Quality Improvement Program ON Improvement of Legibility and Appropriateness of Medication Orders in Patient Record
Quality Improvement Program ON Improvement of Legibility and Appropriateness of Medication Orders in Patient Record
Quality Improvement Program ON Improvement of Legibility and Appropriateness of Medication Orders in Patient Record
ON
IMPROVEMENT OF LEGIBILITY AND APPROPRIATENESS
OF MEDICATION ORDERS IN PATIENT RECORD
Programme Members
Sampling
Sample Size
• 75 per week
Duration of study
One month (December)
Reporting form for QIP –Medication chart illegibility
Wrong Wrong Wrong Brand Discontinu Medication general Medication Medication Medication Lack of
route Dose frequen name ation order names Not illegibility of orders not orders not orders not signature after
cy written for drug written in medication named(Progr Timed(Progr Signed(Progr medication
improper CAPS order ess notes) ess notes) ess notes) administration
1st week 1 0 0 40 23 5 27 9 16 10 15
2nd week 0 1 0 32 24 3 22 7 14 7 13
3rd week 0 0 1 36 16 3 18 7 15 6 10
4rth week 0 0 0 28 10 2 15 6 12 7 6
FINDINGS
Sampling size
3 0 0 0
Graph
Fall risk staff nurses not Lack of side Lack of Grab Any history of Number of wheel
assessment not aware of fall rail in Each bars in toilet patient fall in the chairs and
documented in prevention bed unit? Number of stretchers without
Nursing protocols incidences safety straps and
assessment form belt
sep 20(80) 2 9 10 3 3
oct 18(83 0 6 10 0 0
Nov 13(87) 0 0 10 0 0
Dec 7(84) 0 0 10 0 0
Neuro Ward
Findings
It was observed that fall reduction in problem areas
like neuro ICU was reduced to almost 0 % from 100
%(3-0)
Number of beds without bed rails decreased to “zero”
Nursing documentation on fall risk assessment
improved
Recommendations
All areas to be appropriately equipped with patient
safety devices like bed side rails, anti skid tiles, grab
bars etc
Nurses awareness to be Improved
Patient and family education about fall risk needs to be
improved
New “Fall risk assessment forms “ needs to be
implemented
All wheel chairs and stretchers all over the hospital
needs to be equipped with safety straps and belts
QIP –
Prevention and reduction
of bed sore incidence
Programme Members
Sampling size
Sampling size
Sep 19
Oct 16
Nov 14
Dec 12
Graph
Findings
It was observed that bed sores were reduced by almost
37 % (19-12)
It was observed that nurse education was improved on
back care and general awareness on incidence of bed
sores
Recommendations
•Nurses awareness to be improved about proper back care and care of bed
sores
•Improved and regular monitoring of “critically ill patients” by dietician for
nutritional management
•Water beds to be made available in all critical areas as well as in areas where
patients are prone to acquire bed sores
QIP –
Prevention and reduction
of Thrombophlebitis
Programme Members
Sampling size
Sep 10
Oct 6
Nov 7
Dec 6
Graph
Findings
It was observed that Incidence of Thrombophlebitis
was reduced by almost 40 % (10-6)
It was observed that reporting of thrombophlebitis has
improved in patient care areas
Nurses are more aware of signs and symptoms of onset
of thrombophlebitis
Recording of date of insertion over peripheral line has
been improved
Recommendations
•Antibiotic coated peripheral lines to be put in practice
• Limiting the Duration of intra venous infusions
•Improved Safe handling of the line
•Hand washing practices and usage of PPE’s to be improved
•Planning to introduce policy for administering all high concentrated medicines
through central line