Background A first preliminary study conducted in 2017 among the mothers of a postpartum unit showed that 82% of medication administrations were not traced in the electronic medical chart. In this unit, for women postvaginal delivery only, midwives ensure patient management and prescribe basic pain medication, which are self-managed by the mother. These results reveal the insufficient traceability of self-managed medication in the postpartum unit.
Purpose To evaluate the professional practices of midwives before and after implementation of medication safety procedures by pharmacists.
Material and methods The first round of the audit took place in January 2018. The postpartum unit is divided into four 12-bed sectors and there are 18 midwives working 12 hour shifts. The main criteria evaluated was bedside pillboxes agreement with prescription and computerised traceability of self-administrations. All mothers systematically have the postvaginal delivery analgesia protocol prescribed and their individual chronic treatment if applicable. A mandatory computer commentary was added on the prescription software to be filled in by midwives every 12 hours at pillbox change to allow for twice-daily traceability of self-administered medication. At the same time, a medication safety action plan, including midwives’ awareness to medication errors, was implemented. Following the implementation of safety procedures, a second audit round was held in September 2018.
Results The first audit round involved 16 patients and revealed that 69% of pillboxes were in agreement with prescription. Prescription was computerised for 25% of non-protocol medications. Regarding medication administration, 25% of non-protocol administrations were traced, whereas 12.5% of protocol analgesics were. No medication administration was traced in real-time. The second audit including 11 patients, revealed that 100% of pillboxes were in agreement with the prescription. The prescription was computerised for 100% of non-protocol prescriptions. Ninety per cent of non-protocol medication administrations were electronically traced in real-time as were 75% of the per protocol analgesic administrations.
Conclusion These pharmacist-led medication safety actions made it possible to ensure safe self-management of postpartum treatments by mothers. Pharmacists’ involvement also helped meet the requirements of the French National Health Authority for the traceability of medication administration and medication self-management.
References and/or acknowledgements No conflict of interest.
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