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The Role of Hospital Inpatients in Supporting Medication Safety: A Qualitative Study.

Garfield S, Jheeta S, Husson F, Lloyd J, Taylor A, Boucher C, Jacklin A, Bischler A, Norton C, Hayles R, Franklin BD - PLoS ONE (2016)

Bottom Line: Inpatient medication errors are a significant concern.In this study we aimed to explore hospital inpatients' involvement with medication safety-related behaviours, facilitators and barriers to this involvement, and the impact of electronic prescribing.However, to develop interventions to increase patient involvement with medication safety behaviours, a wider range of factors needs to be considered.

View Article: PubMed Central - PubMed

Affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, United Kingdom.

ABSTRACT

Background: Inpatient medication errors are a significant concern. An approach not yet widely studied is to facilitate greater involvement of inpatients with their medication. At the same time, electronic prescribing is becoming increasingly prevalent in the hospital setting. In this study we aimed to explore hospital inpatients' involvement with medication safety-related behaviours, facilitators and barriers to this involvement, and the impact of electronic prescribing.

Methods: We conducted ethnographic observations and interviews in two UK hospital organisations, one with established electronic prescribing and one that changed from paper to electronic prescribing during our study. Researchers and lay volunteers observed nurses' medication administration rounds, pharmacists' ward rounds, doctor-led ward rounds and drug history taking. We also conducted interviews with healthcare professionals, patients and carers. Interviews were audio-recorded and transcribed. Observation notes and transcripts were coded thematically.

Results: Paper or electronic medication records were shown to patients in only 4 (2%) of 247 cases. However, where they were available during patient-healthcare professional interactions, healthcare professionals often viewed them in order to inform patients about their medicines and answer any questions. Interprofessional discussions about medicines seemed more likely to happen in front of the patient where paper or electronic drug charts were available near the bedside. Patients and carers had more access to paper-based drug charts than electronic equivalents. However, interviews and observations suggest there are potentially more significant factors that affect patient involvement with their inpatient medication. These include patient and healthcare professional beliefs concerning patient involvement, the way in which healthcare professionals operate as a team, and the underlying culture.

Conclusion: Patients appear to have more access to paper-based records than electronic equivalents. However, to develop interventions to increase patient involvement with medication safety behaviours, a wider range of factors needs to be considered.

No MeSH data available.


Flow chart of participants.
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pone.0153721.g001: Flow chart of participants.

Mentions: The number of patients observed during each type of round and the number of participants interviewed are shown in Table 1. Fifty one participants of 57 approached agreed to be interviewed, giving a response rate of 90% (Fig 1).


The Role of Hospital Inpatients in Supporting Medication Safety: A Qualitative Study.

Garfield S, Jheeta S, Husson F, Lloyd J, Taylor A, Boucher C, Jacklin A, Bischler A, Norton C, Hayles R, Franklin BD - PLoS ONE (2016)

Flow chart of participants.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4836703&req=5

pone.0153721.g001: Flow chart of participants.
Mentions: The number of patients observed during each type of round and the number of participants interviewed are shown in Table 1. Fifty one participants of 57 approached agreed to be interviewed, giving a response rate of 90% (Fig 1).

Bottom Line: Inpatient medication errors are a significant concern.In this study we aimed to explore hospital inpatients' involvement with medication safety-related behaviours, facilitators and barriers to this involvement, and the impact of electronic prescribing.However, to develop interventions to increase patient involvement with medication safety behaviours, a wider range of factors needs to be considered.

View Article: PubMed Central - PubMed

Affiliation: Centre for Medication Safety and Service Quality, Imperial College Healthcare NHS Trust, London, United Kingdom.

ABSTRACT

Background: Inpatient medication errors are a significant concern. An approach not yet widely studied is to facilitate greater involvement of inpatients with their medication. At the same time, electronic prescribing is becoming increasingly prevalent in the hospital setting. In this study we aimed to explore hospital inpatients' involvement with medication safety-related behaviours, facilitators and barriers to this involvement, and the impact of electronic prescribing.

Methods: We conducted ethnographic observations and interviews in two UK hospital organisations, one with established electronic prescribing and one that changed from paper to electronic prescribing during our study. Researchers and lay volunteers observed nurses' medication administration rounds, pharmacists' ward rounds, doctor-led ward rounds and drug history taking. We also conducted interviews with healthcare professionals, patients and carers. Interviews were audio-recorded and transcribed. Observation notes and transcripts were coded thematically.

Results: Paper or electronic medication records were shown to patients in only 4 (2%) of 247 cases. However, where they were available during patient-healthcare professional interactions, healthcare professionals often viewed them in order to inform patients about their medicines and answer any questions. Interprofessional discussions about medicines seemed more likely to happen in front of the patient where paper or electronic drug charts were available near the bedside. Patients and carers had more access to paper-based drug charts than electronic equivalents. However, interviews and observations suggest there are potentially more significant factors that affect patient involvement with their inpatient medication. These include patient and healthcare professional beliefs concerning patient involvement, the way in which healthcare professionals operate as a team, and the underlying culture.

Conclusion: Patients appear to have more access to paper-based records than electronic equivalents. However, to develop interventions to increase patient involvement with medication safety behaviours, a wider range of factors needs to be considered.

No MeSH data available.