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Wathne H, May C, Morken IM, Storm M, Husebø AML. Acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illness: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100229. [PMID: 39166216 PMCID: PMC11334779 DOI: 10.1016/j.ijnsa.2024.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
Background Patients living with long-term chronic illnesses often need ongoing medical attention, lifestyle adjustments, and psychosocial support beyond the initial diagnosis and treatment phases. Many experience illness deterioration and subsequently require hospitalisation, especially in the transition period after hospital discharge. A promising strategy for managing long-term conditions is promoting self-management. eHealth interventions involving remote patient monitoring have the potential to promote self-management and offer a more seamless bridge between the hospital and the patient´s home environment. However, such interventions can only significantly impact health and health care if they are effective, accepted and adopted by users, normalised into routine practice and everyday life, and able to be widely implemented. Feasibility studies are used to determine whether an intervention is suitable for the target population and effective in achieving its intended goal. They may also provide critical information about an intervention´s acceptability and usability. Objectives We aimed to evaluate the acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illnesses by use of the core constructs of normalisation process theory. Design A descriptive and explanatory qualitative approach was used, with patients observed during training and semi-structured interviews conducted with patients and nurses after study completion. Settings Participants were recruited from two university hospitals in Norway between December 2021 and February 2023. Participants Ten patients were observed during training, and 27 patients and eight nurses were interviewed after study completion. Methods Structured and overt observations were made while the patients received training to operate the remote patient monitoring service, guided by an observation guide. Semi-structured interviews were conducted with patients and nurse navigators about their experiences of remote follow-up care, guided by open ended questions. Data analysis followed a stepwise deductive inductive method. Results `Achieving acceptance and usability through digital social interaction´ emerged as a unifying theme that bridged the experiences of patients with long-term illnesses and the nurse navigators. This overarching theme was illustrated by four sub-themes, which all reflected the usability and acceptability of the nurse-assisted remote patient monitoring service in various ways. Conclusion Acceptability and usability are critical factors to consider when evaluating remote patient monitoring interventions. In this study, the most important feature for promoting acceptability and usability was the interaction between patients and nurse navigators. Therefore, the intervention´s feasibility and implementation potential rested upon the relationship between its deliverer and receiver.
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Affiliation(s)
- Hege Wathne
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ingvild Margreta Morken
- Department of Quality and Health Technologies, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
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Arab F, Saeedi M. The effect of the case-based learning approach on the level of satisfactions and learning of nursing students in Iran: A randomized controlled trial. Heliyon 2024; 10:e35149. [PMID: 39157409 PMCID: PMC11328019 DOI: 10.1016/j.heliyon.2024.e35149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 07/12/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction Nurses must have sufficient knowledge and skills in the field of medications and medication management. This study was designed to investigate the effect of the case-based learning (CBL) approach on the level of satisfaction and learning of nursing students. Materials and methods This study was conducted using a randomized controlled trial on 70 Iranian third-semester nursing students during a pharmacology internship in 2023. After considering the inclusion criteria, the samples were entered into the study by census method and then they were placed in either the control (35 people) or intervention (35 people) groups by simple random method. Pharmacology training was done in the control group by the usual method (lectures by the instructor and conferences with students) and in the intervention group by the Kaddoura case-based learning method. Data collection tools included a demographic questionnaire, satisfaction of educational approach questionnaire, and exam scores before and after the internship. SPSS version 26 software was used for statistical analysis. Results There was no statistically significant difference (P = 0.88) in the mean scores of the pharmacology pre-test in the control (10.54 ± 2.74) and intervention groups (10.6 ± 3.49) before the intervention. Also, there was no statistically significant difference (P = 0.19) between the pharmacology post-test scores in the control (17.7 ± 1.15) and intervention groups (18.07 ± 0.91). A comparison of pre-test and post-test scores in both control and intervention groups showed that the post-test scores in both groups increased significantly (P < 0.001). The results showed that the intervention group was significantly (P = 0.008) more satisfied with the learning method. Conclusion The case-based educational approach resulted in improved satisfaction among students in the pharmacology course. It is recommended to incorporate this learning method alongside traditional teaching methods, in nursing education, particularly in pharmacology instruction.
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Affiliation(s)
- Farzaneh Arab
- MSc of Nursing, Nursing Department, Saveh University of Medical Sciences, Saveh, Iran
| | - Maryam Saeedi
- Ph.D. of Nursing, Nursing Department, Saveh University of Medical Sciences, Saveh, Iran
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Xu X, Chen H, Xu D, Tan F, Li X. A scoping review of hospital to home transitional care programmes for stroke survivors. J Clin Nurs 2024; 33:3414-3428. [PMID: 38887147 DOI: 10.1111/jocn.17070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/13/2024] [Accepted: 02/05/2024] [Indexed: 06/20/2024]
Abstract
AIM The study was aimed at exploring the current scope of hospital to home transitional care programmes for stroke survivors. BACKGROUND Stroke survivors face the dilemma of solving many complex problems that leave survivors at high risk for readmission as they discharge from hospital. The transitional care model has proved to be effective in reducing readmissions and mortality, thereby improving health outcomes and enhancing patient satisfaction for survivors with stroke. DESIGN A scoping review. METHODS Conducted in accordance with the Joanna Briggs Institute (JBI) Methodology for Scoping Reviews. DATA SOURCES A comprehensive search was conducted in nine databases, including PubMed, Web of Science, Cochrane Library, EMBASE, CINAHL, Medline, China Knowledge Net-work, Wanfang Database and China Biomedical Literature Database (SinoMed) from January 2014 to June 2023. RESULTS Title and abstract screening was performed on 10,171 articles resulting in 287 articles for full-text screening. Full-text screening yielded 49 articles that met inclusion criteria. CONCLUSION This study identified transitional care programmes for stroke survivors, as well as areas for future consideration to be explored in more depth to help improve transitional care for stroke survivors as they transition from hospital to home. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE This study demonstrates that multidisciplinary collaboration becomes an integral part of the transitional care model for stroke survivors, which provides comprehensive and precise medical care to them. REPORTING METHOD PRISMA checklist for scoping reviews. PATIENT AND PUBLIC CONTRIBUTION No patient or public contribution was part of this study.
