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Schuermann AA, Arkin L, Loerzel V. An Exploration of Nurses' Attitudes and Beliefs on Reporting Medication Errors. J Nurs Care Qual 2024; 39:279-285. [PMID: 38704643 DOI: 10.1097/ncq.0000000000000770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2024]
Abstract
BACKGROUND Medication errors in health care are prevalent. Nurses play an important role in reporting; however errors remain underreported in incident reporting systems. Understanding the perspective of nurses will inform strategies to improve reporting and build systems to reduce errors. PURPOSE The purpose of this study was to explore nurses' perceptions and attitudes of medication error reporting practices. METHODS This qualitative study used direct content analysis to analyze interview sessions with 21 total nurses. RESULTS Participant's description of medication error reporting practices fell into 2 themes. Internal factors described circumstances within nurses themselves that affect reporting. External factors described outside influences from processes or places. CONCLUSIONS Medication error reporting is a multidimensional phenomenon with internal and external factors impacting nurses' attitudes and willingness to report errors. Nurses need support from leadership to understand that reporting medication errors can improve practice and impact patient outcomes.
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Affiliation(s)
- Andrea A Schuermann
- Author Affiliations: Quality Department, Orlando Health South Seminole Hospital, Longwood, Florida (Ms Schuermann); Orlando Health Jewett Orthopedic Institute, Orlando, Florida (Ms Arkin); and University of Central Florida College of Nursing, Orlando, Florida (Dr Loerzel)
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Mahmoud HA, Thavorn K, Mulpuru S, McIsaac D, Abdelrazek MA, Mahmoud AA, Forster AJ. Barriers and facilitators to improving patient safety learning systems: a systematic review of qualitative studies and meta-synthesis. BMJ Open Qual 2023; 12:bmjoq-2022-002134. [PMID: 37012003 PMCID: PMC10083845 DOI: 10.1136/bmjoq-2022-002134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND The implementation and continuous improvement of patient safety learning systems (PSLS) is a principal strategy for mitigating preventable harm to patients. Although substantial efforts have sought to improve these systems, there is a need to more comprehensively understand critical success factors. This study aims to summarise the barriers and facilitators perceived by hospital staff and physicians to influence the reporting, analysis, learning and feedback within PSLS in hospitals. METHODS We performed a systematic review and meta-synthesis by searching MEDLINE (Ovid), EMBASE (Ovid), CINAHL, Scopus and Web of Science. We included English-language manuscripts of qualitative studies evaluating effectiveness of the PSLS and excluded studies evaluating specific individual adverse events, such as systems for tracking only medication side effects, for example. We followed the Joanna Briggs Institute methodology for qualitative systematic reviews. RESULTS We extracted data from 22 studies, after screening 2475 for inclusion/exclusion criteria. The included studies focused on reporting aspects of the PSLS, however, there were important barriers and facilitators across the analysis, learning and feedback phases. We identified the following barriers for effective use of PSLS: inadequate organisational support with shortage of resources, lack of training, weak safety culture, lack of accountability, defective policies, blame and a punitive environment, complex system, lack of experience and lack of feedback. We identified the following enabling factors: continuous training, a balance between accountability and responsibility, leaders as role models, anonymous reporting, user-friendly systems, well-structured analysis teams, tangible improvement. CONCLUSION Multiple barriers and facilitators to uptake of PSLS exist. These factors should be considered by decision makers seeking to enhance the impact of PSLS. ETHICS AND DISSEMINATION No formal ethical approval or consent were required as no primary data were collected.
