Quality Improvement Project on Medication Refusal in Geriatric Care

Proceedings of the 2nd Global Conference on Aging and Gerontology

Year: 2025

DOI:

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Quality Improvement Project on Medication Refusal in Geriatric Care

Augustina Konadu Larbi-Ampofo

ABSTRACT:

Medication refusal in geriatric wards poses a significant challenge to patient care. Cognitive decline, polypharmacy, and social issues contribute to poor health outcomes and re-hospitalisations, burdening healthcare funding. This project aimed to improve nurses’ awareness and adherence to medication refusal guidelines in geriatric care. A two-cycle quality improvement project used the Plan-Do-Study-Act methodology to identify gaps in nurses’ knowledge, awareness, and practices regarding medication refusal. Baseline data were collected by surveying 150 geriatric care nurses on medication refusal guidelines. In the first cycle, 62.5% were aware of general guidelines, but 70% did not know where to find them. All nurses knew the proper actions when patients refused medication. To address this gap, a simplified hospital-specific guideline on medication refusal was uploaded to the intranet, and posters were placed in key areas. Consultant geriatricians, heads of nursing, clinical governance and communication teams were involved in change planning and implementation. After two months, awareness rose to 99%, identifying the Trust Intranet as the guideline source. Access to resources improved, with 99% feeling well-equipped compared to 77.5%. Despite initial gaps, adherence to best practices remained high, with 100% knowledge of medication refusal actions in both cycles. Training on medication refusal was incorporated into staff refresher courses to sustain these improvements. This project highlights that simplified guidelines and better resource access can enhance best practices in geriatric care.

keywords: Awareness, Guidelines, Practices