Siah Jia Wen, Cheng Crystal Kai Tian, Choy Chloe Leyi, Tho Poh Chi, Lang Siew Ping
National University Cancer Institute, Singapore, National University Hospital, Singapore.
National University Hospital, Singapore.
JBI Evid Implement. 2024 Aug 23. doi: 10.1097/XEB.0000000000000457.
The aim of the project was to reduce interruptions during oral medication rounds among nurses working in hematology-oncology wards by improving compliance with best practices by 20%.
Medication errors can adversely affect patient safety. Hence, understanding the underlying contributors to medication errors is necessary. Nurses are the ones who administer medications to patients; however, in clinical areas, interruptions are prevalent and could contribute to medication errors. It is therefore recommended that interventions be implemented to minimize interruptions.
This project was conducted in two hematology-oncology wards from March 2022 to March 2023. Target participants were nurses who served medications in the morning. The project followed an evidence-based audit and feedback methodology using the seven-phase JBI Evidence Implementation Framework. JBI's Practical Application of Clinical Evidence System (PACES) was used to support the audit and feedback process. An interruption reduction bundle consisting of three best practices was implemented.
At baseline, only 24% of medications administered occurred without interruption. One month after implementation, there was a 51% improvement in compliance. Six months after implementation, compliance increased to 58%. Nine months post-implementation, the compliance rate remained at 59%. Absolute interruption counts decreased from 47 (baseline), to 27 (1 month post-implementation), to 24 (6 months post-implementation), to 16 (9 months post-implementation). All types of interruptions decreased when comparing the baseline with the latest post-implementation result.
The project used evidence-based interventions in a bundle, effectively reducing interruptions during oral medication rounds, and sustaining positive results.
该项目的目的是通过将最佳实践的依从性提高20%，减少血液肿瘤病房护士口服给药查房期间的干扰。
用药错误会对患者安全产生不利影响。因此，有必要了解用药错误的潜在因素。护士是给患者用药的人；然而，在临床环境中，干扰很普遍，可能导致用药错误。因此，建议实施干预措施以尽量减少干扰。
该项目于2022年3月至2023年3月在两个血液肿瘤病房进行。目标参与者是上午给药的护士。该项目采用基于证据的审核和反馈方法，使用七阶段的JBI证据实施框架。JBI的临床证据系统实际应用（PACES）用于支持审核和反馈过程。实施了一个由三项最佳实践组成的减少干扰综合方案。
在基线时，只有24%的给药过程没有中断。实施一个月后，依从性提高了51%。实施六个月后，依从性提高到58%。实施九个月后，依从率保持在59%。绝对干扰次数从47次（基线）降至27次（实施后1个月），再降至24次（实施后6个月），最后降至16次（实施后9个月）。将基线与最新的实施后结果进行比较时，所有类型的干扰都有所减少。
该项目采用了基于证据的综合干预措施，有效减少了口服给药查房期间的干扰，并维持了积极的效果。
