Large savings from nurse-led sustainable approach to meds

Rebecca Gibbs's picture

This University Hospital Southampton Green Ward Competition project was conceived of and led by nurses and won!  See below for what they did and what it saved.  If you are thinking of doing the same post on the network and let us know how you get on.

Reducing duplicate ordering of medication – Acute Medical Unit

Goal: To reduce the amount of duplicate medication orders on the Acute Medical Unit through cooperation with patients and families.

Background: The Acute Medical Unit (AMU) is a 57-bedded ward tending to the acute health needs of the Southampton population and surrounding areas. As a busy ward, medications that are ordered specifically for individuals are often ordered multiple times. This is an extra cost to the unit, Trust and environment with the amount of medication purchased and then later disposed and wasted.


1.           The goal and background of the project was communicated to the team.

2.          Baseline data was collected.

3.          A Team Leader of each area checked each shift that medication in the iBin (location of all ordered medication) was in the correct POD (patient own drugs) cupboard so that medication was transferred with patients to wards.

4.          To prompt the Team Leader to do this a ‘tick box’ was introduced on the white boards of each area to prompt and remind staff to perform the checks each shift at 0730, 1200 and 2000.

5.          Follow up data was collected during the project.


At baseline, there was no formal process for avoiding duplicate medication orders. After thirteen weeks of running the project, there was an average reduction of 50 duplicate medication orders per week. It is important to note that there will be variation throughout the year depending on the number of patients and the staff demand, further support would be required to identify this variation. Medication cost data was unavailable from the pharmacy; however, we have assumed a conservative estimate of £10 per average medication order as medication costs have a range of thousands of pounds. Using this estimate and the average medication reduction from the duration of the competition, the yearly savings would amount to £26,000 and 11,180kgCO2e using a carbon conversion factor of 0.43KgCO2e/£ for medication orders. These projections are underestimates as time savings in medication orders are reduced every time a duplicate order is averted and medication disposal costs are not included. Furthermore, this does not measure the benefits of patients not waiting for new orders of medication to continue with their treatment.

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