Self-administration scheme wins award …
Calderdale and Huddersfield NHS Foundation Trust — rated as excellent
in the Healthcare Commission’s medicines management health check — was
further recognised last month. It won the “Patient involvement” category
at the Gala Awards ceremony held in Birmingham for the National Prescribing
Centre’s medicines management collaborative programmes that have
been running for the past five years.
The award recognised the trust’s efforts to increase patient safety
and reduce risk through the self-administration of medicines.
Karen Guy, one of only a handful of nurses who are based in pharmacy
departments in the UK, described the benefits to staff, as well as patients,
through the introduction of self-administration. The time spent, for
example, administering medicines on the medicine round dropped from just
over four hours in every 24 hours to less than two hours. Patients’ knowledge
about their medicines, why they had been prescribed them, the dose, course
and possible side effects improved. She explained that the system enables
patients to “practise” taking their medicines before they
are discharged and so enable hospital staff to assist patients and their
carers to cope with more complicated medication regimens.
In other categories Oxford Radcliffe Hospitals NHS Trust, South Staffordshire
Healthcare NHS Foundation Trust, University Hospitals of Leicester NHS
Trust and Hinchingbrooke Healthcare NHS Trust were runners-up. University
Hospitals of Leicester NHS Trust also produced the best “story
board” presented at the Gala Awards.
… But others report no real evidence for SAPs
There is no conclusive evidence that patients who self-administer their
drugs during a hospital stay have improved compliance according to Julia
Wright, head of clinical pharmacy at Southampton University Hospitals NHS
Trust.
Presenting the research to delegates at the United Kingdom Clinical Pharmacy
Association’s autumn symposium held last month in Leicestershire,
Mrs Wright explained that she and her colleagues retrospectively reviewed
51 research papers, chosen on the basis that they described the self-administration
programme (SAP) involved and evaluated it objectively. Patient compliance
was assessed in 12 papers, with statistical evaluation being carried out
in seven. Only four of these found improved compliance scores in the patient
group participating in SAPs, compared with a control group. Just two papers
statistically evaluated the effect of SAPs on medication errors after discharge,
with only one of these showing a beneficial effect. Both papers that statistically
evaluated patient satisfaction found that patients would chose to participate
in a SAP again.
Mrs Wright commented that it is difficult to know whether the benefits
attributed to SAPs would have been realised just from educating patients
about their drugs. Moreover, none of the papers statistically evaluated
the effect of SAPs on nursing and pharmacy staff’s time, so it is
unclear whether the benefits of SAPs are greater than the resources required
to implement and maintain them. |
Hospital Pharmacist