Get It On Time: Quality Improvement in timeliness of administration of medication for patients with Parkinson’s Disease

Local Situation:  

2023 audit showed 57% of Parkinson’s disease medications were given within acceptable time frame of thirty minutes of prescribed time. The target for this project is a sustained improvement (demonstrated by a run chart showing improvement over two months) with a minimum of 80% of these medications being given in 30 minute time window. 

Methods: 

Effective strategies from other centres and Parkinson’s UK resources were adopted to trail as PSDA interventions in our hospital: visual bedside timing reminder aids, educational sessions for nursing and medical teams, posters to raise awareness of importance medication timing amongst all ward MDT members. The number of missed, early, late and on time doses for all inpatients with Parkinson’s disease was checked twice a week to assess response to each of these interventions. Real time feedback was also collected from nursing staff with each intervention cycle. 

Results: 

The hospital is currently achieving an average of 70% of doses in time. Prompting use of visual aids with ward tours has helped reinforce behaviour change.  

Conclusions and future PSDA: 

Feedback from staff showed that visual reminders and alerts can lose impact when there are many already being used. We plan to trial bedside timers for the next cycle which are to be introduced at the medication reconciliation step in the patient journey. To maintain momentum and accountability the hospital systems team is supporting the development of a live monitoring system report for dosing lapses at any time in trust.