Saudi Cultural Missions Theses & Dissertations
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Item Restricted Medicines Reconciliation: A Clinical Audit(Saudi Digital Library, 2023-09-22) Alshahrani, Abdullah; Allen, JaneBackground: Medicine reconciliation (MR) is a crucial strategy that aims to prevent medication errors and enhance patient safety. The National Institute of Health and Care Excellence (NICE) recommend ensuring that all admitted patients should have a completed MR within 24 hours of admission. Aim: This audit aimed to evaluate the MR procedure at Surrey and Sussex Healthcare NHS Trust (SaSH) and to identify any potential challenges that affect compliance with the standard. Methods: A cross-sectional clinical audit was conducted at SaSH with over 185 patients who were admitted between 5 June and 12 June 2023. Of these, 90 were from the medical division and 95 the surgery and gynaecology divisions. Data for this audit were collected retrospectively from 19 June to 30 June 2023 via the Electronic Prescribing and Medicines Administration (EPMA) system, and the collected data were wrangled, coded and analysed using the SPSS software (Armonk, NY: IBM Corp., version 28.0). Results: The findings reveal a significant decrease in the percentage of patients whose MR was completed within 24 hours (22%), as well as a general decline in the total number of completed MRs (51%), particularly compared to the previous audit (59% and 93%, respectively), indicating a lack of adherence to the standard. Such factors as admission division, admission specialty, day the MR was completed, admission time, number of medications upon admission and number of documented drug discrepancies have all shown statistical significance (p < 0.005). Conclusion: The MR process at SaSH failed to meet the standards and demonstrated a decline in completed MRs compared to the last audit performed. Thus, a further re-audit would be recommended after implementing recommendations based on the study findings.10 0Item Restricted What is impact of weight-based dosing of intravenous infusion on patient safety in paediatric intensive care unit at Royal London hospital?(2023) Alsohaimi, Adel; Falade, Josephine; Abou Daya, Mohammed1. Abstract 1.1. Background: Despite evidence for the safety and accuracy of the standard concentration approach (SCI) for intravenous infusion, most paediatric intensive care units (PICUs) in the United Kingdom, including the PICU at Royal London Hospital, continue to use the traditional weight-based approach (WBA), increasing the risk of errors. 1.2. Methodology: This project aimed to investigate the WBA and to explore the extent to which patient safety can be harmed as a consequence of its use. It was designed as a retrospective and prospective cohort study. A secondary analysis was done for medication errors gathered retrospectively from 1 September 2012 to 30 May 2022. Additionally, nine nurses (ten preparations) were observed during preparations of a group of high-alert medications. 1.3. Results: A total of 378 errors were identified during the study period, and sixteen errors were related to WBA, including four types of errors. Calculation and wrong setting of pumps were the highest (n=5; 31.3%), followed by preparation errors involving inaccuracy of withdrawn volume (25%). Interestingly, (n = 12; 75%) of the discovered errors were related to administration of high-alert medications. However, the percentage of harm was limited to 13%. Variation in preparation was noticed, and adherence of nurses to preparation techniques was only 65%. 1.4. Conclusion: Risk of medication errors can be raised by using WBA, and nature of errors results in catastrophic changes, such as ten-fold higher or lower than prescribed concentration, which leads to undesirable consequences. SCI can be a solution and it should be explored.13 0