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Affiliation(s)
- Xuewei Xu
- Department of Nursing Humanities, School of Nursing, China Medical University, Shenyang, China
| | - Huijie Chen
- Department of Nursing Humanities, School of Nursing, China Medical University, Shenyang, China
| | - Dandan Xu
- Department of Nursing Humanities, School of Nursing, China Medical University, Shenyang, China
| | - Fengying Tan
- Department of Community Nursing, School of Nursing, China Medical University, Shenyang, China
| | - Xiaohan Li
- Department of Nursing Humanities, School of Nursing, China Medical University, Shenyang, China
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Güllü A, Tosun B. Effectiveness of the transitional care model in total knee arthroplasty patients: A randomized controlled trial. Int J Nurs Pract 2024:e13283. [PMID: 38989604 DOI: 10.1111/ijn.13283] [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: 10/09/2022] [Revised: 01/20/2024] [Accepted: 06/25/2024] [Indexed: 07/12/2024]
Abstract
AIM This study has aimed to assess the effectiveness of the transitional care model (TCM) on functional status, perceived self-efficacy and healthcare utilization in patients undergoing total knee arthroplasty (TKA). METHOD This randomized controlled study was conducted between February and November 2021 in a public hospital. The study randomly assigned patients to either a 6-week 'TCM' program or usual care. The sample size was n = 70, with each group comprising 35 individuals. Patient outcomes, including self-efficacy, functional status and healthcare service readmission rates, were monitored for TKA patients. RESULTS Nursing care based on the 'TCM' was found to enhance functional status and increase the level of self-efficacy among TKA patients, leading to a decrease in healthcare service readmissions. CONCLUSIONS The study recommends preparing patients and their families for the preoperative and postoperative processes. It emphasizes the importance of providing necessary training and consultancy services under the leadership of orthopaedic nurses responsible for TKA patient care, guided by the principles of TCM.
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Affiliation(s)
- Ayla Güllü
- Faculty of Health Sciences, School of Nursing, Hasan Kalyoncu University, Gaziantep, Turkey
- Faculty of Health Sciences, School of Nursing, Hatay Mustafa Kemal University, Antakya, Turkey
| | - Betul Tosun
- Faculty of Nursing, Hacettepe University, Ankara, Turkey
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Alharbi K, Bakarman SS, Syed W, Bashatah A. Assessment of Undergraduate Nursing Students' Understanding of Herbal Medicines and Herb-Drug Interactions in Riyadh, Saudi Arabia. Med Sci Monit 2024; 30:e944352. [PMID: 38894516 PMCID: PMC11305105 DOI: 10.12659/msm.944352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 04/26/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND The use of herbal medicines (HMs) is increasing, which raises concerns of herb-drug interactions (HDIs). This questionnaire-based study aimed to evaluate knowledge of HMs and HDIs in 147 undergraduate nursing students in Riyadh, Saudi Arabia, between March 2022 to June 2022. MATERIAL AND METHODS An online cross-sectional study was conducted among 147 nursing undergraduates at King Saud University, Riyadh, Saudi Arabia from March 2022 to June 2022, using a self-administered 24-item questionnaire. The convenience sampling method was used to evaluate the knowledge of HMs and interactions of anticoagulants, anti-inflammatory drugs, antibiotics, and antiplatelet drugs with herbs like ginkgo biloba, St. John's wort, garlic, ginger, green tea, and chamomile tea. RESULTS The findings of this study reported that 74.8% of the undergraduates used HMs. With regard to HDIs, 20.4% of nursing undergraduates identified the interaction between gingko biloba and drugs like ibuprofen and warfarin, while 13.6% identified interactions between drugs like warfarin with green tea, ginger, and chamomile tea. Regarding general knowledge, 59% of the students (n=84) reported good knowledge of HMs. Previous history of HM use significantly affected the mean HM knowledge score (t=4.635; P=0.0001). CONCLUSIONS To summarize, Saudi nursing students showed a lack of understanding and knowledge of HDIs. Ability to identify specific HDIs, like ginkgo biloba interactions with warfarin and ibuprofen, and warfarin interactions with green tea and ginger, was limited. There is a need to introduce HM and HDI courses in the academic curriculum.
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Affiliation(s)
- Kholoud Alharbi
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Safiya Salem Bakarman
- Department of Community and Mental Health Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Wajid Syed
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Adel Bashatah
- Department of Nursing Administration and Education, College of Nursing, King Saud University, Riyadh, Saudi Arabia
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You H, Docherty SL, Ashana DC, Oyesanya TO. Transition of Intensive Care Unit Patients and Their Families to Home After Acute Hospital Care. AACN Adv Crit Care 2024; 35:97-108. [PMID: 38848572 DOI: 10.4037/aacnacc2024982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2024]
Abstract
Patients in the intensive care unit (ICU) increasingly are expected to eventually return home after acute hospital care. Yet transitional care for ICU patients and their families is often delayed until the patient is about to be transferred to another location or level of care. Transitions theory is a middle-range nursing theory that aims to provide guidance for safe and effective nursing care and research while an individual experiences a transition. Intensive care unit nurses are well positioned to provide ICU transitional care planning early. This article applies the transitions theory as a theoretical model to guide the study of the transition to home after acute hospital care for ICU patients and their families. This theory application can help ICU nurses provide holistic patient- and family-centered transitional care to achieve optimal outcomes by addressing the predischarge and postdischarge needs of patients and families.
