6 Apr 2011 | Medication Safety
The chart is now being used on all wards in Grey Base Hospital, except the Assessment, Treatment and Rehabilitation Ward and the Dementia Ward (the chart is being used in the Children’s Ward, with the word ‘adult removed).
The DHB runs two other hospitals – Buller and Reefton. The chart has been introduced in the medical ward at Buller Hospital and will be introduced in Reefton in the future, once a long-stay chart is developed.
Grey Base Hospital’s Pharmacy Manager, Nick Leach, has been closely involved with the project.
“We had a really enthusiastic doctor, Tamara Brodie, who could see the benefits of a standardised chart being used by all hospitals. Tamara was leaving the hospital at the end of February 2011, so we worked really hard to get the new chart up and running before then.
“Tamara and I went to national training in October 2010, and then received training at Grey Base Hospital in February.”
Nick says prior to roll out there was a big focus on training staff in the use of the new chart, and promoting its benefits.
“We invited a nurse from each ward to attend train-the-trainer sessions – to be trained and find out more about the reasons behind the national chart so they could become ‘champions’ for the chart on their ward.
“We also put up posters throughout the hospital, so everyone knew the launch date and what the chart looked like.
“All nurses had a training session on the new chart – because we are a smaller hospital we were able to cover everyone. Those who were not able to attend group training were trained individually.
“We provided training to doctors at their Friday meeting, and visited Buller Hospital to train the doctors and nurses there.”
The hospital switched over to the national medication chart on 21 February 2011.
“At Greymouth, we were able to get everyone changed over to the new chart on the same day. Larger DHBs might have to do more of a rolling change over – for example, waiting for an old chart to be completed before introducing the national chart.”
Nick says the chart has generally been well accepted by hospital staff, and any push back or niggles have been minor.
“The chart has 19 spaces for fluids and there has been some concern this won’t be enough. However, lack of space hasn’t been an issue so far. There has also been a bit of negative comment from doctors about having to having to write out ‘micrograms’ in full. But this is important, because it adheres to best practice and also ensures legibility of prescribing.
“Some of the nurses were a bit resistant to including their registration number on the chart. We are addressing this by explaining the importance of the registration number, to identify staff both now and in the future.”
She says some doctors said they preferred the eleven and a half day format of the old chart, to the seven-day format of the new chart and found having to re-chart more often frustrating.
“We are working with doctors on this and explaining the benefits of the whole chart, rather than just focusing on one aspect.”
There have also been many positive comments about the new chart.
“Fluids can be noted on the back of the national chart, whereas previously they had to go on a separate chart. Nurses have told me they find having information about fluids on the same chart as medicines much more convenient.
“As a pharmacist, the two-page layout of the national chart works really well because I can see any anomalies or issues at a glance. The old chart had three pages which included a fold out, which made it harder to read as a whole, especially the administration of the medication.”
Now the chart has been introduced, Nick says the focus is on providing feedback and support to staff.
“Pharmacists on the wards keep a close eye on the charts and provide constructive feedback when something is not being filled out correctly. They can answer any questions about the chart and explain why it is important to do various things a particular way.”
Nick Leach says, overall, the introduction of the new chart has gone very smoothly.
“I’m confident it will make the prescribing, dispensing and administering of our medicines safer. I’d definitely encourage other DHBs to introduce the national chart as soon as they can.”
Photo caption: Kathryn Qu and Ruhama Addis are shown how to use the charts by Dr Tamara Brodie and Pharmacy Manager Nick Leach.