Introduction of 'Anaphylaxis Packs' to improve XXXX safety in a hospital setting.

@entity1 @entity1425 @entity701 @entity17567 @entity2021
Three reported episodes of @entity2021 , where 1:1000 @entity1425 was not immediately obtainable, triggered us to assess its availability on all adult wards. We found @entity1425 was unavailable on 50% of audited wards. A questionnaire for doctors and nurses revealed lack of knowledge on both the management of @entity2021 and location of emergency drugs. Given that @entity2021 is a treatable but potentially fatal condition, we held a meeting to discuss the situation with senior pharmacists, resuscitation managers, and senior doctors. Our intervention was to advise the production of ' @entity2021 packs' as part of the crash trolley kit. This was to be added to the laminated crash trolley check list and to include @entity1425 , @entity17567 , @entity701 , and the @entity2021 algorithm. The aim was to improve ward stock, staff knowledge, and create a consistent location for emergency drugs, so minimising @entity1 error, and @entity1 harm. With a PDSA approach we trialled the intervention on four pilot wards. The packs have now been dispersed trust-wide. Re-audit at four months showed 100% ward stock of @entity2021 packs, more consistent drug location and improved staff knowledge. There were 17 coded incidents of @entity2021 at this hospital in 2011, the actual figure likely being higher. We feel our project has greatly improved @entity1 safety in this area.