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Affiliation(s)
- Hassan Assem Mahmoud
- Epidemiology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
- Public Health, Canadian Red Cross, Ottawa, Ontario, Canada
| | - Kednapa Thavorn
- Epidemiology and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sunita Mulpuru
- Respirology, Ottawa Hospital General Campus, Ottawa, Ontario, Canada
| | - Daniel McIsaac
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Amr Assem Mahmoud
- Public Health and Community Medicine, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt
| | - Alan J Forster
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
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Bai I, Isenor JE, Reeve E, Whelan AM, Martin-Misener R, Burgess S, Kennie-Kaulbach N. Using the behavior change wheel to link published deprescribing strategies to identified local primary healthcare needs. Res Social Adm Pharm 2021; 18:3350-3357. [PMID: 34895842 DOI: 10.1016/j.sapharm.2021.12.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Polypharmacy is a major global problem. Evidence in primary care shows deprescribing can be beneficial. Behaviour change theories such as the Theoretical Domains Framework (TDF) and the Behaviour Change Wheel (BCW) can help develop successful implementation of deprescribing initiatives. OBJECTIVES To link locally identified deprescribing influencers with components of successfully trialed deprescribing strategies, with the aim of informing the development of local deprescribing initiatives. METHODS Two background studies were completed. A qualitative study of interviews and focus groups identified influencers of deprescribing from local primary care physicians, nurse practitioners, and pharmacists. Transcripts were coded using the TDF and mapped to the Intervention Functions of the BCW. A scoping review identified studies that investigated primary care deprescribing strategies, which were mapped to the BCW Intervention Functions and the Behaviour Change Techniques (BCTs). For this analysis, six main TDF domains from the qualitative study were linked to the BCTs identified in the scoping review through the Intervention Functions of the BCW. RESULTS Within the BCW component Capability, one TDF domain identified in the qualitative study, Memory, Attention and Decision Process, was linked to strategies like academic detailing from the scoping review. For the Opportunity component, two TDF domains, Social Influences and Environmental Context and Resources, were linked to strategies such as pharmacist medication reviews, providing patient information leaflets, and evidence-based deprescribing tools. For the Motivation component, three TDF domains, Social/Professional Role and Identity, Intentions, and Beliefs about Consequences, were linked to strategies such as sending deprescribing information to prescribers, using tools to identify eligible patients, and having patients report adverse events of medications. CONCLUSIONS This analysis identified deprescribing strategies that can be used to address influencers related to behaviour change from the perspective of primary care providers, and to assist with future deprescribing initiative development and implementation in the local context.
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Affiliation(s)
- Isaac Bai
- Faculty of Medicine, Dalhousie University, 5849 University Ave, Halifax, NS, Canada
| | - Jennifer E Isenor
- College of Pharmacy, Dalhousie University, 5968 College Street, Halifax, NS, Canada.
| | - Emily Reeve
- College of Pharmacy, Dalhousie University, 5968 College Street, Halifax, NS, Canada; Quality Use of Medicines and Pharmacy Research Centre, UniSA: Clinical and Health Sciences, University of South Australia, Adelaide, SA, Australia; Geriatric Medicine Research, Faculty of Medicine, Dalhousie University and Nova Scotia Health Authority, Halifax, NS, Canada
| | - Anne Marie Whelan
- College of Pharmacy, Dalhousie University, 5968 College Street, Halifax, NS, Canada
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, 5869 University Avenue, Halifax, NS, Canada
| | - Sarah Burgess
- College of Pharmacy, Dalhousie University, 5968 College Street, Halifax, NS, Canada; Pharmacy Department, Nova Scotia Health Authority, Halifax, NS, Canada
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Okuyan B, Bektay MY, Kingir ZB, Save D, Sancar M. Community pharmacy cognitive services during the COVID-19 pandemic: A descriptive study of practices, precautions taken, perceived enablers and barriers and burnout. Int J Clin Pract 2021; 75:e14834. [PMID: 34510660 PMCID: PMC8646293 DOI: 10.1111/ijcp.14834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/09/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The objectives of this study were to identify community pharmacist (CP)-led cognitive services and CPs' precautions taken related to COVID-19, perceived enablers and barriers related to pharmaceutical services and burnout levels during the COVID-19 pandemic. METHOD In this descriptive study, the survey was administered online to CPs in all regions of Turkey. The frequency of their provision of patient counselling, provision of medication information and practices towards precautions during the pandemic were evaluated based on CP self-reports. The Turkish version of the Burnout Measure Short Form was used, and a 30-item questionnaire based on the 12-domain Theoretical Domains Framework was developed to determine CPs' perceived enablers of and barriers to pharmaceutical service delivery during the COVID-19 pandemic. Data were collected using convenience sampling methods. Besides internal consistency reliability, principal component analysis, and correlation analysis, Mann-Whitney U-test was conducted in group comparisons. RESULTS A total of 1098 complete responses were received, for a response rate of 4.11% among 26 747 CPs. The CPs' median burnout score was 3.3 (2.5-4.2). More than half of the CPs (54.5%) referred probable patients with COVID-19 to the hospital. Commonly delivered cognitive CP-led services included preventive health services (89.5%) and medication information services (86.3%). Perceived barriers to delivering pharmaceutical services were a lack of environmental resources and support and a lack of innovation in pharmaceutical services. Perceived enablers were CPs' knowledge, skills, self-confidence, actions, impacts, emotions and perceived behavioural control. CONCLUSION To increase the preparedness of pharmacists for future pandemics or disasters, this study highlighted CP-led cognitive services, precautions taken related to COVID-19, perceived enablers and barriers and burnout during the COVID-19 pandemic. Pharmaceutical services guidelines that could be followed during a pandemic or other disaster should be designed by addressing these findings.
