Elisabeth M Smale, Jessica van den Berg, Jennifer Korporaal-Heijman, Charlotte L Bekker, Bart J F van den Bemt
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引用次数: 0
Abstract
Background: Implementing patient's own medication (POM) and self-administration of medication (SAM) has several benefits for safe and sustainable medication use, including enhanced patient empowerment reduced workload for hospital staff and decreased medication waste. Despite positive attitude of stakeholders, the upscaling of these strategies in hospitals remained limited. This study aimed to (i) identify barriers and facilitators for implementing POM and SAM and (ii) develop implementation strategies to address these.
Methods: Semistructured interviews were conducted among healthcare providers involved in the implementation of POM and SAM in 10 Dutch hospitals. The study population encompassed (hospital and outpatient) pharmacists, pharmacy technicians, nurses, and (ward) physicians. The topic guide was based on COM-B model. Barriers and facilitators were identified with thematic content analysis and were categorized to the Consolidated Framework for Implementation Research (CFIR). Implementation strategies were selected based on identified barriers through the CFIR- Expert Recommendations for Implementing Change (ERIC) tool and identified strategies were clustered into predefined focus areas to develop implementation targets.
Results: The 23 participants generally expressed a positive attitude towards implementation of POM and SAM. Themes reflecting facilitators related to (i) multiple benefits for patients, hospital, and society, (ii) a dedicated multidisciplinary implementation team, (iii) an iterative implementation process, whereas barriers related to (iv) substantial and invasive workflow changes, (v) reluctance to change responsibilities of healthcare providers, and (vi) unclear regulations and reimbursement. The CFIR-ERIC tool highlighted 57 implementation strategies in nine key focus areas to support the implementation of POM and SAM.
Conclusion: To implement POM and PAM successfully, strategies relating to involving stakeholders, changing infrastructure, and using an iterative implementation process are required.
期刊介绍：
The International Journal for Quality in Health Care makes activities and research related to quality and safety in health care available to a worldwide readership. The Journal publishes papers in all disciplines related to the quality and safety of health care, including health services research, health care evaluation, technology assessment, health economics, utilization review, cost containment, and nursing care research, as well as clinical research related to quality of care.
This peer-reviewed journal is truly interdisciplinary and includes contributions from representatives of all health professions such as doctors, nurses, quality assurance professionals, managers, politicians, social workers, and therapists, as well as researchers from health-related backgrounds.
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