Lessons learned from introducing huddle boards to involve nursing staff in targeted observation and reporting of medication effect in a nursing home
Received 6 August 2018
Accepted for publication 21 November 2018
Published 3 January 2019 Volume 2019:12 Pages 43—50
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Dr Scott Fraser
Stephan Ore,1 Elin Olaug Rosvold,2 Ragnhild Hellesø3
1Oppsalhjemmet Nursing Home Norlandia, NO-0982 Oslo, Norway; 2Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0318 Oslo, Norway; 3Department of Nursing Sciences, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0318 Oslo, Norway
Background: Medication administration and management in nursing homes can occur during all phases of the medication process. The aim of this study was to investigate if an introduction of a systematic use of huddle board led to an increased amount of documentation in the patient record of observations of effects and side effects following a change in medication.
Methods: A three-layer intervention approach combining huddle boards, educating the entire staff in medication observation and documentation, and frequent feedback to the staff about the outcome was applied. A standard was set for the expected reporting. Correlation between expected and actual reporting as an average was calculated and the staff received weekly updates on their observation–reporting results.
Results: The huddle board became a hub in providing an overview of the expectations of observations. To visualize the impact of the intervention, use of a run chart gave comprehensive information about the extent to which the expected goal of documentation was reached. Four different organizational steps and one individual action in the last step were taken to improve the observation–reporting. The identifying of the nonreporting nurses and individual staff guidance to these nurses resulted in a significant improvement in observation–reporting. The expected goal of 100% average reporting was achieved 6 months after all wards were included in the improvement project.
Conclusion: The combination of huddle boards, educating the entire staff in observation and documentation, and frequent feedback to the staff about the outcome proved to be a useful approach in medication safety work in nursing homes.
Keywords: patient safety, long-term care, prescribing, huddle board, nursing staff, system-approach, medication-effect documentation
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