Gilmartin Julia F-M, Marriott Jennifer L, Hussainy Safeera Y
Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Vic., Australia.
Int J Pharm Pract. 2014 Dec;22(6):407-14. doi: 10.1111/ijpp.12091. Epub 2014 Jan 23.
Dose administration aids (DAAs) organise medicines that have been repacked according to the day of the week and time of the day in which they must be taken. In Australia, DAAs are commonly prepared by pharmacy staff for residential aged care facility (RACF) medicine administration. Although the limited available literature indicates that DAA incidents of inaccurate or unsuitable medicine repacking do occur, there is a paucity of qualitative research identifying quality improvement strategies for this service.
This study aims to investigate the perceived contributing factors to DAA incidents and strategies for quality improvement in RACFs and pharmacies.
Health professional perceptions were drawn from three structured focus groups, including six pharmacists, five nurses, a pharmacy technician and a personal care worker. Participants were involved in the preparation, supply or use of DAAs at pharmacies or RACFs that were involved in a previous DAA audit. Transcripts were analysed using thematic analysis.
Four major themes were identified as contributing to DAA incidents, with quality improvement strategies aligned to those same four themes: communication, knowledge and awareness, medicine handling and attitude. Strategies included improving interprofessional communication and addressing the limitations associated with RACF medicine records; targeting medicine knowledge gaps and increasing awareness of DAA incidents; encouraging greater care when preparing and checking DAAs; and fostering a team mentality among members of the aged care team.
Recommendations include using current findings to develop multidisciplinary quality improvement initiatives to prevent DAA incidents and to improve the quality of this pharmacy medicine supply service.
剂量给药辅助工具（DAAs）将已重新包装的药品按照一周中的日期和必须服药的时间进行整理。在澳大利亚，DAAs通常由药房工作人员为老年护理机构（RACF）的药品管理而准备。尽管现有有限的文献表明确实会发生药品重新包装不准确或不合适的DAA事件，但缺乏定性研究来确定这项服务的质量改进策略。
本研究旨在调查RACFs和药房中DAA事件的感知促成因素以及质量改进策略。
从三个结构化焦点小组中收集卫生专业人员的看法，包括六名药剂师、五名护士、一名药房技术员和一名个人护理工作者。参与者参与了之前DAA审计涉及的药房或RACFs中DAAs的制备、供应或使用。使用主题分析法对转录本进行分析。
确定了导致DAA事件的四个主要主题，质量改进策略也与这四个主题一致：沟通、知识与意识、药品处理和态度。策略包括改善跨专业沟通并解决与RACF药品记录相关的局限性；针对药品知识差距并提高对DAA事件的认识；在制备和检查DAAs时鼓励更加谨慎；以及在老年护理团队成员中培养团队精神。
建议包括利用当前研究结果制定多学科质量改进举措，以预防DAA事件并提高这项药房药品供应服务的质量。
