(ID: 282) Qualitative review of medication pouches carried on ambulances within the South East using an open card sort methodology

Abstract Introduction Paramedics are healthcare professionals regulated by the Health and Care Professions Council [1]. They work autonomously, providing both immediate and emergency care in a variety of situations. Ambulance staff carry a range of medicines that are administered or supplied under Schedule 17 or Schedule 19 of the Human Medicines Regulations, 2012, or via Patient Group Direction (PGD) [2, 3]. The medicines used in the Trust are carried in 6 main types of small bag, or ‘pouch’. In addition to this, there are groups of non-registered staff (ambulance technicians, etc.) who are not permitted to operate under PGD or Schedule 17 exemption but still carry the same selection of medicines as registered staff. The pouches are packed, quality checked and sealed by the Medicines Team, led by the Chief Pharmacist. Anecdotal feedback from teams is that some medicines may not be in in the most appropriate pouch, and there is evidence that some pouches are so full that items are frequently damaged in transit. Aim The aims of this project were to identify changes to the configuration of medicines pouches to better fit the paramedic mental model and to receive feedback and make suggestions for further improvements in service efficiency and waste reduction. The objectives of the project were: map the mental model of clinical staff, receive suggestions for improvement with the medicines system and reduce wastage; make suggestions on how to separate schedule 19 medicines for ambulance technicians to carry. Methodology An open card sort methodology is traditionally used in website design and was used in a novel application to map the mental model of ambulance staff. Staff were asked to sort a selection of medicines into groups of their choosing. The participants were also asked questions to gain background information and further feedback. The card sort was open for a 4-week period and promoted to all SECAmb ambulance staff via email cascade, internal social media and Trust computer displays in ambulance stations. Ethics was approved by Brighton Research Ethics Application Manager (BREAM) and registered with SECAmb. Results A total of 168 ambulance staff responded to the card sort. Following data cleansing and analysis [4], the medicines were commonly sorted into 7 different pouches. Five of these were the same as the current pouch system, one pouch was renamed to make the contents of the pouch clearer, and one pouch was new. The changes suggested for the medicines system included a new drug bag design and listing the contents of the pouches on the outside so that staff would know what was contained within the pouch without the need to break the quality seal to look. There will also be a separate pouch for those medicines that can be administered by non-registrant staff. Discussion The suggested changes to the medicine pouches should lead to less wastage, lower medication costs and enhance patient care by facilitating quicker access to treatment in an emergency. Further feedback will be sought from staff using prototypes of the suggested pouch design before full implementation.