Finalist in 2017 NSW Health Awards

In October 2017, Parkinson’s NSW Nurse Vincent Carroll along with colleagues from the Mid North Coast Local Health District  and the Parkinson’s NSW Support Group, were recognised for a joint project in the Category ‘Patient Safety First’

The NSW Health Awards recognise innovation and excellence in the delivery of health programs and services to the NSW community throughout the public health system.

The project:

On Time, Every Time for People with Parkinson’s (Mid North Coast Local Health District)

A project to reduce the quantity and duration of patients with Parkinson’s Disease presenting at the emergency department.

 

Challenge

Literature identifies 66 per cent of patients with Parkinson’s Disease (PD) visit hospital each year with 75 per cent not receiving medications on time. Delaying medications for greater than 15 minutes can worsen tremors, rigidity, confusion, agitation, and anxiety. Sixty-six per cent of patients are prescribed contraindicated drugs with serious complications, mostly neuropsychiatric (greater than 50 per cent of patients). Abrupt cessation of PD medications can have severe consequences.

Clinical reviews identified problems PD patients experienced, confirmed by consumer focus groups.

The initial aims were far greater than 75 per cent of PD patients:

  • Identified within four hours of admission
  • Receive on-time medications
  • Carer satisfaction with medication

Solution

The multidisciplinary team developed an innovative strategy to improve safety in this vulnerable patient group, addressing:

  • Medication management
  • The enhancement of clinical knowledge

The interventions focused on:

  • A patient safety approach, bridging departmental and professional barriers
  • Continuation of exact personal medication regimens
  • Identifying and avoiding certain medications harmful to PD patients
  • Identifying alternatives for when a person is nil by mouth.

Results

Initial aims were met, other efficiency and productivity results achieved included:

  • Access to medications in Emergency
  • Reduced prescribing of contraindicated medications
  • On-time medication administration
  • Risk reduction related to indirect outcomes, eg. falls caused by contraindicated medications
  • Reduction in average lengths of stay for PD as a secondary diagnosis, from 9 to 6.2 days
  • Improved teamwork resulting in direct and flow-on efficiencies.

The project is extending across the Local Heath District.

Acknowledgments

Coffs Harbour Parkinson’s Support Group

Parkinson’s NSW

Nambucca Valley Radio

Read more about the 2017 NSW Health Awards on the Health NSW website

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