Improvement Plan
This proposed improvement strategy includes the assessment and intervention to ensure the safe administration of opioids and other balance-altering medicines. It also plans for the safest possible environment for the patient in the minutes and hours following that dispensation. First and foremost, it is vital that all members of the interdisciplinary team are involved in this process. The many doctors, pharmacists, physical therapists, unit managers, and nurses will meet to discuss proper patient screening, creating safe environments, continuing education availability about the various pharmacology, and the very important conversation about intentional rounding and proper staff management.
Each patient, upon admission, should be thoroughly screened to assess the significance of their risk of falling. Areas that should be explored include mobility, visual acuity, mental state, issues with continence, and blood pressure fluctuations. Patient rooms must be free from clutter, appropriately lit, and most importantly, the call button must be within reach and this should be checked and rechecked constantly throughout each shift.
Continuous education for doctors, nurses, and other staff about safety and medication administration must be encouraged. Policies and science are always changing, and anyone involved in patient care must be up to date on every nuanced change. Nurses should stay continuously updated on all drug knowledge by doing their own reading, attending informational presentations, and constantly asking questions of the providers or pharmacists. Not knowing relevant information about medications that one gives can prove detrimental to patient safety.
Finally, and perhaps most importantly, after any medication is administered that can affect a patient’s balance or ability to function optimally, it is imperative that the patient be monitored every 15 minutes for the first hour, and then checked on with intentional rounding for the remainder of the shift and during the entire hospital stay. Just having an hourly rounding schedule in place can mean the difference between a patient’s safety or unfortunate outcomes.
