(Left to right) Andrea de Jong, Director, Emergency Department, Sexual Assault &
Domestic Violence, Sarah Biancucci, Clinical Educator and Professional Practice Lead, Theresa
Daly, volunteer with the Parkinson Society Southwestern Ontario, and Dr. Alex Folkl,
Chief of Emergency.
When a person with Parkinson's arrives at the Emergency Department (ED), timely medication administration is crucial. Even a single missed dose can lead to worsening mobility, heightened anxiety, and an increased risk of falls or aspiration. Understanding the urgency, Guelph General Hospital (GGH) took action to ensure patients receive their medication without unnecessary delays.
One of the key team members leading this initiative is Sarah Biancucci, Clinical Educator and Professional Practice Lead in the ED. With over a decade of experience, Sarah has worked closely with individuals with Parkinson's in emergency settings, understanding the unique challenges they face and the specialized care they require.
“Before this directive, patients often waited hours for their medication because nurses needed a physician's order to administer it," Sarah explains. “These delays could severely impact their symptoms, prolonging hospital stays and complicating recovery."
In response, GGH implemented the Parkinson's Medical Directive at the end of 2021. Developed with support from the ED Quality team, the directive includes built-in safety measures to ensure patients receive the correct medication and dose on time, even when designated as NPO (nothing by mouth) before surgery. Recognizing that missing a dose can have greater consequences than administering it in these cases, the directive empowers nurses to act quickly.
“If a patient is awaiting surgery, we might typically withhold medications, but for Parkinson's, missing a dose can be far more detrimental," Sarah notes. “This directive enables nurses to provide timely care when it's needed most."
The initiative was spurred by advocacy from the Parkinson Society Southwestern Ontario support group. Theresa Daly, a long-time volunteer with Parkinson Canada and Parkinson Society Southwestern Ontario, played a key role in discussions. Drawing on her past experience in GGH's Social Work department, she understood both the complexities of emergency care and the challenges faced by Parkinson's patients.
“This effort aligned with Parkinson Canada's “ACT on time" initiative, which stresses the dangers of delayed medication," Theresa shares. “GGH responded swiftly and decisively to implement a solution, demonstrating real commitment to patient-centered care."
Dr. Folkl, GGH's Chief of Emergency, underscores the directive's importance. “Keeping Parkinson's patients on a fixed medication schedule helps prevent falls, confusion, aspiration, and other complications that can lead to prolonged hospital stays," he explains. “By maintaining their baseline function, we improve patient outcomes and reduce avoidable admissions."
Beyond its immediate benefits, the directive has also enhanced staff education. “Previously, many ED nurses weren't fully aware of how critical Parkinson's medication timing is," Sarah says. “Now, through dedicated training, onboarding materials, and annual competency sign offs, our team understands the importance of timely administration."
Sarah adds; “While ongoing data collection will assess the directive's long-term impact, its positive effects are already evident. Patients and families feel reassured knowing their medication needs are prioritized, and staff are better equipped to provide optimal care."
As GGH observes Parkinson's Awareness Month this April, the hospital is proud to spotlight this initiative as a testament to the power of collaboration between health care professionals, advocates, and the community in driving meaningful change and enhanced outcomes for patients, families, and caregivers.