Safe medication storage in the intensive care unit at a general private Iranian hospital: a best practice implementation project
Behrouz Amini, Maryam Soleimanpour, Mahdieh Esmaeilnezhad, Bahram Jafarinodeh, Azam Badrgholi Tabrizi, Sakineh Hajebrahimi, Mahdieh Asghari, Neda Kabiri, Amin TalebpourABSTRACT
Introduction:
Medication safety in the intensive care unit (ICU) is critical due to the high-risk nature of the environment and the vulnerability of patients. Implementing evidence-based guidelines and structured interventions has been shown to enhance compliance with the best practices, thereby reducing errors and improving patient safety.
Objectives:
The aim of this project was to improve medication storage practices in the ICU of a general private hospital in Tabriz, Iran, by implementing evidence-based interventions.
Methods:
This evidence-based implementation project followed the JBI Evidence Implementation Framework and was conducted in seven phases. A baseline audit was conducted to identify gaps in compliance with the best practices. After the implementation of improvement strategies, a follow-up audit was conducted to measure any changes in practice. Three audit criteria, representing best-practice recommendations for safe medication storage were employed. Twenty eight nurses participated in baseline and follow-up audits.
Results:
The baseline audit revealed low compliance with organizational policies (7%) and inconsistent adherence to manufacturer-recommended storage guidelines (75%). After the intervention, compliance with organizational policies and adherence to storage recommendations increased to 90%. Access control to medications remained consistent at 100% for both audits. The barriers to compliance with best practices included misalignment with the hospital's policies and guidelines due to the pharmacy's private ownership, and lack of an organizational policy and instructions for safe storage of medications. Improvement strategies included holding educational sessions and issuing and communicating medication management instructions to ICU staff.
Conclusion:
This study highlights the importance of structured organizational policies, educational initiatives, and collaborative efforts to enhance medication safety in ICU settings. It demonstrates that evidence-based audits and targeted interventions can address critical gaps in medication management, aligning with previous research on the role of policy and training in improving clinical practices and patient safety.
Spanish abstract:
http://links.lww.com/IJEBH/A586