Niederhauser Andrea, Brühwiler Lea D, Fishman Liat, Schwappach David L B
Stiftung für Patientensicherheit Schweiz, Zürich, Schweiz.
Stiftung für Patientensicherheit Schweiz, Zürich, Schweiz.
Z Evid Fortbild Qual Gesundhwes. 2019 Oct;146:7-14. doi: 10.1016/j.zefq.2019.06.005. Epub 2019 Jul 31.
Reducing adverse drug events in nursing homes is a central patient safety concern. The aim of this study was to assess how often selected medication processes to increase medication safety are already implemented in Swiss nursing homes and to examine how nursing homes that have not yet implemented these processes can be characterized based on their organizational features.
Cross-sectional survey study among directors of nursing in Swiss nursing homes.
420 of 1,525 invited individuals participated in the survey (response rate: 27.5 %). Of these, 65.0 % stated that regular systematic medication reviews have been provided in their institution. 9.5 % of the nursing homes use a list to identify potentially inappropriate medication, and 6.7 % of the nursing homes have a standardized process to monitor side effects of medications. 66.0 % of the participating nursing homes have implemented at least one of these three processes, 34.0 % of the participating nursing homes have not implemented any of the three processes. Statistically significant differences in process implementation were found according to the geographical location of the nursing home, the type of documentation used for medications, the physician model, the number of external general practitioners, as well as the medication supply channel and the legal obligation to cooperate with pharmacists. No differences were found with regard to the nursing home size.
In Swiss nursing homes, central safety-relevant medication processes have not yet been implemented nationwide. In particular, implementation is not widespread in nursing homes where medical care for their residents is provided by many different external general practitioners. The organizational features need to be taken into account to successfully implement quality improvement measures.
减少养老院中的药物不良事件是患者安全的核心关注点。本研究的目的是评估瑞士养老院中为提高用药安全性而选择的用药流程的实施频率，并根据其组织特征研究尚未实施这些流程的养老院的特点。
对瑞士养老院的护理主任进行横断面调查研究。
1525名受邀者中有420人参与了调查（回复率：27.5%）。其中，65.0%表示其机构已进行定期系统的用药审查。9.5%的养老院使用清单来识别潜在不适当的药物，6.7%的养老院有监测药物副作用的标准化流程。66.0%的参与调查的养老院至少实施了这三个流程中的一个，34.0%的参与调查的养老院未实施这三个流程中的任何一个。根据养老院的地理位置、用药文件类型、医生模式、外部全科医生数量以及药品供应渠道和与药剂师合作的法律义务，在流程实施方面发现了统计学上的显著差异。在养老院规模方面未发现差异。
在瑞士养老院中，与安全相关的核心用药流程尚未在全国范围内实施。特别是，在由许多不同的外部全科医生为居民提供医疗服务的养老院中，实施并不普遍。要成功实施质量改进措施，需要考虑组织特征。
