CSI Summary
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Project Topic:
Updated Medication Administration Times
Hospital, City and State:
Bayhealth Hospital Sussex Campus, Milford, Delaware
Unit:
5A-Medical-Surgical/Intermediate Care (IMC)
CSI Participants:
- Breda Roche, BSN, RN
- Catrina Ansbach, ADN, RN
- Susan Singh, BSN, RN
Project Goals/Objectives:
- Increase Staff Satisfaction Survey results 15%
- Decrease nurse turnover 100%
- Increase Patient Post Discharge Satisfaction Survey results 15%
- Increase Medication compliance to 90%
- Decrease medication administration errors
- Improve Healthy Work Environment Assessment Tool (HWEAT) Scores in Appropriate Staffing by 0.5 points
Project Outcomes:
- Increased staff satisfaction survey results from 40% to 90% agree
- Decreased turnover rate to 0.5 RN between April 2024 to November 2024
- Increased timely medication administration from 80.3 to 90.2%
- Medication administration errors were unchanged
- Increased HWEAT aggregate score from 4.30 to 4.67 and all healthy work environment standard scores
- Increased Appropriated Staffing standard score from 3.55 to 4.58
- These outcomes resulted in a positive estimated annual fiscal impact of $144,771
Project Overview:
The timing of the shift report and patient handoff overlapped with the start of medication administration times. As a result, it was difficult to stay on time with medication administration. As a result, staff felt the unit was not staffed appropriately. The HWEAT Appropriate Staffing standard scored the lowest. Therefore, the CSI team consulted with leadership and pharmacy to change the medication administration time on the unit. With the implementation of this project, it allowed a full two hours for medication administration after patient handoff. The time changes assisted staff to have the time to complete vitals, ambulate patients to the bathroom or commode, and set them up for breakfast. The additional time to administer timely medications also reduced staff stress.
In the beginning, there was resistance to the changes that were being implemented. Now, the feedback is very positive. The project has scaled beyond our unit, and we look forward to the positive change it will bring throughout our hospital and another hospital in our system.
Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.
Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.