Developing a culture of medication safety in the rural palliative care home setting New South Wales (NSW) Australia
Bibliographic record
Abstract
Improving Medication Safety for Clients and their Carers in the Rural Palliative Care Home Setting Project commenced January 2008 in response to an error involving a carer administered medication. Clinicians identified that no formalised process existed within NSW for carer medication administration despite a widespread practice of carers administering subcutaneous medications at home, especially in the last few days of life. It was recognised that formalised protocols and standardised training for carers were required to ensure patient safety. The need to respect patient and carer choices is emphasised throughout care while providing effective symptom control in the palliative care home setting. The project consisted of evaluating a carer's preparedness to administer subcutaneous medications and provided education and structured support to the carer to administer these medications. A culture of medication safety emerged that was welcomed and embraced by patients, carers and families and the clinicians. The project developed a legal and ethical framework on which to base these standardised practices. This project was an initiative of a health promoting palliative care service as per Allan Kellehear's 1999 model with service delivery strategies based on the five major ‘action’ principles of the Ottawa Charter. The outcomes demonstrated that carers were trained to safely administer subcutaneous medication and there were no medication errors. Additional outcomes included improvements in After-Hours Occupational Health and Safety for staff, and improved the end of life decision-making abilities and processes for patients, carers and families enabling choice in place of care.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.015 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.008 | 0.007 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.009 |
| Research integrity | 0.001 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".