Congress Abstracts 2006

21

AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE: IMPROVING MEDICATION SAFETY THROUGH A COLLABORATIVE NURSE-PHARMACY COMMITTEE. Michelle Grover, MSN, MBA, RN, OCN^®, Johns Hopkins Hospital, Baltimore, MD.

Patient safety is at the forefront of everything we do as Oncology nurses. It is especially relevant due to the high risk nature of the medications in our practice. Improving communication and multidisciplinary teamwork is an effective strategy to empower bedside Oncology nurses to enhance medication and patient safety.

In keeping with the Joint Commission on Accreditation of Healthcare Organization's 2005 National Patient Safety Goal to "improve the effectiveness of communication among caregivers", the existence of a collaborative Nurse-Pharmacy committee is an important component in building the culture of safety. Recognizing that collaboration and communication contribute to patient safety, this NCI designated Comprehensive Cancer Center created a multidisciplinary committee consisting of nurses and pharmacists to address issues surrounding medication safety.

The Nurse-Pharmacy committee is composed of staff nurses and unit-based pharmacists to ensure that the committee functions as a "grass roots" entity and has the authority to enact changes in the medication delivery process. Co-chaired by a nurse and a pharmacist, medication safety issues are addressed in its bimonthly meetings. Agenda items include: problems with nursing and pharmacy communication and collaboration; adverse drug events; medication QI initiatives; prescribing, dispensing and administration issues; and examination of medication policies, procedures and processes. Agenda items are derived from hospital-based initiatives, departmental QI initiatives and from staff initiated, unit-based issues.

Committee developed initiatives; recommendations and changes in practice are evaluated in an on-going basis. A four-step performance improvement process, "Plan-Do-Study-Act", is utilized. Feedback from all stakeholders regarding committee recommended changes is included in the evaluation process.

Medication use in the Oncology setting, in particular research protocols and chemotherapy regimens, will continue to grow in complexity. Our Nurse-Pharmacy committee utilizes a systems-approach strategy to optimize safe medication delivery and administration, and improve collaboration between Oncology nurses and pharmacists. Providing the opportunity to Oncology nurses to participate in a multidisciplinary committee improves quality of care, involves nurses in QI/PI initiatives, fosters autonomy and interdisciplinary collegiality, and supports professional development, all characteristics of Magnet nurses. Effective communication and teamwork can be the key to success in improving patient safety.