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探索养老院中的药物安全结构和流程:一项横断面研究。

Exploring medication safety structures and processes in nursing homes: a cross-sectional study.

机构信息

Pflegewissenschaft - Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland.

School of Engineering and Management Vaud, HES-SO University of Applied Sciences and Arts, Western Switzerland, Yverdon-les-Bains, Switzerland.

出版信息

Int J Clin Pharm. 2023 Dec;45(6):1464-1471. doi: 10.1007/s11096-023-01625-6. Epub 2023 Aug 10.

Abstract

BACKGROUND

Medication safety is important to limit adverse events for nursing home residents. Several factors, such as interprofessional collaboration with pharmacists and medication reviews, have been shown in the literature to influence medication safety processes.

AIM

This study had three main objectives: (1) To assess how facility- and unit-level organization and infrastructure are related to medication use processes; (2) To determine the extent of medication safety-relevant processes; and (3) To explore pharmacies' and pharmacists' involvement in nursing homes' medication-related processes.

METHOD

Cross-sectional multicenter survey data (2018-2019) from a convenience sample of 118 Swiss nursing homes were used. Data were collected on facility and unit characteristics, pharmacy services, as well as medication safety-related structures and processes. Descriptive statistics were used.

RESULTS

Most of the participating nursing homes (93.2%) had electronic resident health record systems that supported medication safety in various ways (e.g., medication lists, interaction checks). Electronic data exchanges with outside partners such as pharmacies or physicians were available for fewer than half (10.2-46.3%, depending on the partner). Pharmacists collaborating with nursing homes were mainly involved in logistical support. Medication reviews were reportedly conducted regularly in two-thirds of facilities.

CONCLUSION

A high proportion of Swiss nursing homes have implemented diverse processes and structures that support medication use and safety for residents; however, their collaboration with pharmacists remains relatively limited.

摘要

背景

用药安全对于限制养老院居民的不良事件非常重要。文献中已经证实,一些因素如与药剂师的跨专业合作以及药物审查等,会影响用药安全流程。

目的

本研究有三个主要目标:(1)评估设施和单元级别的组织和基础设施与用药流程之间的关系;(2)确定药物安全相关流程的程度;(3)探索药房和药剂师在养老院药物相关流程中的参与情况。

方法

本研究使用了 2018-2019 年瑞士 118 家养老院的便利样本的横断面多中心调查数据。数据收集内容包括设施和单元特征、药房服务以及与药物安全相关的结构和流程。使用描述性统计方法。

结果

大多数参与的养老院(93.2%)都拥有支持用药安全的电子居民健康记录系统,这些系统通过多种方式提供支持(例如,用药清单、相互检查)。与药房或医生等外部合作伙伴进行电子数据交换的养老院不到一半(10.2-46.3%,具体取决于合作伙伴)。与养老院合作的药剂师主要提供后勤支持。据报道,三分之二的养老院定期进行药物审查。

结论

瑞士养老院实施了多种支持居民用药和安全的流程和结构,比例较高;但与药剂师的合作仍相对有限。

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Emerging approaches to polypharmacy among older adults.老年人多重用药的新方法。
Nat Aging. 2021 Apr;1(4):347-356. doi: 10.1038/s43587-021-00045-3. Epub 2021 Mar 22.
2
[Polypharmacy in nursing homes: options to improve drug therapy safety].[养老院中的多重用药:提高药物治疗安全性的选择]
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2023 May;66(5):530-539. doi: 10.1007/s00103-023-03694-4. Epub 2023 Apr 12.
8
Medication use quality and safety in older adults: 2020 update.老年人用药质量和安全:2020 更新版。
J Am Geriatr Soc. 2022 Feb;70(2):389-397. doi: 10.1111/jgs.17603. Epub 2021 Dec 13.

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