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Self-administration of medications in inpatient postnatal women: an opportunity to empower self-care, improved medicines knowledge and adherence utilising clinical pharmacists and midwifery workforce and use of a midwife formulary
  1. Sherry Ann Wright1,
  2. Claire Higgins2,
  3. Jenny Carson1,
  4. Moira Kinnear3,
  5. Pauline Smith4,
  6. Nirmala Mary5,
  7. Emma Westall6,
  8. Sadaf Arshad1
  1. 1Lead Pharmacist, Women's Services, Royal Infirmary of Edinburgh, NHS Lothian University Hospitals Division, Edinburgh, UK
  2. 2Pharmacy Technician, Women's Services, Royal Infirmary of Edinburgh, NHS Lothian University Hospitals Division, Edinburgh, UK
  3. 3Pharmacy, Education and Research and Development, NHS Lothian University Hospitals Division, Edinburgh, UK
  4. 4Clinical Midwifery Manager, Women's Services, NHS Lothian University Hospitals Division, Edinburgh, UK
  5. 5Consultant Obstetrician, Women's Services, Royal Infirmary of Edinburgh, NHS Lothian University Hospitals Division, Edinburgh, UK
  6. 6Charge Nurse, ward 119, Midwifery, Women's Services, NHS Lothian University Hospitals Division, Edinburgh, UK
  1. Correspondence to Sherry Ann Wright, Lead Pharmacist, Women's Services, Royal Infirmary of Edinburgh, NHS Lothian University Hospitals Division, Edinburgh EH1 3EG, UK; sherryann71{at}hotmail.com

Abstract

Objectives To assess the impact of self-administration of medicines (facilitated by a midwife formulary) on postnatal women’s knowledge of certain post-delivery medications, awareness of the Green Bag Scheme, factors contributing to constipation, pain satisfaction, adherence, and time released to midwives plus feedback from these women and their midwives.

Methods The study was conducted in consented postnatal women, who self-administered medications from their bedside lockers. The mode of delivery and parity were recorded. Data were compared in women who self-administered to those who did not. Midwives used our established midwife formulary to write their essential unprescribed medications. Direct interview questionnaires were used to obtain their knowledge on chosen post-delivery medicines, pain satisfaction, the Green Bag Scheme and factors contributing to constipation. Regular medicines counts were used to check adherence. Midwives’ time not administering these self-administered medications was estimated. Self-reported questionnaires were used to obtain feedback from participants and midwives. Responses were analysed proportionately and where appropriate by simple statistics.

Results Women (n=203) who self-administered were compared with those (n=401) who did not. Greater medicines’ knowledge and better (96% vs 79%) pain satisfaction were found in self-administering women. Knowledge of each contributing factor to constipation varied. Mode of delivery and parity had no impact on these outcomes. Adherence seemed high 96% (195/203). Awareness of the Green Bag Scheme was poor (66/604). Most women, 94% (191/203) found the service helpful and 89% (178/200) would take part again. At least 224 hours were released to midwives by these self-administering women. 164/203 (81%) midwives felt the scheme was beneficial.

Conclusions Self-administering women had better pain satisfaction, medication knowledge and adherence. The need to improve engagement in the Green Bag Scheme was flagged. This service, supported by use of a midwife formulary, can release time to midwives to do other tasks including care for women with more complex issues. A business case for this service is under review.

  • pharmacy service
  • hospital
  • workforce
  • reproductive medicine
  • acute pain
  • practice guideline

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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