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Affiliation(s)
- HyunBin You
- HyunBin You is a PhD candidate, School of Nursing, Duke University, DUMC 3322, 307 Trent Drive, Durham, NC 27710
| | - Sharron L Docherty
- Sharron L. Docherty is Associate Professor, School of Nursing, and Associate Professor, Department of Medicine, Duke University, Durham, North Carolina
| | - Deepshikha C Ashana
- Deepshikha C. Ashana is Assistant Professor, Department of Medicine; Core Faculty Member, Duke-Margolis Center for Health Policy; and Assistant Professor, Department of Population Health Sciences, Duke University, Durham, North Carolina
| | - Tolu O Oyesanya
- Tolu O. Oyesanya is Associate Professor, School of Nursing, Duke University, Durham, North Carolina
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Liu Y, Li X, Yang M, Ding Y, Ji M. Screening indicators to evaluate the clinical significance of drug-drug interactions in polypharmacy among older adults with psychiatric disorders: a delphi study. BMC Psychiatry 2024; 24:417. [PMID: 38834965 PMCID: PMC11151475 DOI: 10.1186/s12888-024-05872-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND Polypharmacy is common in older adults with psychiatric disorders, but no consensus has reached about the reliable indicators evaluating the benefits and risks of drug-drug interactions (DDIs) in polypharmacy. We aimed to identify indicators suitable for evaluating the clinical significance of DDIs in polypharmacy in older adults with psychiatric disorders. METHODS The online tools were used to distribute and collect the questionnaires. The Delphi method was applied to analyze experts' opinions. The degree of authority and coordination of experts were analyzed using the coefficient of variation, coefficient of coordination, expert's judgment factor, familiarity with the study content factor, and Kendall coordination coefficient. Statistical analysis was conducted using the IBM SPSS® Statistics Package version 26.0. RESULTS After three rounds of expert consultation, five primary and eleven secondary indicators were identified. The primary "pharmacodynamic indicator" included "severity of adverse drug reactions", "duration of adverse drug reaction", "symptom relief", "time to onset of symptomatic relief", "number of days in hospital", and "duration of medication". The secondary "pharmacokinetic indicator" contained "dosage administered" and "dosing intervals". The primary "patient tolerance indicator" contained one secondary indicator of "patient tolerability". The primary indicator "patient adherence" contained one secondary indicator of "patient adherence to medication". The primary indicator "cost of drug combination" contained one secondary indicator of "readmission". These indicators were used to determine the clinical significance of DDIs during polypharmacy. CONCLUSIONS The clinical significance of drug combinations should be taken into account when polypharmacy is used in the elderly. The five primary indicators and eleven secondary indicators might be preferred to evaluate their risks and benefits. Medication management in this population requires a multidisciplinary team, in which nurses play a key role. Future research should focus on how to establish efficient multidisciplinary team workflows and use functional factors to assess DDIs in polypharmacy for psychiatric disorders.
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Affiliation(s)
- Yu Liu
- Department of Nursing, Kangda College of Nanjing Medical University, 88 Chunhui Road, Huaguoshan Avenue, Haizhou District, Lianyungang, Jiangsu Province, 222000, China
| | - Xuefeng Li
- Department of Geriatrics, The First People's Hospital of Lianyungang, No. 6 East Zhenhua Road, Haizhou District, Lianyungang, Jiangsu Province, 222061, China
| | - Man Yang
- Department of Psychiatry, The Fourth People's Hospital of Lianyungang, Affiliated to Kangda College, Nanjing Medical University, No. 316 Jiefang East Road, Haizhou District, Lianyungang, Jiangsu Province, 222000, China
| | - Yaping Ding
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, 211166, China.
| | - Minghui Ji
- Department of Fundamental and Community Nursing, School of Nursing, Nanjing Medical University, 101 Longmian Avenue, Jiangning District, Nanjing, Jiangsu Province, 211166, China.
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Idris MUBM, Jamil NB, Yi X, Su-Fee L, Yuh AS, Aloweni F, Towle RM. Keeping patients safe through medication review and management in the community. Br J Community Nurs 2024; 29:288-293. [PMID: 38814838 DOI: 10.12968/bjcn.2024.29.6.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
BACKGROUND There are numerous publications on inpatient medication errors. However, little focus is given to medication errors that occur at home. AIMS To describe and analyse the types of medication errors among community-dwelling patients following their discharge from an acute care hospital in Singapore. METHOD This is a retrospective review of a 'good catch' reporting system from December 2018 to March 2022. Medication-related errors were extracted and analysed. FINDINGS A total of 73 reported medication-related error incidents were reviewed. The mean age of the patients was 78 years old (SD=9). Most patients managed their medications independently at home (45.2%, n=33). The majority of medications involved were cardiovascular medications (51.5%, n=50). Incorrect dosing (41.1%, n=39) was the most common medication error reported. Poor understanding of medication usage (35.6%, n=26) and lack of awareness of medication changes after discharge (24.7%, n=18) were the primary causes of the errors. CONCLUSION This study's findings provide valuable insights into reducing medication errors at home. More attention must be given to post-discharge care, especially to preventable medication errors. Medication administration and management education can be emphasised using teach-back methods.
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Affiliation(s)
| | | | - Xu Yi
- Assistant Director of Nursing; SingHealth, Singapore General Hospital
| | - Lim Su-Fee
- Clinical Assistant Professor; Singapore General Hospital, SingHealth Community Hospitals
| | - Ang Shin Yuh
- Clinical Assistant Professor; SingHealth, Singapore General Hospital
| | - Fazila Aloweni
- Clinical Assistant Professor; Singapore General Hospital
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Zhu LL, Wang YH, Lan MJ, Zhou Q. Exploring the Roles of Nurses in Medication Reconciliation for Older Adults at Hospital Discharge: A Narrative Approach. Clin Interv Aging 2024; 19:367-373. [PMID: 38476831 PMCID: PMC10929123 DOI: 10.2147/cia.s450319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Medication reconciliation (MR) is the process of comparing a patient's medication orders to all of the medications that the patient has been taking in order to identify and resolve medication discrepancies. It is an effective means of risk management to avoid medication errors (eg, omissions, duplication, dosage errors, or drug interactions). Some guidelines explicitly state that MR is a pharmacist-led transition of care; however, there is a shortage of qualified pharmacists to meet the increasing clinical needs, and clinical nurses' roles have not been clearly described. This paper aimed to enable nurses to gain confidence in contributing to MR at discharge and to make the industry aware of the potential risks if nurses do not actively intervene in this area. A narrative approach was used to introduce experiences in identifying discrepancies and medication errors through MR at discharge in a geriatric ward of an academic medical center hospital in China. The nurses' main roles in MR involve chasing, checking, and education. Clinical nurses, an untapped hospital resource, can actively engage in MR at discharge if they receive effective training and motivation. Multidisciplinary collaboration at discharge allowed many discrepancies to be reconciled before harming older patients. It is worth conducting further research in MR when discharging older adults, such as the cost-effectiveness of nurses' efforts, the value of electronic tools and the impact of MR-targeted education and training for nursing students and nursing staff.