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Affiliation(s)
- Betul Okuyan
- Clinical Pharmacy DepartmentFaculty of PharmacyMarmara UniversityIstanbulTurkey
| | - Muhammed Yunus Bektay
- Clinical Pharmacy DepartmentFaculty of PharmacyMarmara UniversityIstanbulTurkey
- Clinical Pharmacy DepartmentFaculty of PharmacyBezmialem UniversityIstanbulTurkey
| | - Zehra Betul Kingir
- Clinical Pharmacy DepartmentFaculty of PharmacyMarmara UniversityIstanbulTurkey
- Pharmaceutical ServicesVocational School of Health ServicesÜsküdar UniversityIstanbulTurkey
| | - Dilsad Save
- Public Health DepartmentFaculty of MedicineMarmara UniversityIstanbulTurkey
| | - Mesut Sancar
- Clinical Pharmacy DepartmentFaculty of PharmacyMarmara UniversityIstanbulTurkey
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Okuyan B, Balta E, Ozcan V, Durak Albayrak O, Turker M, Sancar M. Turkish community pharmacists' behavioral determinants in provision of pharmaceutical care to elderly patients. Int J Clin Pharm 2021; 43:1024-1035. [PMID: 33411182 DOI: 10.1007/s11096-020-01211-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/26/2020] [Indexed: 11/30/2022]
Abstract
Background It is crucial to develop and implement community pharmacist-led pharmaceutical care services in primary care that could prevent and detect potentially inappropriate prescribing and promote medication adherence in older patients. Objective The aim of this study was to determine community pharmacists' perceived barriers and facilitators face during the provision of pharmaceutical care to older patients by using a theoretical domains framework. Method A cross-sectional online survey was conducted among community pharmacists in Turkey. A Turkish version of the 50-item Determinants of Implementation Behavior Questionnaire was developed to evaluate behavioral determinants of community pharmacists on delivering pharmaceutical care to older patients. Main outcome measures The behavioral determinants of community pharmacists. Results A total of 354 community pharmacists answered the questionnaire. The mean age was 43.2 (standard deviation = 11.1), and 227 (64%) of the pharmacists were female. Community pharmacists' positive opinions on pharmaceutical care service outcomes in older patients and feedback were regarded as facilitators. Community pharmacists' motivational level and emotions were additional determinant facilitators in delivering pharmaceutical care to older patients. Their negative opinions on the impact and action of pharmaceutical care in older patients were regarded as barriers. Conclusion In primary health care, a theory-based e-distant training program for community pharmacists and the guidelines for standard pharmaceutical care services led by community pharmacists could be designed by addressing barriers related to the impact and action of pharmaceutical care in older patients.
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Affiliation(s)
- Betul Okuyan
- Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Maltepe, Istanbul, Turkey.
