A novel program of self-administration of medications within an acute inpatient rehabilitation unit

Abstract

Introduction: Self-administration of medications (SAM) is a critical component of independent living in the face of chronic illnesses. The current local practice, where nurses manage all aspects of inpatient medication administration, has significant limitations in promoting this important activity post-discharge. Inpatient SAM is considered novel in Singapore. In this paper, we aim to describe the process of establishing a SAM program in a local rehabilitation inpatient ward. Materials and methods: In 2016, a multidisciplinary workgroup was formed in a local general hospital to develop a SAM protocol to empower participants to better self-manage their medications post-discharge through a series of graduated assessments and targeted education. The program started as a pilot in April 2017, and was eventually expanded to all rehabilitation wards within the hospital. Medication errors and near-misses were tracked, and surveys targeting participating patients and staff were given at the end of each encounter. Results: As of 31 December 2019, 160 patients were enrolled into the SAM program. Of these, 75, 63 and 22 patients were in SAM 1, SAM 2 and SAM 3 (tiers representing differing independence levels), respectively, at discharge. There were no medication errors. One near-miss was reported. The program was well-received by both patients and staff. Conclusions: We present a novel and viable protocol for the inpatient selection and assessment of patients, with the aim of supporting safe SAM post-discharge through educational empowerment and early identification of barriers with interventions.