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Affiliation(s)
- Ling-Ling Zhu
- VIP Geriatric Ward, Division of Nursing, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Yan-Hong Wang
- Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Mei-Juan Lan
- Division of Nursing, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Quan Zhou
- Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China
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Mardani A, Azizi M, Alazmani Noodeh F, Alizadeh A, Maleki M, Vaismoradi M, Glarcher M. A concept analysis of transitional care for people with cancer. Nurs Open 2024; 11:e2083. [PMID: 38268301 PMCID: PMC10803885 DOI: 10.1002/nop2.2083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 11/17/2023] [Accepted: 12/21/2023] [Indexed: 01/26/2024] Open
Abstract
AIM Transitional care as the journey between different caregivers in multiple healthcare centres is crucial for the provision of care to people with cancer, but it is often complex and poorly coordinated. This study aimed to analyse the concept of transitional care for people with cancer. DESIGN Rodgers' evolutionary concept analysis. METHODS A systematic literature search was conducted on the databases of PubMed (including MEDLINE), EMBASE, Scopus and Web of Science to retrieve articles published between 2000 and 2022. RESULTS Twenty-nine eligible articles were selected and their findings were classified in terms of related concepts and alternative terms, antecedents, attributes and consequences. Attributes included three main categories, namely 'nurse-related attributes', 'organisation-related attributes' and 'patient-related attributes'. Antecedents of transitional care for people with cancer were categorized into two main categories: 'patient-related antecedents' and 'caregiver-related antecedents'. Consequences were categorized into 'psychological consequences' and 'objective consequences'.
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Affiliation(s)
- Abbas Mardani
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyZanjan University of Medical SciencesZanjanIran
| | - Maryam Azizi
- Department of Health in Disaster and Emergencies, Faculty of NursingAja University of Medical SciencesTehranIran
| | - Farshid Alazmani Noodeh
- Critical Care Nursing Department, Faculty of NursingAja University of Medical SciencesTehranIran
| | - Azizeh Alizadeh
- Department of Education and Research, Army Center of Excellence (NEZAJA)Center of Consultation of Khanevadeh HospitalTehranIran
| | - Maryam Maleki
- Department of Pediatric and Neonatal Intensive Care Nursing Education, School of Nursing and MidwiferyTehran University of Medical SciencesTehranIran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health SciencesNord UniversityBodøNorway
- Faculty of Science and HealthCharles Sturt UniversityOrangeNew South WalesAustralia
| | - Manela Glarcher
- Institute of Nursing Science and PracticeParacelsus Medical UniversitySalzburgAustria
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Park J, You SB, Ryu GW, Kim Y. Attributes of errors, facilitators, and barriers related to rate control of IV medications: a scoping review. Syst Rev 2023; 12:230. [PMID: 38093372 PMCID: PMC10717502 DOI: 10.1186/s13643-023-02386-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Intravenous (IV) medication is commonly administered and closely associated with patient safety. Although nurses dedicate considerable time and effort to rate the control of IV medications, many medication errors have been linked to the wrong rate of IV medication. Further, there is a lack of comprehensive studies examining the literature on rate control of IV medications. This study aimed to identify the attributes of errors, facilitators, and barriers related to rate control of IV medications by summarizing and synthesizing the existing literature. METHODS This scoping review was conducted using the framework proposed by Arksey and O'Malley and PRISMA-ScR. Overall, four databases-PubMed, Web of Science, EMBASE, and CINAHL-were employed to search for studies published in English before January 2023. We also manually searched reference lists, related journals, and Google Scholar. RESULTS A total of 1211 studies were retrieved from the database searches and 23 studies were identified from manual searches, after which 22 studies were selected for the analysis. Among the nine project or experiment studies, two interventions were effective in decreasing errors related to rate control of IV medications. One of them was prospective, continuous incident reporting followed by prevention strategies, and the other encompassed six interventions to mitigate interruptions in medication verification and administration. Facilitators and barriers related to rate control of IV medications were classified as human, design, and system-related contributing factors. The sub-categories of human factors were classified as knowledge deficit, performance deficit, and incorrect dosage or infusion rate. The sub-category of design factor was device. The system-related contributing factors were classified as frequent interruptions and distractions, training, assignment or placement of healthcare providers (HCPs) or inexperienced personnel, policies and procedures, and communication systems between HCPs. CONCLUSIONS Further research is needed to develop effective interventions to improve IV rate control. Considering the rapid growth of technology in medical settings, interventions and policy changes regarding education and the work environment are necessary. Additionally, each key group such as HCPs, healthcare administrators, and engineers specializing in IV medication infusion devices should perform its role and cooperate for appropriate IV rate control within a structured system.
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Affiliation(s)
- Jeongok Park
- College of Nursing, Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Korea
| | - Sang Bin You
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Gi Wook Ryu
- Department of Nursing, Hansei University, 30, Hanse-Ro, Gunpo-Si, 15852, Gyeonggi-Do, Korea.
| | - Youngkyung Kim
- College of Nursing and Brain Korea 21 FOUR Project, Yonsei University, Seoul, Korea.
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Clark CM, Eimer MC, Intorre FM. Transitions of Care: Strategies for Medication Optimization and Deprescribing in Older Adults. J Gerontol Nurs 2023; 49:5-10. [PMID: 38015150 DOI: 10.3928/00989134-20231107-02] [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: 11/29/2023]
Abstract
Older adults have an increased risk of adverse drug events related to polypharmacy and potentially inappropriate medication (PIM) use. These patients are even more vulnerable as they transition through different health care settings. In 2023, the American Geriatrics Society published an updated version of the Beers Criteria®, providing updated guidance on identifying and managing PIMs. Nurses and nurse practitioners play important roles in medication management across the continuum of care. The current article aims to illustrate key concepts regarding medication safety and deprescribing for older adult patients during transitions of care. [Journal of Gerontological Nursing, 49(12), 5-10.].
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Hashemian M, Salami Z, Azizpour I, Mirzaei A. Evaluation of the safety status of intrahospital transfer of critically ill patients from the perspective of emergency and ICU nurses: a cross-sectional study in Iran. BMJ Open 2023; 13:e072584. [PMID: 37879698 PMCID: PMC10603409 DOI: 10.1136/bmjopen-2023-072584] [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] [Received: 02/08/2023] [Accepted: 10/09/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE Critically ill patients often require intrahospital transfer (IHT) for diagnostic and therapeutic procedures. However, this process carries potential risks and can harm the patient's safety. This study aimed to assess the safety of IHT for critically ill patients by gathering feedback from emergency and intensive care unit (ICU) nurses. DESIGN A cross-sectional study. SETTING A study was conducted in Ardabil City, Iran's educational and medical hospitals. The study involved 288 emergency and ICU nurses. The data were collected through a paper-based form, which included demographic and work-related characteristics and an IHT safety scale. RESULTS The mean score of IHT was 75.2±15.53. The results of multiple regression analysis showed that work experience (B=0.291, p=0.011), perception of IHT safety (B=0.196, p=0.003), education level (B=-0.123, p=0.038) and equipment checker (B=-0.121, p=0.045), variables were the predictors of IHT safety. CONCLUSION The study found that the safety level during the interhospital transfer (IHT) was low. Hospitals aim to create a safe environment that minimises the risks associated with IHT. Therefore, they must identify potential risks during the transfer process and take necessary measures to mitigate them. Practical strategies that can be employed include using experienced nursing staff, conducting equipment checks, ensuring a complete understanding of the tools and technologies involved in the transfer process, and increasing awareness of IHT safety.
