Abstract
Nursing home patients often have multiple diagnoses and a high prevalence of polypharmacy and are at risk of experiencing adverse drug events. The study aims to explore the dynamic interactions of stakeholders and work system elements in the medication administration process in a nursing home ward. Data were collected using observations and interviews. A deductive content analysis led to a SEIPS-based process map and an accompanying work system analysis. The study increases knowledge of the complexity of the medication administration process by portraying the dynamic interactions between the major stakeholders in the work system, and the temporal flow of the activities involved. Secondly, it identifies facilitators and barriers in the work system linked to the medication administration process. Most barriers and facilitators are associated with the work system elements – tools & technology, organisation and tasks – and occur early in the medication administration process.
Highlights
Medication administration causes a significant number of healthcare-related adverse events in primary care (Andersson et al, 2018; Ferrah et al, 2017; Marchon and Mendes Jr, 2014)
Since there are few studies that investigate medication administra tion within nursing homes as a whole, the current study aimed to explore the dynamic interactions of stakeholders and work system elements in the medication administration process (MAP) in a nursing home ward
The staff consisted of 25 members – six full-time registered nurses (RN), two nurse assistants (NA) and an associated medical doctor (MD) in a 50% with two regular visits per week
Summary
Medication administration causes a significant number of healthcare-related adverse events in primary care (Andersson et al, 2018; Ferrah et al, 2017; Marchon and Mendes Jr, 2014). About one-third of all adverse drug events (ADE) are associated with medication administration errors (MAE) that are preventable (WHO, 2016). 13–31% of the residents in nursing homes have experienced medication administration errors (MAE) (Ferrah et al, 2017). Nursing home pa tients often have multiple diagnoses and a high prevalence of poly pharmacy and are at high risk of being subjected to adverse drug events (ADE) (Herr et al, 2017). This may result in additional monitoring, interventions, hospitalisation or death (Handler et al, 2006)
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