| | - Ecehan Balta
- Turkish Pharmacists' Association, Ankara, Turkey
| | - Vildan Ozcan
- Turkish Pharmacists' Association, Ankara, Turkey
| | | | | | - Mesut Sancar
- Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Maltepe, Istanbul, Turkey
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Stewart D, MacLure K, Pallivalapila A, Dijkstra A, Wilbur K, Wilby K, Awaisu A, McLay JS, Thomas B, Ryan C, El Kassem W, Singh R, Al Hail MSH. Views and experiences of decision-makers on organisational safety culture and medication errors. Int J Clin Pract 2020; 74:e13560. [PMID: 32478911 DOI: 10.1111/ijcp.13560] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 05/26/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND In 2017, the World Health Organization published "Medication Without Harm, WHO Global Patient Safety Challenge," to reduce patient harm caused by unsafe medication use practices. While the five objectives emphasise the need to create a framework for action, engaging key stakeholders and others, most published research has focused on the perspectives of health professionals. The aim was to explore the views and experiences of decision-makers in Qatar on organisational safety culture, medication errors and error reporting. METHOD Qualitative, semi-structured interviews were conducted with healthcare decision-makers (policy-makers, professional leaders and managers, lead educators and trainers) in Qatar. Participants were recruited via purposive and snowball sampling, continued to the point of data saturation. The interview schedule focused on: error causation and error prevention; engendering a safety culture; and initiatives to encourage error reporting. Interviews were digitally recorded, transcribed and independently analysed by two researchers using the Framework Approach. RESULTS From the 21 interviews conducted, key themes were the need to: promote trust within the organisation through articulating a fair blame culture; eliminate management, professional and cultural hierarchies; focus on team building, open communication and feedback; promote professional development; and scale-up successful initiatives. There was recognition that the current medication error reporting processes and systems were suboptimal, with suggested enhancements in themes of promoting a fair blame culture and open communication. CONCLUSION These positive and negative aspects of organisational culture can inform the development of theory-based interventions to promote patient safety. Central to these will be the further development and sustainment of a "fair" blame culture in Qatar and beyond.
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Affiliation(s)
- Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Katie MacLure
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, UK
| | | | - Andrea Dijkstra
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Kerry Wilbur
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Kyle Wilby
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Ahmed Awaisu
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - James S McLay
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Binny Thomas
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Cristin Ryan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, Dublin, Ireland
| | - Wessam El Kassem
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Moza S H Al Hail
- Women's Wellness and Research Center, Hamad Medical Corporation, Doha, Qatar
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Waljee JF, Chung KC. Bringing Evidence into Practice in Hand Surgery. Hand Clin 2020; 36:131-136. [PMID: 32307042 DOI: 10.1016/j.hcl.2020.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Despite the significant investment in scientific investigation to enhance clinical care, the uptake of new interventions and innovations into clinical care and policy remains slow. Understanding and examining the factors that influence the dissemination and implementation of best practices are critical to promote high-quality health care. This review provides an overview of the evidence base in hand surgery, the science that underlies dissemination and innovation, and the emergence of learning health systems in health care.
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Affiliation(s)
- Jennifer F Waljee
- Section of Plastic Surgery, Department of Surgery, Michigan Medicine, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340, USA.
| | - Kevin C Chung
- Section of Plastic Surgery, Department of Surgery, Michigan Medicine, 1500 East Medical Center Drive, 2130 Taubman Center, SPC 5340, Ann Arbor, MI 48109-5340, USA
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Stewart D, Thomas B, MacLure K, Wilbur K, Wilby K, Pallivalapila A, Dijkstra A, Ryan C, El Kassem W, Awaisu A, McLay JS, Singh R, Al Hail M. Exploring facilitators and barriers to medication error reporting among healthcare professionals in Qatar using the theoretical domains framework: A mixed-methods approach. PLoS One 2018; 13:e0204987. [PMID: 30278077 PMCID: PMC6168162 DOI: 10.1371/journal.pone.0204987] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 09/18/2018] [Indexed: 11/24/2022] Open
Abstract
Background There is a need for theory informed interventions to optimise medication reporting. This study aimed to quantify and explain behavioural determinants relating to error reporting of healthcare professionals in Qatar as a basis of developing interventions to optimise the effectiveness and efficiency of error reporting. Methods A sequential explanatory mixed methods design comprising a cross-sectional survey followed by focus groups in Hamad Medical Corporation, Qatar. All doctors, nurses and pharmacists were invited to complete a questionnaire that included items of behavioural determinants derived from the Theoretical Domains Framework (TDF), an integrative framework of 33 theories of behaviour change. Principal component analysis (PCA) was used to identify components, with total component scores computed. Differences in total scores among demographic groupings were tested using Mann-Whitney U test (2 groups) or Kruskal-Wallis (>2 groups). Respondents expressing interest in focus group participation were sampled purposively, and discussions based on survey findings using the TDF to provide further insight to survey findings. Ethical approval was received from Hamad Medical Corporation, Robert Gordon University, and Qatar University. Results One thousand, six hundred and four questionnaires were received (67.9% nurses, 13.3% doctors, 12.9% pharmacists). Questionnaire items clustered into six components of: knowledge and skills related to error reporting; feedback and support; action and impact; motivation; effort; and emotions. There were statistically significant higher scores in relation to age (older more positive, p<0.001), experience as a healthcare professional (more experienced most positive apart from those with the highest level of experience, p<0.001), and profession (pharmacists most positive, p<0.05). Fifty-four healthcare professionals from different disciplines participated in the focus groups. Themes mapped to nine of fourteen TDF domains. In terms of emotions, the themes that emerged as barriers to error reporting were: fear and worry on submitting a report; that submitting was likely to lead to further investigation that could impact performance evaluation and career progression; concerns over the impact on working relationships; and the potential lack of confidentiality. Conclusions This study has quantified and explained key facilitators and barriers of medication error reporting. Barriers appeared to be largely centred on issues relating to emotions and related beliefs of consequences. Quantitative results demonstrated that while these were issues for all healthcare professionals, those younger and less experienced were most concerned. Qualitative findings highlighted particular concerns relating to these emotional aspects. These results can be used to develop theoretically informed interventions with the aims of improving the effectiveness and efficiency of the medication reporting systems impacting patient safety.
