Sova Päivi, Celikkayalar Ercan, Sneck Sami, Holmström Anna-Riia
Clinical Support Services, Wellbeing Services County of Lapland, Ounasrinteentie 22, Rovaniemi, 96400, Finland.
Department of Clinical Support Services and Diagnostics, Wellbeing Services County of Kanta-Häme, Hämeenlinna, Finland.
BMC Prim Care. 2025 Feb 7;26(1):30. doi: 10.1186/s12875-025-02722-3.
In rural areas, primary care faces several challenges, and medication therapy is one of the most complex processes in primary care. With a specific, proactive, medication-safety self-assessment tool designed for rural primary care units, healthcare professionals could identify development needs in their medication processes.
The Delphi consensus method with two Delphi rounds was used to create a medication-safety self-assessment tool for rural primary care units in Finnish Lapland. A preliminary tool was designed based on three national and international risk management tools. Statements of the preliminary tool were evaluated with a two-round Delphi panel by 12 experts in primary care and patient safety. Evaluated aspects were suitability for primary care settings, medication safety relevance, and the necessity of the statements to be included in the developed rural, primary care, medication-safety self-assessment tool.
In the first Delphi round, a consensus of ≥ 85% on being "sufficiently important and essential" was reached on 39% of the statements (n = 118/304), of which 86% (n = 101/118) were included, and 14% (n = 17/118) were excluded from the final primary care medication- safety self-assessment tool. In the second round, 84% of the statements (n = 141/167) reached a consensus, of which 70% (n = 98/141) were excluded and 30% (n = 43/141) included in the final tool. The included 144 statements were divided into 12 thematic sub-groups: (1) Patient information, (2) Drug information, (3) Communication of drug orders and other drug information; (4) Drug labeling, packaging and nomenclature; (5) Drug storage and distribution, (6) Medication device acquisition and use, (7) Environmental factors, workflow and staffing patterns; (8) Staff competency and education, (9) Patient education, (10) Preventive risk management, 11. Learning from medication safety incidents, and 12. Electronic health record.
The developed medication-safety self-assessment tool is targeted for proactive medication risk management in rural primary care settings. While experts reached a consensus for the Primary care Medication Safety Self Assessment tool contents, adopting the tool to suit the rural primary care environments in different countries should be further investigated.
在农村地区，初级医疗面临诸多挑战，药物治疗是初级医疗中最复杂的过程之一。借助专门为农村初级医疗单位设计的特定、主动的药物安全自我评估工具，医疗专业人员能够识别其药物治疗过程中的发展需求。
采用两轮德尔菲共识法，为芬兰拉普兰地区的农村初级医疗单位创建一种药物安全自我评估工具。基于三种国家和国际风险管理工具设计了一个初步工具。由12名初级医疗和患者安全领域的专家组成的两轮德尔菲小组对初步工具的陈述进行了评估。评估的方面包括对初级医疗环境的适用性、药物安全相关性以及这些陈述纳入所开发的农村初级医疗药物安全自我评估工具的必要性。
在第一轮德尔菲中，39%的陈述（n = 118/304）在“足够重要和必要”方面达成了≥85%的共识，其中86%（n = 101/118）被纳入，14%（n = 17/118）被排除在最终的初级医疗药物安全自我评估工具之外。在第二轮中，84%的陈述（n = 141/167）达成了共识，其中70%（n = 98/141）被排除，30%（n = 43/141）被纳入最终工具。纳入的144条陈述被分为12个主题子组：（1）患者信息，（2）药物信息，（3）药物医嘱及其他药物信息的沟通；（4）药物标签、包装和命名；（5）药物储存与分发，（6）药物设备的采购与使用，（7）环境因素、工作流程和人员配置模式；（8）员工能力与教育，（9）患者教育，（10）预防性风险管理，11. 从药物安全事件中学习，以及12. 电子健康记录。
所开发的药物安全自我评估工具旨在用于农村初级医疗环境中的主动药物风险管理。虽然专家们就初级医疗药物安全自我评估工具的内容达成了共识，但应进一步研究如何使该工具适用于不同国家的农村初级医疗环境。
