Implementing a Medication Advisory Committee (MAC) in a Residential

ABI Service

DONNA CLARIDGE, JOANNE HERBERT

AND ROBYN BREWIN

Introduction of Austin Street

•Design specifically to cater for 10 young people with an acquired brain injury. •Open August 2010 •Non government Organization Villa Maria •Funded by the department of Human Services •My Future, My Choice initiative

Vision of Austin Street

•Provide support in medical, social, psychological and rehabilitation care •Person Centered Approach •Holistic focus for each resident based around their dreams and goals •Unique model providing 24/7 active support from nursing staff and residential support workers

The Residents

•Residents aged from 25-50 years old •Very high complex health and care needs, such as; Memory problems Epilepsy Diabetes Visual Disorders Attention & Concentration issues Motivation Hypersensitivity Depression Anger Communication problems Hearing difficulties Impulsivity Self-centeredness Swallowing disorders

Why we needed a medication advisory committee MAC? •Policy of Austin street is that medication is only administered by nursing staff due to the high complex needs of the residents •Need to maintain residents health •Need to support resident when unwell •Duty of care to provide guidelines, education, current and up to date information and practice on the use of medicines •To facilitate a meaningful framework for best practice in medication management •July 2012 MAC was implemented

Who was invited to participate ?

Invitation was sent out to the following requesting their representation and participation in the Medication Advisory Committee: Consultant Pharmacist Owner/Operator/ Pharmacist of our appointed pharmacy DHS Family representative of Austin Street residents Austin Street Doctor by invitation Villa Maria quality coordinator by invitation Austin Street – including Nursing Staff, Clinical care Coordinator and Manager

Implementation of the MAC

•Meeting to be formally minuted •A set agenda consisting of: Managers report Clinical Coordinators report Incident reports PRN usage Pharmacists report General business

•Meetings conducted quarterly •Meeting guided by formal terms of reference

Meeting opportunities

•Discuss common issues •Model and promote best practice in the workplace •Problem solve •Reflect •Share information and resources •Learn and promote training opportunities

Objectives

•To review, implement and evaluate Disability Service policies and procedures in relation to best practice in medication management •To be a point of referral and a resource in relation to medication administration at Austin Street. •To improve and maintain open communication between Austin Street, Austin Street Medical Practitioners and the appointed Pharmacy •To monitor and review all aspects of medication management for residents, inclusive of legislative requirements. In Particular: Code of Guidance: Management of the administration of medications (Disability Services) – AHPRA Disability ACT 2006 Drugs, Poisons and Controlled Substances ACT Villa Maria Policies and Procedures

•To review the outcome of medication audits initiated by the Austin Street Clinical Care Coordinator. From these Audits identify and analyze •To review all medication related errors and incidents, and identify and patterns •To monitor staff practice and make recommendations regarding staff training and development •To monitor outcomes from the implementation of recommendations from the medication reviews. •To identify areas for continuous improvement, recommend system changes to the quality coordinator •To provide the opportunity for family advocate to provide input into decisions in relation to medication management

Challenges of implementing the MAC

•Inability for medical practitioners to attend due to the time for the meetings in the morning •Maintain confidentially

Achievements

•Introduction of nurse initiated medications •A new procedure for obtaining medication phone orders from medical practitioners •Commencement of annual medication reviews and weekly reviews and required •Introduction of medication audits •Implementation of pain assessment charts and pain management strategies •Guidelines for best practice for enteric medication administration •Submission of reports regarding medication use and adverse effects •Ongoing education resources and training sessions

•The greatest achievement has been to increase our knowledge and resource base.

Most important achievement

MANAGER CLINICAL CARE COORDINATOR

TEAM LEADER

RESIDENTIAL SUPPORT WORKERS

NURSING STAFF AUSTIN

ST RESIDENTS

MANAGER CLINICAL CARE COORDINATOR

TEAM LEADER

RESIDENTIAL SUPPORT WORKERS

NURSING STAFF AUSTIN

ST RESIDENTS

CONSULTANT PHARMACIST

MANAGER CLINICAL CARE COORDINATOR

TEAM LEADER

RESIDENTIAL SUPPORT WORKERS

NURSING STAFF AUSTIN

ST RESIDENTS

CONSULTANT PHARMACIST

APPOINTED PHARMACIST

MANAGER CLINICAL CARE COORDINATOR

TEAM LEADER

RESIDENTIAL SUPPORT WORKERS

NURSING STAFF AUSTIN

ST RESIDENTS

CONSULTANT PHARMACIST

APPOINTED PHARMACIST

DHS

MANAGER CLINICAL CARE COORDINATOR

TEAM LEADER

RESIDENTIAL SUPPORT WORKERS

NURSING STAFF AUSTIN

ST RESIDENTS

CONSULTANT PHARMACIST

APPOINTED PHARMACIST

DHS

GENERAL PRACTITIONER

MANAGER CLINICAL CARE COORDINATOR

TEAM LEADER

RESIDENTIAL SUPPORT WORKERS

NURSING STAFF AUSTIN

ST RESIDENTS

CONSULTANT PHARMACIST

APPOINTED PHARMACIST

DHS

GENERAL PRACTITIONER

FAMILY REPRESENTATIVE

•Advocacy •Lay perspective •Involvement •Peace of Mind

References

• www.health.vic.gov.au/dpu/downloads/medication/resource kit

• Resource details to enable one to consider and implement a ‘MAC’