A Quality Improvement Project Assessing the Timely Administration of Anti-Parkinsonian Medications Following an Acute Admission

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H Brown 1; A Sanda Gilligan 1; M Mushtaq 1; K Honney 1
1. Department of Integrated Care of the Elderly, Queen Elizabeth Hospital, King’s Lynn.
Clinical Quality
CQ - Patient Safety

Abstract

Introduction

This quality improvement project (QIP) aimed to determine whether the acute admission of patients with Parkinson’s Disease (PD) is meeting the current NICE guidelines in the appropriate prescription and timely administration of anti-parkinsonian medications (APM). The project evaluated the accuracy of prescriptions, quantified delays in medication administration, and established the causative factors for delays. 

Methods

This QIP was a retrospective study with two cycles analysed over a one-year period. Following consent and approval, notes for eligible patients meeting the inclusion criteria of a PD diagnosis being treated with APM’s, were retrieved. The records were analysed and reviewed against a data collection tool. Two criteria were established with a targeted compliance of 100% without exception: the first outlined that patients should have their APM administered on time without a delay of more than 30 minutes (criteria 1); the second appraised the accuracy of the prescription on drug charts (criteria 2).

Results

The combined cycles included sixty-five patients which were analysed based on the QIP objectives. In the first cycle, the compliance of criteria 1 was 21%, and criteria 2 was 58.6%. Following these results, key interventions were implemented in the trust: regular teaching on APM’s, commencement of mandatory PD training, posters created and displayed, stocks of APM kept in the emergency department, new guidelines for PD management published, and ‘Give it on Time’ stickers clearly placed on patient notes with a diagnosis of PD. Following the intervention, the second cycle’s compliance of criteria 1 improved to 65% and criteria 2 increased to 88.5%. Notably, after interventions, more patients (36%) were empowered to self-administer their medications. 

Conclusions

Overall, this QIP identified a low compliance with the standards set by NICE guidelines in the first cycle. Following the key interventions, the compliance improved significantly and this subsequently enhanced patient safety and outcomes.