Parkinson's nurse wins award for developing a new system to monitor access to timely medication

Nick, a specialist Parkinson's nurse at Biggart Hospital in Prestwick, recently won an advanced project award from the Parkinson's Academy for his work around improving the timely administration of Parkinson’s medicines.

He has been a Parkinson’s nurse for 13 years, after starting out as a general nurse, where he spent time on a geriatric rehab ward, meeting lots of people living with Parkinson’s. When he started in his role as a Parkinson’s nurse, covering Ayrshire, one of the biggest challenges Nick faced was knowing when his patients had been admitted to hospital. There was no system in place to alert specialist nurses when their patients were hospitalised.

Introducing electronic prescribing

To try and improve this issue, Nick began speaking with colleagues to see if there was a way to receive automatic notifications when patients entered the hospital. Electronic prescribing, which NHS Ayrshire & Arran was already practising, proved to be key.

Nick explained: "We approached our digital pharmacist, Richard Cottrell, with a basic premise. We wanted to know if we could use electronic prescribing to tell us when our patients were in hospital, based on where Parkinson’s medication was being given."

It turned out to be completely possible. Nick and the Parkinson’s team now receive an automatic email every morning at 7am, which tells them the name of the patient, which hospital they are in, what medication they are prescribed, what times they have been prescribed and what times they were given. These reports, which summarise the previous 24 hours, cover every administration, for every medication for Parkinson’s, for every patient in a hospital in Ayrshire and Arran.

"It was set up and all we wanted to know was if our patients were in hospital. But through the way it was developed, we ended up also knowing how medicines were prescribed and administered. So that took us forward another step," continued Nick.

Moving a step further

Nick and his colleagues now also receive a monthly set of data on the timing of every administration of Parkinson’s medication within a hospital in Ayrshire and Arran. 

Explaining how the system works, Nick said: "We use the NICE guidance, which states that Parkinson’s medication should be administered within 30 minutes, either side of the prescribed time. We see whether medication given in hospital is within this 30 minute window, indicated with the colour green, or late which is marked red.

"This means we can monitor if people are on the right medication and whether or not it is being given at the right time. So we can properly assess where we never could before, down to the second."

The role of the Parkinson's tulip in Parkinson's timely medication administration

While there were clear benefits from the new system, data obtained through the system showed that the timely administration of Parkinson’s medicines remained a challenge. So the team worked to develop a further system of dynamic visual prompts, which appear alongside relevant patient details on the ward electronic whiteboard. Clear improvements were soon achieved in the proportion of administrations of Parkinson’s medicines given within 30 minutes of scheduled administration.

Richard Cottrell, digital pharmacist explained: "Previously we had done work with pill timers and alarms to remind staff when to give medication, but what we developed automated the whole process.

"Now on the whiteboard in the ward, every patient prescribed Parkinson’s medication has a tulip symbol beside their name. It acts as a visual prompt, flashing when it’s close to the time to give medication. We implemented this on a couple of wards and it had a really big impact in terms of timely administration. It’s now been rolled out to just about every ward in Ayrshire and Arran."

Collectively the work of the team in Ayrshire helped to reduce staff time by establishing a patient's medication needs and ensuring they receive the best treatment tailored for them. It is hoped that the model will eventually be introduced in NHS boards across Scotland.

The 2022 UK Parkinson's Audit showed that only 42% of people reported getting their medication on time while in hospital. The Parkinson’s Excellence Network is working to ensure all people with Parkinson’s receive their medications correctly and on time, every time, when they're in hospital. 

Time critical medications is one of our national priority programmes, launched in response to service improvement priorities identified in the 2019 UK Parkinson’s Audit. Read more about the UK Parkinson's Audit.

Recognition from the Scottish Parliament

Nick's achievements don't stop there. He was recently recognised by members of the Scottish Parliament for the work he's done to improve the timely administration of Parkinson’s medication to hospital patients in Ayrshire. Sharon Dowey, MSP, put forward the motion, which received backing from a cross-party group of MSPs.

Commenting on the recognition, Nick said: "It’s great to be recognised like this, but this was a real team effort and the credit belongs to everyone who was involved."

Well done again to Nick and the whole Ayrshire team! Their work is a fantastic example of best practice in Parkinson's medication management.