Safety in home care: A research protocol for studying medication management.

Patricia B Marck,Marilyn Macdonald,Melissa Griffin,Ariella Lang,Anthony Easty,Serena Corsini-Munt

doi:10.1186/1748-5908-5-43

Abstract

BackgroundPatient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care.MethodsA socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB), Ontario (ON), Quebec (QC) and Nova Scotia (NS), we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research.DiscussionThe application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange throughout the study with the use of participatory data collection methods.

Highlights

Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern
Overview of literature: Medication safety for seniors receiving home care This study addresses a critical gap in our current understanding of medication safety for seniors within the Canadian home care sector
In order to enhance transferability, we have thoroughly described our methods and will pay particular attention in the writing of our findings to describe in detail the conceptual path we follow to arrive at our explanations

Summary

Introduction

Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. There is a clear need to engage the providers and recipients of care in studying and improving medication safety, and our study contributes to that agenda by adopting a collaborative approach to exploring the nature and safety of medication management for chronically ill seniors receiving home care services. A recent study observed that as many as 1 in 11 seniors in Halifax, Nova Scotia experienced a PDRM over a two-year period [17] Many of these lapses in safety occur in clients' homes. Social, economic, and community issues are critical when medicationrelated problems are being assessed Such issues include: whether the client can afford medication and transportation to fill the prescription; confusion about the purpose, dose, or timing of the medications; and living with an overwhelmed caregiver who has their own health concerns

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Conclusion