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Medicines safety

Improving the safe and secure storage of patient medication in secondary care

The work described here was presented at the UKCPA Virtual Conference Poster Day 2021

Medication errors such as dose omissions of critical medications can lead to patient harm. A strategy to ensure timely administration of medication is to increase rates of near patient dispensing. To enable this, appropriate facilities should be available for the safe and secure storage of patients’ own drugs by the bedside, which comply with national guidance. 

Previous audits have illustrated poor compliance with this across the Trust so a quality improvement project was undertaken on a 44 bedded ward to improve the safe and secure storage of patients own medications. 

Medication dispensed for specific patients or patients’ own drugs should be stored in a bedside locker. Often medicines were not stored securely due to lockers being left unlocked, and medicines regularly left out for ease of access. Nurses were also unsatisfied with the functionality of the bedside lockers. 

Only 61 percent of lockers were locked and nearly one third of lockers were defective

Previous audits across the Trust, staff feedback and incident reports highlighted a problem with the appropriate use of bedside lockers. Across the Trust only 69 percent of patient’s own medication was stored inside bedside lockers, only 61 percent of lockers were locked and nearly one third of lockers were defective (such as broken locks). Stakeholder discussions identified broken lockers as the biggest barrier to storing patient’s medicines safely and securely.

After collaboration with stakeholders, interventions included all bedside lockers being restored to full functionality and new electronic keys being provided. This intervention was carried out on the infectious diseases ward only. 

Interventions were tested using Plan, Do, Study, Act (PDSA) cycles. The interventions were performed in August 2020 and led by the pharmacist and pharmacy technician. 

Quantitative and qualitative data was collected at baseline and after each intervention for the measures below: 

  • Number of beds with PODS securely stored inside locker
  • Bedside locker being locked if storing medicines
  • Bedside locker functioning as intended 
  • Nurse satisfaction with bedside lockers on ward.

Following the PDSA cycles, 100 percent of bedside lockers were functioning as intended. Compliance to medication being stored inside the bedside locker increased from 40 to 41 beds (91 to 94 percent), with around three-quarters (33 beds) of bedside lockers being locked compared with less than two-thirds (22 beds) at baseline. Nurse satisfaction with the bedside lockers also increased post-intervention. 

Stakeholder involvement was key to the project’s success and staff feedback was positive. Further improvement work needs to be carried out to ensure that medication is always locked away in the bedside lockers. Further improvement cycles include education about the importance of the safe and secure storage of patients own medications. 

The opinions expressed in this article are those of the author. They do not purport to reflect the opinions or views of the UKCPA or its members. We encourage readers to follow links and references to primary research papers and guidance.

Competing interest statement: 

The author declares: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

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