Medication Management in a Non-medical Environment

The Participation and Inclusion program offers community based and on-site recreational, life skills and creative arts programs to Holland Bloorview clients and community participants. Programs are designed to support clients with disabilities, often with significant complexity and participants who are typically developing. Programs are run by staff without a health care background such as nursing. Many of the children/youth who attend these programs must be administered medications during programming. Historically, each program had its own method of managing medication. Following a voluntary review of medication practices by the Institute of Safe Medication Practices and a failure mode effects and analysis (FMEA), standard protocols were established that adapted medication management best practices to a non-medical environment. The teams created and adopted a common intake form to collect medication history, and developed a new medication administration record with photo identification. Programs implemented two patient identifiers when giving medication, introduced wrist bands, same name flagging, the practice of two staff members verifying medication administration records, which also includes family sign off The project enhanced practice, provided a safe work environment for staff, improved safety with existing non-nursing resources, and maintained the community-based recreational, life skills and creative arts focus of these programs. These improvements support access to quality of life programs for clients with disabilities who have medication needs. Practices such as the medication form have been adopted by others and this work has received international recognition at the Institute of Healthcare Improvement.