THE DEVELOPMENT OF A PAEDIATRIC SPECIFIC ONLINE INJECTABLE MEDICINES GUIDE Stage one: An assessment of paediatric nurses current practice Lilley R, St James's Hospital. Collins S, Leeds General Infirmary. North-Lewis P, St James's Hospital, Leeds Teaching Hospitals NHS Trust (LTHT), UK
The National Patient Safety Agency (NPSA) set out recommendations for the availability of technical information for the preparation and administration of injectable medicines in 2007 . This survey was undertaken to establish which sources of information paediatric nurses use when preparing or administering drugs and their level of satisfaction with them. This is part of an overall service development to improve the safety of injectable drugs for paediatric patients.
Methods: Ninety questionnaires were distributed to nurses in 18 paediatric areas over two LTHT sites. The questionnaires, containing 7 questions, were designed to assess the opinions of staff who administer injectable drugs.
Results: Of the questionnaires distributed, 86% were completed; respondents represented a range of nurses (58% band 5, 26% band 6, 17% band 7). On the whole respondents were satisfied with the standard of technical information they currently utilised: the median satisfaction score was 7 out 10 (where 1 was very dissatisfied and 10 was very satisfied). However, the majority of responders believed that they did not have access to technical information from 4 out the 9 categories suggested by the NPSA. For example whilst 61% believed that information regarding reconstitution was supplied for most injectable medicines, 68% believed that they did not have access to specialised technical information (e.g. displacement values) for the majority of the injectable drugs they administered.
74% of nurses use at least three resources to find technical information, less than 7% of those questioned use only one reference source. The most commonly utilised were the BNFC (90%), product information leaflet supplied with the drug (83%) and ward based literature (posters, files etc) (81%). Only 21% used the online Injectable Medicines Guide (Medusa) although it is available throughout LTHT. Ward based guides were often out of date, with some not updated since 1997 (median 2006, range 1997-2009).
Conclusions: Although the majority of paediatric nurses surveyed appeared satisfied with the quantity of information available regarding paediatric injectable drugs, further questioning showed a lack of accessibility of technical data at ward level as recommended by the NPSA. Paediatric nurses most commonly used the BNFC as a reference source, however it does not provide the detailed technical information required.
This survey has highlighted the need for a comprehensive single resource for nurses to use at ward level that is easy to maintain and update. We are now in the process of developing a paediatric specific online injectable medicines guide to meet this need.
References: 1. NHS National Patient Safety Agency. Patient Safety Alert: Promoting safer use of injectable medicines. s.l. : NPSA, 2007. Ref: NPSA/2007/20.