WHERE THIS HAPPENED: Derriford Hospital, Plymouth Hospitals NHS Trust
The Department of Health has defined hospital acquired venous thromboembolism (VTE) as any VTE event occurring within 90 days of hospital admission or surgery. Hospital acquired thrombosis (HAT) is common during and after hospital admission and is considered a major patient safety issue. Current NICE guideline (CG 92) 2010, recommends that medical patients assessed at risk of VTE should have pharmacological prophylaxis commenced as soon as possible after risk assessment has been completed and continued until the patient is no longer at increased risk of VTE.
This quality improvement project was carried out in the medical assessment unit in Derriford Hospital, Plymouth. We aimed to increase appropriate VTE pharmacological prophylaxis to 100% prescribed in 6 hours by the end of May 2016 using the Plan-DoStudy-Act (PDSA) methodology. The primary outcome measure was whether or not enoxaparin was given within 6 hours of admission.
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WHERE THIS HAPPENED: South Tees Hospitals NHS Foundation Trust
Enhancing the patient experience, improving staff satisfaction, and reducing wastage in Chemotherapy Services.
Patients arrive early and undergo a number of tests particularly relating to pathology. After 1-2 hours the results are available and the chemotherapy prescription is, or in some cases is not, confirmed. The patients, and their carers, must then wait whilst the chemotherapy is prepared in the pharmacy department. Pharmacy receives the majority of its chemotherapy orders within a small time frame with little or no indication of priority and is under pressure to complete the workload as quickly as possible.
Patients and ward staff become frustrated with delays to Chemotherapy and this is reflected in communications between teams. To help manage the expected pressure the pharmacy prepares as much chemotherapy as possible in advance of prescriptions being confirmed, however where chemotherapy doesn’t go ahead these drugs are wasted. Waiting patients occupy clinical space for longer than is necessary and this creates capacity pressures.
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Impact of pharmacist involvement in enhanced recovery pathways in improving patient care in those undergoing lower gastrointestinal surgery
WHERE THIS HAPPENED: Central Manchester University Hospitals NHS Trust
Undertaken as a NICE scholar, the aim of this project was to demonstrate the impact of pharmacist involvement on surgical enhanced recovery pathways in improving patient outcomes by the implementation of the principles of NICE guidance on medicines optimisation.
The role of pharmacists in medicines reconciliation has been well documented in the literature. NICE guidance states that medicines reconciliation should be undertaken within 24 hours of admission to hospital. However in the elective surgical patient group, it may be more prudent if medicines reconciliation is undertaken prior to admission in the pre-operative phase so as to reduce this variance and manage any peri-operative drug issues more effectively.
Post-operatively, patients were also followed up actively by a dedicated enhanced recovery pharmacist following the principles underpinning the NICE guidance on medicines optimisation (NG5).
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WHERE THIS HAPPENED: Derby Teaching Hospitals NHS Foundation Trust and Derbyshire Community Health Services NHS Trust
WHERE THIS HAPPENED: Manchester Royal Eye Hospital
Childhood cataract (CC) has an incidence of 3.5 per 10,000 by age 15 years. Diagnosis of any underlying cause is important to ensure effective and prompt management of multisystem complications, to facilitate accurate genetic counselling and to streamline multidisciplinary care. Next generation sequencing (NGS) has been shown to be effective in providing an underlying diagnosis in 70% of patients with CC in a research setting. This project aimed to integrate NGS testing in CC within six months of presentation and increase the rate of diagnosis.
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The empty boxes are given to relatives to fill with items belonging to the patient such as photos, aromas, toys and letters.
This helps to make families feel involved.
Trish said: “The idea is that the things inside the box are personal to the patients so that when you get them out and you talk through them you can find out a bit more about your patient but it is also something that will interest your patient and encourage them to engage with you.”
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