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Learning Objective 1: medication safety via standarise medication chart
Learning Objective 2: familiar with the concept of complex adaptive system and action research in the health care system
Medication management pathway is a complex process with diverse professional groups. The aim of this action research project is to improve mediation safety for elderly people in a hospital using the National In-Patient Medication Chart (NIMC).
Modified Bamenda model of action research is adopted in this inquiry. The modified Bamenda model primarily consists of the situation analysis and the concurrent threads of inquiry. Information gathered from the situation will lead to three concurrent threads of inquiry. Each thread will work through cycles of Planning (P), Action (A) and Research Inquiry (R). These three processes are re-united into a new situation analysis phase to re-exanimate and reflect current situation, and design the next action research cycle.
Situation analysis took place by the form of an audit in November 07. Six key area of patient safety are measured via the NIMC which includes patient identification, adverse drug reaction documentation, dose frequency and administrating times entered by prescribers, clear prescribers's signature with printed name and warfarin dosage with target INR.
Forty-nine percent of medication charts has correct and complete identification
Ninety-three percent has ADR details completed
Eighty-four percent of the dose frequency and time written by prescribers
Ninty-seven percent of the orders have the frequency of dose clear and correct
Ninety- nine percent of the medications prescribed have Prescribers name clearly printed and signed.
Seventy-seven percent of the warfarin has the INR documented
Base on the preliminary results from the audit, some of the indicators did not reach the target range. A further attempt to improve this result will continue with key people to address issues related to acceptability, integrity, and effectiveness of NIMC.