1449 Drug drills: improving paediatric team performance and confidence when prescribing and preparing unfamiliar emergency medications

Abstract

Background Emergency medications are infrequently required in district general paediatric departments, however when they are it is important for them to be given in a timely manner. Feedback from local simulation scenarios revealed that prescribing and preparing unfamiliar emergency medications was something that both medical and nursing teams felt anxious about. Regular simulation practice is therefore essential for improving patient care and safety in emergency scenarios. Objectives The aim of this project was to improve paediatric team ability and confidence when prescribing and preparing unfamiliar emergency medications in order to improve patient care and safety. Methods A series of ‘drug drills’ involving emergency medication were created: asthma (salbutamol and magnesium sulphate); sedation (morphine and midazolam); duct dependent cardiac disease (prostaglandin) and septic shock (adrenaline and noradrenaline). Doctors timed how long it took to prescribe the medication after reading a scenario. Nursing staff subsequently timed how long it took them to prepare and administer the medication. Participants completed an online survey after the ‘drug drill’ and were asked to record how long it took for them to complete the drill, and whether they felt more or less confident prescribing/preparing these medications. They were also encouraged to provide feedback and learning points to be shared amongst the team to facilitate shared learning. In future,‘drug drills’ will be repeated to assess whether our performance and confidence has improved as a result of extra practice and group feedback. Results To date, ‘drug drills’ have been completed by 19 doctors and 12 nurses. Preliminary results and feedback have been positive with 100% of staff saying they felt more confident prescribing/preparing medication after completion. As a result of the feedback received, changes have already been implemented to help staff in future. For example, we have increased the stock number of 50ml syringes in the resuscitation room as this consistently delayed drug preparation. Also, prescription and administration guidelines are now available on a tablet in the resuscitation room for ease of access. Conclusions Staff had improved confidence after completing the ‘drug drills’, which is expected to translate into better performance and patient care. We aim to repeat these drills in the future to see if our prescribing and preparation times have improved, and whether we have leant from learning points that were identified from feedback.