Northern Health and Social Care Trust (NHSCT)

Project summary

Enoxaparin is prescribed for prophylaxis or treatment of venous thromboembolic events. In NHSCT, approximately 390 patients/month are discharged on Enoxaparin, many of whom self-administer injections. Patients often feel unprepared, leading to improper technique, non-compliance, increased risk of complications, and avoidable readmissions. Challenges include inconsistent teaching, limited time for education, poor retention of verbal instruction and patient anxiety. A key driver for this project was the Transforming Medication Safety Northern Ireland (TMSNI) strategy, aligned with the WHO’s third Global Patient Safety Challenge: Medication Without Harm. The HSCNI ‘Know, Check, Ask’ campaign also encourages patient involvement in safe medication use. Enoxaparin is classified as a high-risk medicine and features prominently in transitions of care, making it a relevant focus. This project aimed to improve patient education and safety around Enoxaparin. In collaboration with My Journey (an NHSCT initiative using digital media to share clinical information) and the NHSCT Quality Improvement Team, a standardised, high-quality Enoxaparin self-administration video was produced by the pharmacy team. The video includes visual and verbal demonstration of injection technique, explanation of indication for use and key safety considerations. Objectives included standardising Enoxaparin education, empowering patients, improving confidence and competence, reducing administration errors, adverse events, improving time efficiency for pharmacy and nursing teams and ultimately enhancing patient safety. Patients receive a leaflet containing a QR code linking to the video, and pharmacists remain available for follow-up counselling during working hours, with trained healthcare professionals supporting out-of-hours. An advantage is that patients and carers can rewatch the video, reinforcing technique and building confidence. Since implementation, 100% of patients now receive complete, standardised information. Pharmacist education time has reduced by an average of 9 minutes/patient—reinvesting 15 hours per 100 patients into other clinical duties such as medicines reconciliation, ward rounds and reviews. This video demonstrates a scalable, cost-effective approach to enhancing clinical outcomes and patient experience. Following its success, a Direct Oral Anticoagulant podcast was developed, contributing to our ‘Managing Your Medications Safely’ pharmacist-led educational resources.