The Science Journal of the American Association for Respiratory Care

2012 OPEN FORUM Abstracts

ON-TIME AVAILABILITY OF METERED DOSE INHALERS: A QUALITY PROJECT COMPLETED BY RESPIRATORY CARE AND PHARMACY TO ENSURE MEDICATION IS AVAILABLE IN A TIMELY FASHION.

Than Hla1, Melissa A. Acosta1, Pamela J. Dorrell1, Jana K. Harris2, Fred C. Harrison1, Mary J. Johnson1, Melissa J. Krueger1, Amelia A. Lowell1; 1Respiratory Care, Mayo Clinic in Arizona, Phoenix, AZ; 2Pharmacy, Mayo Clinic in Arizona, Phoenix, AZ

Having patient medications available on-time is important for safe and effective patient care. The Respiratory Care Department at Mayo Clinic in Arizona identified an issue with the availability of respiratory medications for patients with new respiratory treatment orders or for patients who had been transferred from another nursing unit within the hospital. Of particular concern was metered dose inhaler (MDI) availability. Since MDIs are not stored in the nursing unit Pyxis and must be delivered from the Pharmacy with each new order, the MDI was frequently not available for therapists to provide to the patient. Treatments were often delayed while therapists tried to get the medication from the Pharmacy. Additionally, when patients were transferred from one nursing unit to another, MDIs were not transferred with them and the therapists spent time looking for the medication. The group used multiple quality tools to identify the root cause of why the medication was not available. A fishbone diagram was used to identify potential causes of the problem. A data collection form was developed and information for 30 MDIs on 28 patients with new orders or who had been transferred was collected. Analysis showed that 47% of the MDIs were not available when the treatment was due. Using a Pareto chart to identify the frequency of each cause, it was determined that the most frequent cause was the pharmacy not sending the MDI on time. A process management chart indicating the process followed by Respiratory Care was completed. The pharmacy was contacted to review the information gathered from the project and to help identify a solution. All orders are entered electronically through the Cerner electronic medical record (EMR) system. It was identified that several methods of creating, correcting, or reordering medications are available. Regardless of the ordering method, therapists are notified via Cerner that a new medication has been ordered. It was discovered that unless orders were entered in a specific manner, the orders were not presenting to the pharmacy properly which caused the delay in medication delivery. As a result of the project, the Cerner notification process for the pharmacy was reworked. Therapists were educated on the proper method for ordering. Follow-up data collection on 20 MDIs was completed and analysis has shown that the on-time availability of MDIs has improved 70% from the baseline. Sponsored Research - None