Medication safety analysis of elderly inpatients based on improved functional resonance analysis method (FRAM): a mixed methods study.

The study aimed to quantitatively assess functional risks in the medication administration process of elderly inpatients and develop management measures from a holistic system safety perspective. The functional resonance analysis method and decision-making trial and evaluation laboratory (DEMATEL) method were introduced to graphically model the medication administration process in elderly inpatients and identify safety issues affecting the complex interactions of functions. Semi-structured interviews based on the Fit between Individual, task, technology, and environment framework were used to explore medication safety management measures. A total of 18 functional modules were included in the medication process model for elderly inpatients. The DEMATEL results showed that medical order entry accounted for the highest proportion of the medication process, followed by label printing. Patient identification and drug verification, as downstream links, showed high impacts and influence. Among the safety management measures, task-technology fit and technology-individual fit were the most common. In the future, more research on medication management in elderly patients with different levels of care, settings and contexts, such as home and community, is needed. Attention should be paid to the integration and effect of implementing management measures to comprehensively safeguard patient medication safety.