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Affiliation(s)
- Maryam Hashemian
- Department of Emergency Nursing, Ardabil University of Medical Sciences, Ardebil, Iran (the Islamic Republic of)
| | - Zahra Salami
- Department of Emergency Nursing, Ardabil University of Medical Sciences, Ardebil, Iran (the Islamic Republic of)
| | - Islam Azizpour
- Department of Emergency Nursing, Ardabil University of Medical Sciences, Ardebil, Iran (the Islamic Republic of)
| | - Alireza Mirzaei
- Department of Emergency Nursing, Ardabil University of Medical Sciences, Ardebil, Iran (the Islamic Republic of)
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Pereira F, Meyer-Massetti C, Del Río Carral M, von Gunten A, Wernli B, Verloo H. Development of a patient-centred medication management model for polymedicated home-dwelling older adults after hospital discharge: results of a mixed methods study. BMJ Open 2023; 13:e072738. [PMID: 37730411 PMCID: PMC10514617 DOI: 10.1136/bmjopen-2023-072738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023] Open
Abstract
OBJECTIVE This study aimed to investigate medication management among polymedicated, home-dwelling older adults after discharge from a hospital centre in French-speaking Switzerland and then develop a model to optimise medication management and prevent adverse health outcomes associated with medication-related problems (MRPs). DESIGN Explanatory, sequential, mixed methods study based on detailed quantitative and qualitative findings reported previously. SETTING Hospital and community healthcare in the French-speaking part of Switzerland. PARTICIPANTS The quantitative strand retrospectively examined 3 years of hospital electronic patient records (n=53 690 hospitalisations of inpatients aged 65 years or older) to identify the different profiles of those at risk of 30-day hospital readmission and unplanned nursing home admission. The qualitative strand explored the perspectives of older adults (n=28), their informal caregivers (n=17) and healthcare professionals (n=13) on medication management after hospital discharge. RESULTS Quantitative results from older adults' profiles, affected by similar patient-related, medication-related and environment-related factors, were enhanced and supported by qualitative findings. The combined findings enabled us to design an interprofessional, collaborative medication management model to prevent MRPs among home-dwelling older adults after hospital discharge. The model comprised four interactive fields of action: listening to polymedicated home-dwelling older adults and their informal caregivers; involving older adults and their informal caregivers in shared, medication-related decision-making; empowering older adults and their informal caregivers for safe medication self-management; optimising collaborative medication management practices. CONCLUSION By linking the retrospective and prospective findings from our explanatory sequential study involving multiple stakeholders' perspectives, we created a deeper comprehension of the complexities and challenges of safe medication management among polymedicated, home-dwelling older adults after their discharge from hospital. We subsequently designed an innovative, collaborative, patient-centred model for optimising medication management and preventing MRPs in this population.
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Affiliation(s)
- Filipa Pereira
- Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal
- School of Health Sciences, HES-SO Valais/ Wallis, Sion, Switzerland
| | - Carla Meyer-Massetti
- Clinical Pharmacology and Toxicology, Clinical of General Internal Medicine, Inselspital, University Hospital of Bern, Bern, Switzerland
- Institute for Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - María Del Río Carral
- Institute of Psychology, Research Center for the Psychology of Health, Aging and Sports Examination (PHASE), University of Lausanne, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
| | - Boris Wernli
- Swiss Centre of Expertise in the Social Sciences (FORS), University of Lausanne, Lausanne, Switzerland
| | - Henk Verloo
- School of Health Sciences, HES-SO Valais/ Wallis, Sion, Switzerland
- Service of Old Age Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
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15
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Lachance SL, Zucker DM, Hutchins JM. Adult Cannabis Use: An Exploratory Case Study. J Gerontol Nurs 2023; 49:19-26. [PMID: 37523334 DOI: 10.3928/00989134-20230707-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Cannabis use is on the rise among adults and older adults managing chronic health conditions in the United States. There is limited understanding of this trend and the factors influencing cannabis use in the health care community. The current study explores the perceptions and experiences of adults and older adults with chronic health conditions who use cannabis regularly. Case study data were gathered through interviews guided by the Biopsychosocial Model. Biological, psychological, and social reasons for cannabis use emerged in the interviews. Despite reporting adverse events, cannabis was reported as an effective treatment for participants' chronic health issues, and participants were more comfortable with its use compared to prescription medications. A feeling of autonomy contributed to cannabis use being perceived as positive. Cannabis use is rising in the United States. Primary care providers must regularly screen older adults to identify appropriate and inappropriate use patterns. [Journal of Gerontological Nursing, 49(8), 19-26.].
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16
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Park J, Han AY. Medication safety education in nursing research: Text network analysis and topic modeling. NURSE EDUCATION TODAY 2023; 121:105674. [PMID: 36481524 DOI: 10.1016/j.nedt.2022.105674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This study aimed to identify the knowledge structure of medication safety nursing education literature by developing schematic diagrams of the relationship between keywords from a macro perspective. This study also identifies the research topics and trends over time. DESIGN This quantitative content study used text network analysis to explore keywords and research topics using topic modeling within the medication safety nursing education literature. DATA SOURCES PubMed, EMBASE, and Cochrane databases were used to search for the medication safety nursing education literature published until December 2021. METHODS Keywords from 2085 articles were examined using text network analysis and topic modeling with NetMiner 4.4.3. RESULTS The keywords with the most frequency and the highest networking degree in centrality were "patient," "medication," "program," "nurse," and "care." The emerging keywords assessed by time periods were identified; the first phase ("heart failure," "insulin," "chemotherapy," and "infusion"), the second phase ("medication errors," "staff," and "information"), the third phase ("program," "management," and "data"). The results of topic modeling were as follows: safe medication administration, safe medication reconciliation process, medication education for patients, medication errors in nursing practice, and multidisciplinary teamwork for medication safety. CONCLUSION These findings will help nursing researchers and educators to understand the trends and insights for medication safety education and educate future nurses to provide safer nursing care.
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Affiliation(s)
- Jinkyung Park
- College of Nursing, Chonnam National University, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Republic of Korea
| | - A Young Han
- Department of Nursing, College of Life Science and Industry, Sunchon National University, 255, Jungang-ro, Suncheon-Si, Jeollanam-do 57922, Republic of Korea.
