Tappeiner Waltraud, Wieser Heike, Obkircher Rita, Pigneter Jessica, Roth Jacob, Ausserhofer Dietmar
Claudiana Research, College of Healthcare Professions Claudiana, Bolzano/Bozen, Italy
Claudiana Research, College of Healthcare Professions Claudiana, Bolzano/Bozen, Italy.
BMJ Open. 2024 Dec 26;14(12):e091616. doi: 10.1136/bmjopen-2024-091616.
To explore nursing home (NH) staff's experiences implementing an automated blister packaging system for solid, orally ingestible drugs.
This was a descriptive qualitative study. Semistructured interviews were used for data collection, and qualitative content analysis was applied for data analysis.
Four NHs in a region in Northern Italy participated in the piloting of an automated blister packaging system.
The purposive sample comprised 40 NH staff (seven registered nurses, 11 certified nursing assistants, three nursing aids, seven nursing managers, four directors and eight physicians) RESULTS: Six main categories emerged from the data analysis: (1) impacting safety, including improved medication process, perceived insecurities and remaining error sources; (2) creating free spaces, including time, individualised care and drug storage and logistics; (3) serving residents, (4) meeting expectations, including met and unmet expectations; (5) generating efforts and (6) producing waste. They all merged into one theme 'It pays off!'
As experienced by NH staff, the automated blister packaging system improved medication safety and reduced the workload of registered nurses, but it is not an 'all-around carefree package'. Continuous quality improvement and risk management strategies are recommended to accompany and sustain implementation, as well as further clarification of roles and duties among the different care workers involved in medication management. Further research is needed to gain a better understanding of the impact of an automated blister packaging system on registered nurses' competencies in NHs regarding medication management and residents' therapies and safety.
探讨养老院工作人员在实施固体口服药物自动泡罩包装系统方面的经验。
这是一项描述性定性研究。采用半结构化访谈收集数据，并运用定性内容分析法进行数据分析。
意大利北部一个地区的四家养老院参与了自动泡罩包装系统的试点。
目的抽样包括40名养老院工作人员（7名注册护士、11名持证护理助理、3名护理辅助人员、7名护理经理、4名主任和8名医生）。结果：数据分析得出六个主要类别：（1）影响安全，包括改进用药流程、感知到的不安全感和剩余的错误来源；（2）创造自由空间，包括时间、个性化护理以及药品储存和物流；（3）服务居民；（4）满足期望，包括已满足和未满足的期望；（5）产生努力；（6）产生废物。它们都合并为一个主题“这是值得的！”
正如养老院工作人员所体验到的，自动泡罩包装系统提高了用药安全性，减轻了注册护士的工作量，但它并非一个“全方位无忧无虑的方案”。建议采用持续质量改进和风险管理策略来伴随并维持实施，同时进一步明确参与药物管理的不同护理人员之间的职责。需要进一步研究，以更好地了解自动泡罩包装系统对养老院注册护士在药物管理、居民治疗和安全方面能力的影响。
