Author Biographical Info

Mary Chilaka, RN, is a hematology/oncology nurse and a Doctor of Nursing Practice student specializing in Psychiatric-Mental Health at the Cizik School of Nursing, UTHealth Houston. Her professional and academic work is grounded in a deep commitment to advocating for individuals with intellectual disabilities, particularly those who cannot advocate for themselves. Mary’s writing aims to empower healthcare providers, students, and policymakers with insights that drive compassion, equity, and change. She is based in Houston, TX, and enjoys traveling, reading fiction, and staying active. Her guiding principle is: “You have to believe in yourself for others to believe in you.”

Date of Doctor of Nursing Practice Project Completion

2024

Faculty Advisor

Dr. Kelly Kearney

Abstract

PURPOSE

This quality improvement (QI) project aimed to enhance medication safety in group homes for individuals with intellectual disabilities by implementing standardized protocols and a skills competency checklist for Unlicensed Assistive Personnel (UAPs).

BACKGROUND

Medication errors in group homes often result from inconsistent training and oversight among UAPs. This project addressed these gaps by introducing structured training, a competency checklist, and workflow improvements to enhance adherence to best practices.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) cycle, key interventions included bi-weekly training, hands-on shadowing, competency assessments, and "do not disturb" signage to minimize distractions. Data collection included pre- and post-training surveys, weekly adherence audits, and qualitative feedback. Over twelve weeks, 294 medication administration charts were audited to evaluate adherence. Twenty-five Unlicensed Personnel Assistants (UAPS) participated in the QI project. (N=25).

RESULTS

Adherence to the checklist consistently exceeded 80%, with multiple weeks reaching 100%. Pre- and post-training survey scores improved from 10–75% to 75–100%. UAPs and leadership reported enhanced workflow efficiency, reduced distractions, and increased accountability.

IMPLICATIONS

Standardized protocols and structured training significantly improved medication safety. Sustained engagement, ongoing audits, and leadership support are critical for long-term success. Future efforts should assess long-term adherence, patient outcomes, and cost-effectiveness to refine and expand these interventions.

Keywords

intellectual disability, medication errors, standardized protocols, checklists, Quality Improvement, Group homes.

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