Dr Karen Davies1,2, Dr Karen Hay3, Professor Karen Whitfield2, Ms Karen Chippindall4, Dr Peter Donovan1,2, Professor Samantha Keogh1,5, Professor Ian Coombes1,2
1Royal Brisbane And Women’s Hospital, Herston, Brisbane, Australia
2University of Queensland, Brisbane, Australia
3QIMR Berghofer Medical Research Institute, Herston, Brisbane, Australia
4Redcliffe Hospital, Redcliffe, Australia
5Queensland University of Technology, Kelvin Grove, Australia
Introduction: The Medication Administration Evaluation Feedback Tool (MAEFT) is a validated 22 criteria best practice checklist, to evaluate nursing adherence to medication administration guidelines, including infection prevention strategies and antimicrobial management.
Methods: The study was a sequential, incomplete, stepped-wedge, cluster randomised trial with three one-month phases: control, intervention and follow-up intervention. It included two hospitals, six randomised wards, with fifteen consented nurses in each ward (total n=90). The intervention used the MAEFT for nurses to self-assess their performance before being observed administering medications and provided formative feedback on their performance. Participant acceptability was measured with a 10-question survey.
Results: Control, nurses adhered to guidelines 88% of the time (IQR: 83-93), compared with 94% (89-100) (p<0.001) with the intervention, and 95% (93-100) (p<0.001) with follow-up. For self-assessment, participants believed they adhered to guidelines 92% of the time (85-98) with the intervention and 97% (87-100) at follow-up (p=0.001). There was 21% improvement conducting the 5 moments of hand hygiene, 25% increase labelling medicines such as antibiotics, 33% improvement refusing to administer a prescription that is not correct, 49% improvement in asking the patient if they knew what the medication was for, 13% increase in both asking the patient what they are allergic to and conducting a 2-nurse check of high-risk medications such as antibiotics at the bedside. Participants found the process a positive experience.
Conclusion: The study shows that using the MAEFT demonstrates a statistically significant improvement in nurse’s compliance with medication administration including antibiotics, compared to prior to the intervention.
Biography: Karen is a Nurse Research Fellow with the Herston Infectious Diseases Institute (HeIDI). Karen has 18 years’ experience specialising in the role of safe medication practice for nurses as well as doctors, and pharmacist. She has a special interest in IV administration practice research. Karen conducted her PhD at the University of Queensland designing a tool to evaluate nurses medication administration standard of practice and continues this program of work with postdoctoral studies.