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Cheng C, Yu H, Wang Q. Nurses' Experiences Concerning Older Adults with Polypharmacy: A Meta-Synthesis of Qualitative Findings. Healthcare (Basel) 2023; 11:healthcare11030334. [PMID: 36766909 PMCID: PMC9914425 DOI: 10.3390/healthcare11030334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/26/2023] Open
Abstract
Polypharmacy is an increasing health concern among older adults and results in many health risks. Nurses have an important role to play in supporting medication management and promoting medication safety across different settings. This study aims to provide a meta-synthesis of qualitative studies investigating the perceptions and experiences of nurses in caring for older adults with polypharmacy. Electronic databases including PsycArticles, CINAHL Complete, MEDLINE, and ERIC were searched between September 2001 and July 2022. Potential studies were checked against inclusion and exclusion criteria. We included peer-reviewed studies reporting data on the experiences of nursing staff across different settings. Studies unitizing any qualitative approach were included, and the included studies were reviewed and analyzed using a thematic synthesis approach. Study quality was examined using the Critical Appraisal Skills Programme checklist for qualitative research. A total of nine studies with 91 nurses were included. Four major themes emerged: older adults suffering from polypharmacy, the importance of multidisciplinary teams, nursing roles in caring for older adults, and the complexity and barriers of implementing polypharmacy management. Healthcare professionals should pay attention to the impacts of polypharmacy in older adults' lives and should acknowledge the importance of team-based polypharmacy care in supporting older adults. Nurses play a key role in caring for older adults with polypharmacy, therefore, they should be empowered and be involved in medication management.
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Affiliation(s)
- Cheng Cheng
- School of Nursing, Fudan University, Shanghai 200032, China
- Correspondence: ; Tel.: +86-21-64431003
| | - Huan Yu
- School of Nursing, Anhui Medical University, Hefei 230032, China
| | - Qingling Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
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18
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Kim C, Kim M, Lee G, Park E, Schlenk EA. Effectiveness of nurse‐led interventions on medication adherence in adults taking medication for metabolic syndrome: A systematic review and meta‐analysis. J Clin Nurs 2022. [DOI: 10.1111/jocn.16589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/14/2022] [Accepted: 11/03/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Chun‐Ja Kim
- College of Nursing and the Research Institute of Nursing Science Ajou University Suwon South Korea
| | - Moonsun Kim
- Department of Nursing, Graduate School and College of Nursing Ajou University Suwon South Korea
| | - Ga‐Young Lee
- Department of Nursing, Graduate School and College of Nursing Ajou University Suwon South Korea
| | - Eunyoung Park
- Chungnam National University College of Nursing Daejeon South Korea
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19
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Berdida DJE, Grande RAN, Lopez V, Ramirez SH, Manting MME, Berdida MME, Bañas CB. A national online survey of Filipinos' knowledge, attitude, and awareness of antibiotic use and resistance: A cross-sectional study. Nurs Forum 2022; 57:1299-1313. [PMID: 36161465 DOI: 10.1111/nuf.12803] [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: 07/17/2022] [Revised: 08/23/2022] [Accepted: 09/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Antibiotic resistance is one of the 21st century's most challenging clinical and public health issues. However, this health issue remains underreported in the Philippines. AIM This study examined Filipinos' knowledge, attitude, and awareness regarding antibiotic use and resistance and the associated predictive variables of antibiotic resistance. METHODS A cross-sectional design and Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used in this study. Convenience sampling of 3767 participants completed the Eurobarometer survey on antibiotic resistance from October 2021 to February 2022. χ2 and regression analysis were used to analyze the data. RESULTS Most participants were familiar with the popular types of available antibiotics. Males and healthcare workers had a higher percentage of correct responses on antibiotic resistance knowledge. Participants had moderate to high knowledge levels of antibiotic resistance. Age, educational attainment, profession, antibiotic use in the previous year, and household members taking antibiotics were significant predictors of the level of knowledge of antibiotic resistance. There was a significant difference in participants' sex, age, and educational attainment in their attitudes toward acquisition, hygienic practices, and the role of health professionals in antibiotic resistance. CONCLUSION Government agencies and policymakers should consider the identified predictors when establishing policies on antibiotic resistance. This will ensure that antibiotic use is safe and effective.
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Affiliation(s)
| | - Rizal Angelo N Grande
- Mental Health Nursing Department, College of Nursing, University of Ha'il, Ha'il City, Saudi Arabia
| | - Violeta Lopez
- School of Nursing, Midwifery and Social Sciences, Central Queensland University, Rockhampton, Queensland, Australia
| | - Sheryl H Ramirez
- University Research Innovation and Extension, Universidad de Manila, Manila, Philippines
| | - Muhmin Michael E Manting
- Department of Biological Sciences, Mindanao State University-Iligan Institute of Technology, Iligan City, Lanao del Norte, Philippines
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20
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Effects of a nurse-led medication self-management intervention on medication adherence and health outcomes in older people with multimorbidity: A randomised controlled trial. Int J Nurs Stud 2022; 134:104314. [DOI: 10.1016/j.ijnurstu.2022.104314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/27/2022]
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21
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Pereira F, Bieri M, Martins MM, del Río Carral M, Verloo H. Safe Medication Management for Polymedicated Home-Dwelling Older Adults after Hospital Discharge: A Qualitative Study of Older Adults, Informal Caregivers and Healthcare Professionals’ Perspectives. NURSING REPORTS 2022; 12:403-423. [PMID: 35736616 PMCID: PMC9230543 DOI: 10.3390/nursrep12020039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Safe medication management is particularly challenging among polymedicated home-dwelling older adults after hospital discharge. This study aimed to identify and categorise the stressors experienced and reconstitution strategies adopted by older adults, their informal caregivers, and healthcare professionals as they manage older adults’ medications after hospital discharge. A primary study collected the perspectives of 28 older adults, 17 informal caregivers, and 13 healthcare professionals using a qualitative descriptive design. The Neuman Systems Model was used as the basis for a secondary deductive content analysis. Findings revealed that post-discharge medication management at home involved numerous stressors, often including dysfunctions in communication, collaboration, and coordination between the multiple stakeholders involved. Reconstitution strategies for safe medication management were not always successful or satisfactory and were sometimes identified as stressors themselves. Older adults, informal caregivers, and healthcare professionals’ perspectives highlighted several potential opportunities for improving safe medication management through nurse-led, interprofessional, patient-centred practices.
