 19, 2009
• Renfrew County Municipal LTC Miramichi Lodge,
  Pembroke Bonnechere Manor, Renfrew

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Objectives

• Share experiences related to improving
  medication safety
• ISMP Canada MSSA survey
• Results
• Lessons learned
• Challenges

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Renfrew County LTC

• Bonnechere Manor Renfrew
• 180 residents
• Miramichi Lodge Pembroke
• 166 residents

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Our Teams

• ISMP MSSA project team
• Miramichi Lodge Sept 2006 - 2007
• Bonnechere Manor Sept 2007 2008
• The teams interprofessional
• NP, RN, RPN, pharmacist, dietitian, Directors of
  Care, nursing students

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ISMP Canada MSSA ( Medication Safety
Self-Assessment Survey

• Identified areas for improvement
• Staff competence education
• Medication device acquisition, use and monitoring
• Quality process and risk management

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ISMP Canada MSSA ( Medication Safety
Self-Assessment Survey

• Activities
• Miramichi Lodge
• Medication Safety Support Program
• Orientation manual for RPN
• Medication Safety Support Binder
• Medication Placemat Wall Chart
• Bonnechere Manor
• Clinical Bulletin on key areas

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Additional Endeavors

• NP Incidental teaching resident specific
• Benzodiazepine use
• Renal function creatinine clearance
• Beers criteria
• Oral anticoagulant therapy

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Results

• ? awareness of medication safety
• ( goes beyond errors of omission/commission)
• ? use of inappropriate medications
• ? proper dosing ( e.g. adjusting for renal
  insufficiency)

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Results

• ? resident/family education specific to
  medication
• ? collaboration with pharmacists physician
• ? attention to medication reviews

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Lessons Learned

• Motivated staff
• Integrate into existing organizational
  professional practice
• Develop champions empower and support the team
• Advance practice nurse leader preferably on
  staff

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Lessons Learned

• Be accountable know your professional standards
• Think outside the box!
• Go beyond the task!
• Make current research accessible

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Lessons Learned

• Educate upwards
• Start somewhere ( anywhere)
• Take the time

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Challenges

• Sustainability
• Accessibility
• Resistance to change
• Competing/increasing demands
• The silo effect
• Creating true collaboration teamwork

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Resources

• Beers criteria
• ( http//archinte.ama-assn.org/cgi/content/short/
  163/22/2716 )
• ? GiiC ( Geriatric Interprofessional
  interorganizational collaboration toolkit
• ( http//rgps.on.ca/giic/GiiC/giic-contents.ht
  ml )
• ? Dosage adjustments for renal insufficiency
• (www.tippsnetwork.ca/pdfs/clinicalVolume2Issue1.pd
  f )