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医疗机构间沟通障碍导致转院期间药物差异的解决延迟。

Inter-facility communication barriers delay resolving medication discrepancies during transitions of care.

机构信息

Division of Pharmacy Practice and Administration, University of Missouri-Kansas City, School of Pharmacy, Kansas City, MO, 64108, USA.

Department of Nursing, University of Massachusetts-Boston, Boston, MA, USA.

出版信息

Res Social Adm Pharm. 2019 Apr;15(4):366-369. doi: 10.1016/j.sapharm.2018.05.124. Epub 2018 Jun 8.

Abstract

BACKGROUND

Medication discrepancies occurring during transitions of care between hospitals and nursing homes increase the risk of adverse events for patients. Resolving mismatched information between hospitals and nursing homes adds additional burden to nursing home staff.

OBJECTIVE

The aim of this study was to characterize challenges facing nursing home staff in receiving and resolving medication discrepancies during resident intake.

METHODS

This study used one focus group comprised of five nurses, one pharmacist and two administrators from four nursing homes to explore the staffs' experiences resolving medication discrepancies at resident intake. Thematic analysis was used to determine primary themes and categories arising from focus group transcripts.

RESULTS

Three common challenges included 1) Nursing homes relying upon external providers for accurate information that is frequently delayed; 2) Prescribing data shared between hospitals and nursing facilities on incompatible formats with inconsistent content; 3) Following a specific communication workflow between facilities to resolve errors as efficiently as possible.

CONCLUSIONS

Improving access to formularies and medical histories for providers across the continuum of care and improving information sharing across transitions would improve communication, decrease discrepancies and increase patient safety during post-acute care transitions.

摘要

背景

医院和养老院之间的护理交接过程中出现的用药差异会增加患者发生不良事件的风险。解决医院和养老院之间信息不匹配的问题会给养老院的工作人员增加额外的负担。

目的

本研究旨在描述养老院工作人员在接收和解决居民入住时用药差异方面面临的挑战。

方法

本研究使用了一个由来自四家养老院的五名护士、一名药剂师和两名管理人员组成的焦点小组,以探讨工作人员在居民入住时解决用药差异的经验。使用主题分析确定了焦点小组记录中出现的主要主题和类别。

结果

三个常见的挑战包括:1)养老院依赖外部供应商获取准确信息,但这些信息经常延迟;2)医院和养老院之间共享的处方数据格式不兼容,内容不一致;3)为了尽可能有效地解决错误,按照特定的沟通工作流程在设施之间进行。

结论

改善整个护理连续体中提供者获取处方和病史的机会,并改善过渡期间的信息共享,将提高沟通效率,减少差异,提高患者在急性后期护理过渡期间的安全性。

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