Abstract
This project was presented at the 2018 ANNA conference. Funding to support the author’s conference attendance was received from Parkinson’s New South Wales and Mid North Coast Local Health District.
Background: Individuals with Parkinson’s disease (PD) have more hospital admissions, longer hospital stay, more complications and worse outcomes compared with similar patients without PD. Limited understanding about PD among healthcare professionals and medication management are key issues for individuals with PD.
Methods: This study presents a collaborative clinical practice improvement project that was implemented in a hospital in New South Wales, Australia (September 2015 to May 2018) to resolve issues for patients with PD on admission to hospital. Innovative interventions were implemented to address specific issues identified in the study setting, including an emergency department patient tracking icon, early referral to pharmacists and measures to ensure on-time medication administration and avoidance of contraindicated medications. Qualitative and quantitative data were collected through focus group discussions with PD support group members, surveys involving nurses and patients/carers and a chart audit. Data were analysed using descriptive statistics.
Results: These initiatives resulted in practice improvements including identification of 100% of patients with PD presenting/admitted to hospital within 4 hours of presentation/admission, a 19% increase in patients receiving medications on time, an 89% reduction in prescription of contraindicated medications and reduced length of hospital stay. In addition, 80% of patients/carers reported they were very satisfied with their medication management.
Conclusion: Patient safety was improved and clinical staff expressed satisfaction with care provision. The initiatives were also standardised across the hospital in a clinical guideline for the care of patients with PD.