ADMISSION WARD AUDIT ON MEDICINE CABINET CONTENTS
1.Abstract: Background: Like many hospitals in NHS, the admission ward in the Western General Hospital (WGH) uses bedside medicine cabinets (POD lockers) to store patient’s own medications (POD) upon their admission. The POD locker content must be checked upon admission and changes to the Prescription and Administration Chart (MC) and must also reflect what is prescribed in the patient’s MC, in accordance with the NHS Lothian Safe Use of Medicines Policy & Procedures (Hospital Policy). There is concern, raised by the admission ward pharmacist, that the medical staff in the admission ward are not following the hospital policy regarding the POD lockers content. Particularly in emptying of the POD lockers between each patient occupying the bedspace. This includes medications found in POD lockers but not prescribed for the patient in the MC, medications containing other patient’s names on the label and unremoved discontinued medications found in POD lockers. These medications will be referred to as Identified Errors (IE). The presence of these medications in the POD lockers can represent the degree of compliance of the staff regarding the POD locker hospital policy. Method: Comparing the medications found in the patient’s POD locker with what is prescribed for the patient in the MC will be the main focus in the method. All patient occupying a bedspace in the admission ward are included. Each patient must have a POD locker and an MC to collect the data from. The data collection form paper was printed to document the medications found in the patient’s POD locker and the label details of each medications that is considered to be an IE. A floor-plan form paper was also printed to assure the inclusion of all patients in the admission ward and document any issue regarding the collection of data for each bedspace. An average period of patient’s stay on admission ward is calculated by the average days spent by the patients included in the audit. Results: Out of 185 bedspaces included in the audit, 31% (n=58) of medicine cabinets were found to contain IE. Out of 683 total medications found in POD locker, 14% (n=95) were considered to be IE. Within these IE: 13% (n=90) were not prescribed in the patient’s MC, 3% (n=22) were found with other patient’s name on their label and 0.4% (n=3) found to be discontinued medications that remained in the patient’s POD locker. All patients included (n=183), 19% (n=35) of patients had medications that were not prescribed under their names. The average estimated stay for a patient in the admission ward is 1.4 (≂33hr) days/patient While, 16% (n=29) of patients were found to have their names on the medication label yet they were not prescribed for them in the MC. Conclusion: The audit shows that the medical staff do not, fully, follow the NHS Lothian Safe Use of Medicines Policy & Procedures regarding the medicine cabinet in the admission ward. Even though, the findings do not indicate the rout of the issue found in the admission ward. Adding a clinical staff, with at least a basic knowledge of medication, to help in checking the POD lockers would most likely significantly decrease number of IE.