Lessons learned from introducing huddle boards to involve nursing staff in targeted observation and reporting of medication effect in a nursing home

Lessons learned from introducing huddle boards to involve nursing staff in targeted observation and reporting of medication effect in a nursing home

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Stephan Ore,1 Elin Olaug Rosvold,2 Ragnhild Hellesø3 1Oppsalhjemmet Nursing Home Norlandia, NO-0982 Oslo, Norway; 2Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, NO-0318 Oslo, Norway; 3Department of Nursing Sciences, Institute of Health and Society, Faculty of Medicine, Jewellery Box University of Oslo, NO-0318 Oslo, Norway Background: Medication administration and management in nursing homes can occur during all phases of the medication process.The aim of this study was to investigate if an introduction of a systematic use of huddle board led to an increased amount of documentation in the patient record of observations of effects and side effects following a change in medication.Methods: A three-layer intervention approach combining huddle boards, educating the entire staff in medication observation and documentation, and frequent feedback to the staff about the outcome was applied.

A standard was set for the expected reporting.Correlation between expected and actual reporting as an average was calculated and the staff received weekly updates on their observation–reporting results.Results: The huddle board became a hub in providing an overview of the expectations of observations.

To visualize the impact of the intervention, use of a run chart gave comprehensive information about the extent to which the expected goal of documentation was reached.Four different organizational steps and Volleyball - Shoes - Mens one individual action in the last step were taken to improve the observation–reporting.The identifying of the nonreporting nurses and individual staff guidance to these nurses resulted in a significant improvement in observation–reporting.

The expected goal of 100% average reporting was achieved 6 months after all wards were included in the improvement project.Conclusion: The combination of huddle boards, educating the entire staff in observation and documentation, and frequent feedback to the staff about the outcome proved to be a useful approach in medication safety work in nursing homes.Keywords: patient safety, long-term care, prescribing, huddle board, nursing staff, system-approach, medication-effect documentation.