Establishing an Electronic Referral System from Speech and Language Therapy to Pharmacy to Improve Medication Administration in Patients with Dysphagia in an Acute Hospital Setting

Abstract

Dysphagia affects swallowing not only of food and drink, but also of orally administered medications. Altering solid or liquid dose formulations renders administration unlicensed and may have adverse effects. Medication administration in patients with dysphagia necessitates a multidisciplinary approach with no one profession holding all necessary expertise. This project aimed to improve the process of medication administration for patients with dysphagia in an acute hospital. Following a baseline audit of practice, an electronic referral system from Speech & Language Therapy (SLT) to Pharmacy was established. Repeat post-implementation audits documenting medication administration to patients with dysphagia and SLT compliance in completing electronic referral were conducted. Of the 43 patients included in the post-implementation audits, 14 (32.6%) were referred from SLT to Pharmacy using the electronic referral system. Those patients referred electronically were reviewed by Pharmacy quicker than those patients who were not referred and had a higher percentage of optimally administered medications. All SLTs eligible (n = 10) were surveyed to explore use of the system and barriers to its use; reasons given for not completing an electronic referral included not prioritizing the referral if under time pressure and lack of IT access to make the referral. Overall compliance with use of the electronic referral system was lower than expected; further work is needed to establish consistency of practice in using the electronic referral system in the interest of optimizing medication administration to patients.

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Correspondence to Sheila Robinson.

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Conflict of interest

The primary author (SR) received sponsorship of €73.80 from Rosemont Pharmaceuticals towards printing a poster based on the completed study. Rosemont Pharmaceuticals had no input into the content of the poster and no involvement with the manuscript itself. The second and third authors (JH, SMcC) declare that they have no conflict of interest.

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Permission was sought and granted by the Clinical Research and Ethics Committee (CREC)/ Social Research & Ethics Committee (SREC) of the Cork Teaching Hospitals (online Appendix 1) and the Quality Unit of CUH (online Appendix 2).

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Robinson, S., Hosford, J. & McCarthy, S. Establishing an Electronic Referral System from Speech and Language Therapy to Pharmacy to Improve Medication Administration in Patients with Dysphagia in an Acute Hospital Setting. Dysphagia (2021). https://doi.org/10.1007/s00455-021-10256-w

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Keywords

  • Dysphagia
  • Pharmaceutical preparations
  • Medication administration
  • Multidisciplinary
  • Patient safety
  • Electronic referral