Facilitators and Barriers to Safe Medication Administration to Hospital Inpatients: A Mixed Methods Study of Nurses’ Medication Administration Processes and Systems (the MAPS Study)
Fig 5
Spaghetti diagram showing changes in travel pattern of one nurse during a ‘two-nurse’ evening drug round at site C (map of ward not drawn to scale).
At site C, two nurses typically worked together on the drug round to administer medications to all patients; one nurse ‘caller’ and one nurse ‘runner’. The diagram shows the path of travel by the nurse ‘caller’ who initially stayed with the drug trolley: she used the laptop attached to the drug trolley to access the patient’s electronic medication administration record, called out doses to the ‘runner’ to retrieve medications from the bedside medication locker and prepared some doses from the drug trolley. After preparing medicines for the patient in room 6, the nurse caller went ‘ahead’ while the nurse runner remained to administer the doses; this process was repeated whenever a patient required assistance to take the medicines and led to a ‘single-nurse’ drug round for parts of the remaining round. During the drug round, the nurse caller went to the nurse base station twice (to retrieve a patient‘s folder to check oxygen saturation and to retrieve another patient’s folder for paper warfarin medication order) and treatment room once (to retrieve medication from the fridge). S03, site code; DR045, drug round code; N34 and N31, nurse codes.