Department of Pharmacy, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Department of Pharmacy, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
J Clin Nurs. 2023 Jun;32(11-12):2709-2721. doi: 10.1111/jocn.16369. Epub 2022 May 20.
To identify stakeholders' views on inpatient Self-Administration of Medication and corresponding prerequisites for successful implementation.
Self-Administration of Medication allows capable patients to manage their medication regimen throughout hospitalisation. It is assumed to facilitate continuity of care, increase medication safety and patient empowerment. To enable sustainable implementation stakeholders should support it. Knowledge about stakeholders' views regarding Self-Administration of Medication is currently lacking.
A qualitative study was conducted among stakeholders using semi-structured interviews.
Using purposive and snowball sampling fourteen representatives from Dutch healthcare associations, organisations and authorities were interviewed between April and July 2019. These stakeholders were asked to reflected on Self-Administration of Medication and its implementation. Data were examined using inductive thematic content analysis and reported following the COREQ checklist.
Most stakeholders were positive towards Self-Administration of Medication and foresaw benefits in terms of the following: improvements to patient-centred care, contributions to sustainable use of healthcare assets and the need and opportunity for change. Critical concerns included reflecting potential risks for patient safety, concerns about implementation feasibility and questions regarding implementation necessity. Stakeholders highlighted prerequisites pertaining to the implementation process in which the following two themes emerged: (1) initiate a supported change and (2) perform research for best practices and identification of benefits. Other prerequisites concerned distinct levels within healthcare including individual patients (i.e. adequate communication), hospital organisation (i.e. to establish a workflow to secure medication safety) and healthcare system (i.e. to facilitate multidisciplinary collaboration in healthcare).
Stakeholders were predominantly positive about Self-Administration of Medication. For successful and sustainable implementation of Self-Administration of Medication, prerequisites identified in this study should be met.
This study provided knowledge about stakeholders' views which could foster implementation and evaluation of Self-Administration of Medication, which may, in turn, promote effective deployment and patient empowerment.
确定利益相关者对住院患者自我给药的看法以及成功实施的相应前提条件。
自我给药允许有能力的患者在住院期间管理自己的药物治疗方案。它被认为可以促进护理的连续性,提高药物安全性和患者的自主权。为了实现可持续实施,利益相关者应该支持它。目前,关于利益相关者对自我给药的看法的知识还很缺乏。
使用半结构化访谈,对利益相关者进行了一项定性研究。
2019 年 4 月至 7 月,通过目的性和滚雪球抽样,对来自荷兰医疗保健协会、组织和当局的 14 名代表进行了采访。这些利益相关者被要求对自我给药及其实施进行反思。使用归纳主题内容分析对数据进行检查,并按照 COREQ 清单进行报告。
大多数利益相关者对自我给药持积极态度,并预见了以下方面的好处:改善以患者为中心的护理,对可持续使用医疗保健资产的贡献,以及变革的必要性和机会。关键问题包括对患者安全潜在风险的思考,对实施可行性的关注以及对实施必要性的质疑。利益相关者强调了与实施过程相关的前提条件,其中出现了以下两个主题:(1)启动支持性变革;(2)开展最佳实践研究并确定收益。其他前提条件涉及医疗保健的不同层面,包括个体患者(即进行充分的沟通)、医院组织(即建立工作流程以确保药物安全)和医疗保健系统(即促进医疗保健领域的多学科合作)。
利益相关者对自我给药主要持积极态度。为了成功和可持续地实施自我给药,本研究确定的前提条件应该得到满足。
本研究提供了利益相关者观点的知识,这可以促进自我给药的实施和评估,从而促进有效的部署和患者赋权。