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Affiliation(s)
- Filipa Pereira
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
- School of Health Sciences, HES-SO Valais/Wallis, 1950 Sion, Switzerland; (M.B.); (H.V.)
- Correspondence:
| | - Marion Bieri
- School of Health Sciences, HES-SO Valais/Wallis, 1950 Sion, Switzerland; (M.B.); (H.V.)
| | | | - María del Río Carral
- Research Center for Psychology of Health, Aging and Sport Examination, Institute of Psychology, University of Lausanne, 1015 Lausanne, Switzerland;
| | - Henk Verloo
- School of Health Sciences, HES-SO Valais/Wallis, 1950 Sion, Switzerland; (M.B.); (H.V.)
- Service of Old Age Psychiatry, Lausanne University Hospital, 1008 Prilly, Switzerland
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22
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Mardani A, Paal P, Weck C, Jamshed S, Vaismoradi M. Practical Considerations of PRN Medicines Management: An Integrative Systematic Review. Front Pharmacol 2022; 13:759998. [PMID: 35496317 PMCID: PMC9039188 DOI: 10.3389/fphar.2022.759998] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 03/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background and objectives: Highly widespread use of pro re nata (PRN) medicines in various healthcare settings is a potential area for improper medication prescription and administration leading to patient harm. This study aimed to summarize and integrate the findings of all relevant individual studies regarding the practical considerations of PRN medicines management including strategies and interventions by healthcare professionals for safe prescription, dispensing, administration, monitoring, and deprescription of PRN medicines in healthcare settings. Methods: An integrative systematic review on international databases were performed. Electronic databases including Web of Knowledge, Scopus, PubMed (including MEDLINE), and Cinahl were searched to retrieve articles published until end of May 2021. Original qualitative, quantitative, and mixed methods studies written in English were included with a focus on PRN medicines management in healthcare settings. Research synthesis using the narrative method was performed to summarise the results of included studies. Results: Thirty-one studies on PRN medicines in healthcare settings by different healthcare providers were included after the screening of the databases based on eligibility criteria. They were published from 1987 to 2021. The majority of studies were from Australia, the United States, Canada, and the United Kingdom and were conducted in psychiatric settings. Given variations in their purposes, methods, and outcomes, the research synthesis was conducted narratively based on diversities and similarities in findings. Eight categories were developed by the authors as follows: "PRN indications and precautionary measures," "requirements of PRN prescription," "interventions for PRN administration," "monitoring and follow up interventions," "deprescription strategies," "healthcare professionals' role," "participation of patients and families," and "multidisciplinary collaboration." Each category consists of several items and describes what factors should be considered by healthcare professionals for PRN medicines management. Conclusion: The review findings provide insights on the practical considerations of PRN medicines management in clinical practice. The suggested list of considerations in our review can be used by healthcare professionals for optimal PRN medicines management and safeguarding patient care.
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Affiliation(s)
- Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Piret Paal
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Christiane Weck
- Palliative Care, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum Agatharied, Hausham, Germany
| | - Shazia Jamshed
- Clinical Pharmacy and Practice, Faculty of Pharmacy, University Sultan Zainal Abidin, Terengganu, Malaysia
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The Evolving Roles of Nurses Providing Care at Home: A Qualitative Case Study Research of a Transitional Care Team. Int J Integr Care 2022; 22:3. [PMID: 35087352 PMCID: PMC8782082 DOI: 10.5334/ijic.5838] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 01/06/2022] [Indexed: 01/01/2023] Open
Abstract
Purpose: To examine the roles of transitional care nurses in an integrated healthcare system and how the integrated healthcare system influences their evolving roles. Background: Transitional care teams have been introduced to enable the seamless transfer of patients from acute-care to the home settings. A qualitative case study of the transitional care team was conducted to understand the changing roles of these nurses in an integrated Regional Health System (RHS) in Singapore. Methods: A hospital transitional team of an integrated RHS was studied. Purposive sampling was used. Non-participant observations and follow-up interviews were conducted with four nurses. Data were triangulated with the interviews of two managers and three healthcare professionals, and the analysis of documents. Within-case thematic analysis was carried out. Results: Three themes were identified: ‘Coming together to meet the needs of all’; ‘Standing strong amidst the stormy waves’; and ‘Searching for the right formula in handling complexity’. These themes have explained on the atypical roles taken on by nurses in their attempts to close the gaps and meet the patients’ needs. Various factors influencing the evolving roles were revealed. Conclusion: The roles of nurses have ‘emerged differently’ from their traditional counterparts. Various nursing roles have been undertaken to facilitate care integration. The findings emphasised the important balance between formal structural practices and informal processes in facilitating and supporting the nurses in their role development.
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Navarroli JE. Emergency Nurses Association Position Statement: Medication Management and Reconciliation in the Emergency Setting. J Emerg Nurs 2022; 48:88-93. [PMID: 34996575 DOI: 10.1016/j.jen.2021.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/27/2021] [Accepted: 10/06/2021] [Indexed: 11/28/2022]
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Vaismoradi M, Behboudi-Gandevani S, Lorenzl S, Weck C, Paal P. Needs Assessment of Safe Medicines Management for Older People With Cognitive Disorders in Home Care: An Integrative Systematic Review. Front Neurol 2021; 12:694572. [PMID: 34539551 PMCID: PMC8446192 DOI: 10.3389/fneur.2021.694572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/21/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives: The global trend of healthcare is to improve the quality and safety of care for older people with cognitive disorders in their own home. There is a need to identify how medicines management for these older people who are cared by their family caregivers can be safeguarded. This integrative systematic review aimed to perform the needs assessment of medicines management for older people with cognitive disorders who receive care from their family caregivers in their own home. Methods: An integrative systematic review of the international literature was conducted to retrieve all original qualitative and quantitative studies that involved the family caregivers of older people with cognitive disorders in medicines management in their own home. MeSH terms and relevant keywords were used to search four online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science and to retrieve studies published up to March 2021. Data were extracted by two independent researchers, and the review process was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Given that selected studies were heterogeneous in terms of the methodological structure and research outcomes, a meta-analysis could not be performed. Therefore, narrative data analysis and knowledge synthesis were performed to report the review results. Results: The search process led to retrieving 1,241 studies, of which 12 studies were selected for data analysis and knowledge synthesis. They involved 3,890 older people with cognitive disorders and 3,465 family caregivers. Their methodologies varied and included cohort, randomised controlled trial, cross-sectional studies, grounded theory, qualitative framework analysis, and thematic analysis. The pillars that supported safe medicines management with the participation of family caregivers in home care consisted of the interconnection between older people's needs, family caregivers' role, and collaboration of multidisciplinary healthcare professionals. Conclusion: Medicines management for older people with cognitive disorders is complex and multidimensional. This systematic review provides a comprehensive image of the interconnection between factors influencing the safety of medicines management in home care. Considering that home-based medicines management is accompanied with stress and burden in family caregivers, multidisciplinary collaboration between healthcare professionals is essential along with the empowerment of family caregivers through education and support.
