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地区护士对75岁老人的预防性家访:识别与不安全用药管理相关因素的契机。

District nurses' preventive home visits to 75-year-olds: an opportunity to identify factors related to unsafe medication management.

作者信息

Lagerin Annica, Carlsson Axel C, Nilsson Gunnar, Westman Jeanette, Törnkvist Lena

机构信息

Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden

Centre for Family Medicine, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden Department of Public Health and Caring Sciences/Section of Geriatrics, Uppsala University, Uppsala, Sweden.

出版信息

Scand J Public Health. 2014 Dec;42(8):786-94. doi: 10.1177/1403494814550680. Epub 2014 Sep 26.

Abstract

AIMS

To investigate factors related to unsafe medication management among 75-year-olds during preventive home visits, and to describe the interventions district nurses used.

METHODS

An explorative study. During a 9- to 12-month period, 36 DNs used the Safe Medication Assessment (SMA) tool during preventive home visits to 75-year-olds who used at least one drug (n=113).

RESULTS

One or more factors related to unsafe medication management were identified in 84% of the 75-year-olds. More than 40% used five or more drugs, and 34.5% reported symptoms potentially indicative of adverse effects of their drugs. Nearly 30% had prescribers from more than two medical units, and 7.1% of the older persons were appraised as having reduced cognitive ability. DNs intervened in more than two-thirds of the cases and used a variety of nursing care interventions to improve the safety of medication management.

CONCLUSIONS

Preventive home visits seem to provide a unique opportunity to promote safe medication management. Several factors related to unsafe medication management were identified, and several different nursing care interventions were carried out to ensure safe medication management. Use of the SMA tool in preventive home visits seems to be advantageous in improving the safety of medication management among older persons.

摘要

目的

调查75岁老人在预防性家访期间不安全用药管理的相关因素,并描述社区护士所采用的干预措施。

方法

一项探索性研究。在9至12个月的时间里,36名社区护士在对至少使用一种药物的75岁老人进行预防性家访时使用了安全用药评估(SMA)工具(n = 113)。

结果

在84%的75岁老人中发现了一个或多个与不安全用药管理相关的因素。超过40%的老人使用五种或更多药物,34.5%的老人报告有可能表明其药物不良反应的症状。近30%的老人有来自两个以上医疗单位的开方医生,7.1%的老年人被评估为认知能力下降。社区护士在三分之二以上的案例中进行了干预,并采用了多种护理干预措施来提高用药管理的安全性。

结论

预防性家访似乎为促进安全用药管理提供了一个独特的机会。确定了几个与不安全用药管理相关的因素,并实施了几种不同的护理干预措施以确保安全用药管理。在预防性家访中使用SMA工具似乎有利于提高老年人用药管理的安全性。

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