Abstract
BackgroundAlmost every patient admitted to hospital will receive medication during their stay. Medication errors are an important cause of patient morbidity and mortality, as well as an economic burden for healthcare institutions. Research suggests that current methods of storing medication on hospital wards are not fit for purpose, contributing to inefficiency and error.AimTo improve medication storage in inpatient areas, by exploring variation and challenges related to medication storage and designing a prototype solution.MethodsSet in four hospitals in an English teaching hospital trust, the study used a mixed methods approach comprising a quantitative descriptive survey of storage facilities and practices followed by mixed methods observations of medication rounds and interviews with patients, nurses and pharmacy staff. Quantitative data were presented descriptively and qualitative data analysed thematically and using a human-centered design approach.ResultsWe identified wide variation in medication storage facilities and practices across 77 wards. Observations and staff interviews in six wards revealed five problem areas: poor management of multiple storage facilities; lack of visibility and organisation of medication within trolleys; inadequate size of storage; lack of ownership and knowledge of standard practice; and use of key locks. Patients were largely satisfied with receiving their medication. Systematic and consistent physical organisation of medication in medication trolleys, and integrating and implementing principles of best practice, were identified as areas for intervention.Discussion and conclusionVariation in medication storage facilities and practices existed both across the organization and on individual wards. Multiple challenges were identified in how medication was stored, which if addressed may improve the efficiency and safety of medication administration and in turn, staff and patient experience. The use of design principles alongside a research approach resulted in a rapid, iterative process for developing and refining potential solutions to improve inpatient medication storage.
Highlights
Medication is the most commonly used medical intervention, with most hospital inpatients receiving medication during their stay
Medication errors are an important cause of patient morbidity and mortality, as well as an economic burden for healthcare institutions
Multiple challenges were identified in how medication was stored, which if addressed may improve the efficiency and safety of medication administration and in turn, staff and patient experience
Summary
Medication is the most commonly used medical intervention, with most hospital inpatients receiving medication during their stay. Medication errors do occur and may cause considerable patient harm, as well as being an economic burden for healthcare institutions [1,2,3]. In 2017 the World Health Organization (WHO) identified Medication Without Harm as the theme for its third Global Patient Safety Challenge [2] This seeks to improve medication safety by strengthening systems for reducing medication errors and avoidable medication-related harm [2]. This approach highlights that medication administration does not occur in isolation, but occurs within wider systems, involving multiple stages, healthcare professionals, patients and carers. Research suggests that current methods of storing medication on hospital wards are not fit for purpose, contributing to inefficiency and error
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