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Affiliation(s)
- Derek Stewart
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Binny Thomas
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom
- Women's Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Katie MacLure
- School of Pharmacy and Life Sciences, Robert Gordon University, Aberdeen, United Kingdom
| | - Kerry Wilbur
- College of Pharmacy, Qatar University, Doha, Qatar
| | - Kyle Wilby
- College of Pharmacy, Qatar University, Doha, Qatar
| | | | | | - Cristin Ryan
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin, Ireland, Dublin
| | | | - Ahmed Awaisu
- College of Pharmacy, Qatar University, Doha, Qatar
| | - James S McLay
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom
| | | | - Moza Al Hail
- Women's Hospital, Hamad Medical Corporation, Doha, Qatar
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Isenor JE, Minard LV, Stewart SA, Curran JA, Deal H, Rodrigues G, Sketris IS. Identification of the relationship between barriers and facilitators of pharmacist prescribing and self-reported prescribing activity using the theoretical domains framework. Res Social Adm Pharm 2018; 14:784-791. [DOI: 10.1016/j.sapharm.2017.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/02/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
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Rishoej RM, Lai Nielsen H, Strzelec SM, Fritsdal Refer J, Allermann Beck S, Gramstrup HM, Thybo Christesen H, Juel Kjeldsen L, Hallas J, Almarsdóttir AB. Qualitative exploration of practices to prevent medication errors in neonatal intensive care units: a focus group study. Ther Adv Drug Saf 2018; 9:343-353. [PMID: 30034776 DOI: 10.1177/2042098618771541] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 03/23/2018] [Indexed: 11/16/2022] Open
Abstract
Background Medication errors (MEs) in neonates are frequent and associated with increased potential for harm compared with adults. The effect of learning from reported MEs is potentially lacking due to underreporting, lack of feedback and missing actions to improve medication safety. A new approach involving positive recognition of current and future strategies may facilitate greater exploration of how to improve medication safety in neonates. We aimed to explore current and potential future practices to prevent MEs in neonatal intensive care units (NICUs). Methods Focus group interviews of physicians and nurses were conducted at three Danish NICUs. Participants were included if they had at least 1 month of working experience and provided direct patient care. A semistructured interview guide involving three questions was used: (a) how do you feel about discussing prevention of MEs? (b) how do you currently prevent MEs from occurring? and (c) how can we become better at preventing MEs in the future? Content analysis was used to identify themes in the interviews. Results Participants commented that MEs still occur and that action must be taken to improve medication safety. Current practices to prevent MEs involved technology, procedures, education, skills and hospital pharmacy services. Potential future practices to prevent MEs included customizing the computerized physician order entry systems to support optimal prescribing, standardizing the double-check process, training of calculation skills and teamwork and increased use of hospital pharmacy services. Conclusions Several current and potential future practices to reduce MEs in NICUs were identified, highlighting the complexity of MEs. Our findings support an interdisciplinary multifaceted intervention involving both technical and nontechnical elements to improve medication safety in NICUs.
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Affiliation(s)
- Rikke Mie Rishoej
- Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 19, 2. 5000 Odense C, Denmark
| | | | | | - Jane Fritsdal Refer
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | | | - Hanne Marie Gramstrup
- Department of Paediatrics and Adolescent Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Thybo Christesen
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Jesper Hallas
- Department of Public Health, University of Southern Denmark, Odense, Denmark
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