Understanding the impact of supervision on reducing medication risks: an interview study in long-term elderly care
| Autor: | S. M. Kleefstra, E. M. Zijp, Rudolf B Kool, J. A. Vermeulen |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Safety Management Health Personnel Elderly care Nursing homes Supervision Health informatics Health administration Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] Medication incident reports Interviews as Topic 03 medical and health sciences 0302 clinical medicine Elderly Government Agencies SAFER Health care Medicine Homes for the Aged Humans 030212 general & internal medicine Safety culture Aged Netherlands Risk Management Medical Errors business.industry 030503 health policy & services Health Policy Nursing research Public health lcsh:Public aspects of medicine lcsh:RA1-1270 medicine.disease Long-Term Care 3. Good health Medical emergency 0305 other medical science business Medication safety risks Research Article |
| Zdroj: | BMC Health Services Research BMC Health Services Research, 17, 1, pp. 464 BMC Health Services Research, Vol 17, Iss 1, Pp 1-10 (2017) BMC Health Services Research, 17, 464 |
| ISSN: | 1472-6963 |
| Popis: | Background In 2009, the Dutch Health Care Inspectorate (IGZ) observed several serious risks to safety involving medication within elderly care facilities. However, by 2011, high risks had been reduced in almost all the organisations we visited. And yet the IGZ analysed too the alarming increase in the number of incidents arising in the self-reported national indicator of medication safety between 2009 and 2010. The aim of this study was to understand the factors that can explain this contradiction between the increase in self-reported medication incidents and the observation of the IGZ in reducing the risks to medication safety through supervision. Methods We interviewed health care professionals of ten care facilities, visited by the IGZ, who were involved in, or responsible for, the improvement of medication safety in their institutions. As outcome measures we used the rate of medication safety risk per facility; the perceptions of the participant with regard to the reports of medication incidents; the level of medication safety of the facility; the measures used to improve medication safety; and the supervision of medication safety. This was a mixed methods study, qualitative in that we used semi-structured interviews, and quantitative, by calculating risks for the different organisations we visited. The findings from both study methods resulted in a comprehensive view and an in-depth understanding of this contradiction. Results The contradiction between the increase in self-reported medication incidents and the observation of reduced risks was explained by three themes: activities designed to improve medication safety, the reporting of medication incidents, and, lastly, the impact of supervision. The focus of the IGZ on issues of medication safety stimulated most elderly care facilities to reduce medication risks. Also, a change in the culture of reporting incidents caused an increase in the number of reported incidents. Conclusions Supervision contributed to an improvement in actions geared towards reducing the risks associated with the safety of medication. It also increased a willingness to report such incidents. The more incidents reported are therefore not necessarily a sign of an increase in the risks, but can also be considered as a sign of a safer culture. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2418-6) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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