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Affiliation(s)
| | | | - Stefan Lorenzl
- Palliative Care, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum Agatharied, Hausham, Germany
| | - Christiane Weck
- Palliative Care, Paracelsus Medical University, Salzburg, Austria.,Department of Neurology, Klinikum Agatharied, Hausham, Germany
| | - Piret Paal
- WHO Collaborating Centre at the Institute for Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
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Dilles T, Heczkova J, Tziaferi S, Helgesen AK, Grøndahl VA, Van Rompaey B, Sino CG, Jordan S. Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5973. [PMID: 34199519 PMCID: PMC8199654 DOI: 10.3390/ijerph18115973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/28/2021] [Accepted: 05/29/2021] [Indexed: 12/13/2022]
Abstract
Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care.
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Affiliation(s)
- Tinne Dilles
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
| | - Jana Heczkova
- First Faculty of Medicine, Institute of Nursing Theory and Practice, Charles University, 11000 Prague, Czech Republic;
| | - Styliani Tziaferi
- Laboratory of Integrated Health Care, Department of Nursing, University of Peloponnese, 22100 Tripolis, Greece;
| | - Ann Karin Helgesen
- Faculty of Health and Welfare, Østfold University College, 1757 Halden, Norway; (A.K.H.); (V.A.G.)
| | | | - Bart Van Rompaey
- Centre for Research and Innovation in Care (CRIC), Nurse and Pharmaceutical Care (NuPhaC), Department of Nursing and Midwifery Science, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Antwerp, Belgium;
| | - Carolien G. Sino
- Research Group Care for the Chronically Ill, University of Applied Sciences Utrecht, 3584 CH Utrecht, The Netherlands;
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, Wales, UK;
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Salehi T, Seyedfatemi N, Mirzaee MS, Maleki M, Mardani A. Nurses' Knowledge, Attitudes, and Practice in Relation to Pharmacovigilance and Adverse Drug Reaction Reporting: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6630404. [PMID: 33937402 PMCID: PMC8062168 DOI: 10.1155/2021/6630404] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/23/2021] [Accepted: 03/29/2021] [Indexed: 12/30/2022]
Abstract
AIM To describe and synthesize aspects of knowledge, attitudes, and practice regarding pharmacovigilance and adverse drug reaction (ADR) reporting and to explore associated barriers from a nurse perspective. METHODS A systematic review was conducted. Electronic databases including MEDLINE, Embase, Scopus, and Web of Knowledge from January 2010 to October 2020 were searched. Original observational studies that were written in English and which focused on nurses' knowledge, attitudes, practice, and perceived barriers regarding pharmacovigilance and ADR reporting in various healthcare settings were included. RESULTS Twenty-three studies published in English from 2010 to 2020 were retrieved during the search process. Overall, in the knowledge domain, the median percentages of nurses who were aware of the definitions of ADRs were 74.1%, while only 26.3% were aware of the adverse drug reaction reporting form. In the attitude domain, 84.6% of nurses believed ADR reporting to be important for patient/medicine safety and 37.1% had a fear of legal liability following ADR reporting. Although 67.1% of nurses encountered ADRs during their professional life, only 21.2% had a history of ADR reporting. In addition, lack of knowledge/training (median: 47.1%) was identified as the most common barrier in ADR reporting from a nursing viewpoint. CONCLUSION Despite positive nurse attitudes, knowledge and practice in relation to pharmacovigilance activities and ADR reporting did not occur regularly or often. Improving nurses' knowledge through in-service training and degree-level education and addressing the main barriers of ADR reporting may help to achieve an improved level of reporting.
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Affiliation(s)
- Tahmine Salehi
- Nursing Care Research Center, Department of Nursing Management, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naiemeh Seyedfatemi
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Saeed Mirzaee
- Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Maleki
- School of Nursing & Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Mardani
- Nursing Care Research Center, Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Vaismoradi M, Jordan S, Logan PA, Amaniyan S, Glarcher M. A Systematic Review of the Legal Considerations Surrounding Medicines Management. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:65. [PMID: 33450903 PMCID: PMC7828352 DOI: 10.3390/medicina57010065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 12/13/2022]
Abstract
This study explores the legal considerations surrounding medicines management, providing a synthesis of existing knowledge. An integrative systematic review of the current international knowledge was performed. The search encompassed the online databases of PubMed (including Medline), Scopus, CINAHL, and Web of Science using MeSH terms and relevant keywords relating to the legal considerations of medicines management in healthcare settings. The search process led to the identification of 6051 studies published between 2010 and 2020, of which six articles were found to be appropriate for data analysis and synthesis based on inclusion criteria. Research methods were varied and included qualitative interviews, mixed-methods designs, retrospective case reports and cross-sectional interrupted time-series analysis. Their foci were on the delegation of medicines management, pharmacovigilance and reporting of adverse drug reactions (ADRs) before and after legislation by nurses, physicians and pharmacists, medico-legal litigation, use of forced medication and the prescription monitoring program. Given the heterogenicity of the studies in terms of aims and research methods, a meta-analysis could not be performed and, therefore, our review findings are presented narratively under the categories of 'healthcare providers' education and monitoring tasks', 'individual and shared responsibility', and 'patients' rights'. This review identifies legal aspects surrounding medicines management, including supervision and monitoring of the effects of medicines; healthcare providers' knowledge and attitudes; support and standardised tools for monitoring and reporting medicines' adverse side effects/ADRs; electronic health record systems; individual and shared perceptions of responsibility; recognition of nurses' roles; detection of sentinel medication errors; covert or non-voluntary administration of medication, and patient participation.
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Affiliation(s)
- Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway
| | - Sue Jordan
- Department of Nursing, Swansea University, Swansea SA2 8PP, UK;
| | - Patricia A. Logan
- Faculty of Science, Charles Sturt University, Bathurst 2795, Australia;
| | - Sara Amaniyan
- Student Research Center, Semnan University of Medical Sciences, Semnan 3514799442, Iran;
| | - Manela Glarcher
- Institute of Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria;
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