'Nurse I made a change: A novel approach to promoting communication regarding medication orders

Aim: Medication omission and delayed administration are major medication safety issues, with the potential to impact significantly on the outcomes of hospitalised patients and health resource utilisation. This initiative formed part of a larger translational project aiming to reduce the incidence of omitted or delayed administration of medications to hospital inpatients, by improving interdisciplinary communication regarding newly charted and amended medication orders.

Method: Observational audits of ward rounds, nursing clinical handover and medication administration rounds were undertaken at the hospital during 2014 to improve understanding of the issues contributing to medication omission and delays. These audits were supported by multidisciplinary focus groups. A common theme that emerged was inadequate and inconsistent communication between prescribers and nursing staff when changes were made to medication charts. The “Nurse, I Made a Change” campaign was launched in early 2015. This campaign involved the development and distribution of posters and other promotional material featuring photographs of senior hospital consultants promoting prescribers to inform nurses of changes to the medication chart. This serious message was delivered in a light-hearted fashion, by dressing the consultants in various costumes. Focus group feedback was used to assess the outcomes of this strategy.

Results: Multidisciplinary stakeholder engagement suggested that the initiative reached a well distributed group of clinicians, had widespread appeal and delivered the message in a fun, attention-grabbing manner. Nursing and medical staff reported a significant improvement in communication of medication chart changes and a subsequent improvement in the timeliness of medication administration.

Conclusions: This project demonstrated a simple, novel and low cost approach to a widely described problem using fun, humour and the influence of respected senior hospital clinicians to improve interdisciplinary communication and timeliness of inpatient medication administration. The inititative is customisable to any healthcare setting through engagement of local clinical champions.