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Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study

BACKGROUND: An on-site pharmacist (OSP) intervention was implemented which sought to improve medication management within residential aged care facilities (RACFs) in the Australian Capital Territory, Australia. The objectives of this mixed methods study were to evaluate the implementation fidelity o...

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Autores principales: Batten, Miranda, Koerner, Jane, Kosari, Sam, Naunton, Mark, Lewis, Joanne, Strickland, Karen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604517/
https://www.ncbi.nlm.nih.gov/pubmed/37891564
http://dx.doi.org/10.1186/s12913-023-10172-9
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author Batten, Miranda
Koerner, Jane
Kosari, Sam
Naunton, Mark
Lewis, Joanne
Strickland, Karen
author_facet Batten, Miranda
Koerner, Jane
Kosari, Sam
Naunton, Mark
Lewis, Joanne
Strickland, Karen
author_sort Batten, Miranda
collection PubMed
description BACKGROUND: An on-site pharmacist (OSP) intervention was implemented which sought to improve medication management within residential aged care facilities (RACFs) in the Australian Capital Territory, Australia. The objectives of this mixed methods study were to evaluate the implementation fidelity of the OSP intervention and to determine the moderating factors which influenced delivery of this intervention. METHODS: This convergent parallel mixed methods study was underpinned by Hasson’s conceptual framework for implementation fidelity. Implementation fidelity for seven intervention RACFs was quantitatively assessed using three quantitative data sets: (1) range of OSP intervention activities delivered; (2) random sample of 10% of medication reviews assessed for quality; (3) proportion of residents who received at least one medication review. Semi-structured interviews (n = 14) with managers and OSPs across the intervention RACFs were conducted to identify moderating factors which may have influenced OSP intervention delivery. RESULTS: The OSP intervention was generally delivered as intended with overall medium levels of implementation fidelity. This delivery was supported by a range of facilitation strategies with most participants perceiving that the intervention was delivered to a high standard. RACF managers and OSPs were mostly well engaged and responsive. A number of potential barriers (including the part-time OSP role, COVID-19 pandemic, RACFs spread out over a large area with significant distance between resident dwellings) and facilitators (including the pharmacist support meetings, OSPs who took time to establish relationships, RACF managers who actively supported OSPs and worked with them) for OSP intervention delivery were identified which have potential implications for the roll out of OSPs within Australian RACFs. CONCLUSION: In this study, the implementation fidelity of OSP intervention delivery was assessed with overall medium levels of fidelity found across the intervention RACFs. This suggested that the OSP intervention can generally be delivered as intended in real world RACFs. OSP intervention delivery was influenced by a range of moderating factors, some of which posed barriers and others which facilitated the OSP intervention being delivered as intended. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-10172-9.
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spelling pubmed-106045172023-10-28 Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study Batten, Miranda Koerner, Jane Kosari, Sam Naunton, Mark Lewis, Joanne Strickland, Karen BMC Health Serv Res Research BACKGROUND: An on-site pharmacist (OSP) intervention was implemented which sought to improve medication management within residential aged care facilities (RACFs) in the Australian Capital Territory, Australia. The objectives of this mixed methods study were to evaluate the implementation fidelity of the OSP intervention and to determine the moderating factors which influenced delivery of this intervention. METHODS: This convergent parallel mixed methods study was underpinned by Hasson’s conceptual framework for implementation fidelity. Implementation fidelity for seven intervention RACFs was quantitatively assessed using three quantitative data sets: (1) range of OSP intervention activities delivered; (2) random sample of 10% of medication reviews assessed for quality; (3) proportion of residents who received at least one medication review. Semi-structured interviews (n = 14) with managers and OSPs across the intervention RACFs were conducted to identify moderating factors which may have influenced OSP intervention delivery. RESULTS: The OSP intervention was generally delivered as intended with overall medium levels of implementation fidelity. This delivery was supported by a range of facilitation strategies with most participants perceiving that the intervention was delivered to a high standard. RACF managers and OSPs were mostly well engaged and responsive. A number of potential barriers (including the part-time OSP role, COVID-19 pandemic, RACFs spread out over a large area with significant distance between resident dwellings) and facilitators (including the pharmacist support meetings, OSPs who took time to establish relationships, RACF managers who actively supported OSPs and worked with them) for OSP intervention delivery were identified which have potential implications for the roll out of OSPs within Australian RACFs. CONCLUSION: In this study, the implementation fidelity of OSP intervention delivery was assessed with overall medium levels of fidelity found across the intervention RACFs. This suggested that the OSP intervention can generally be delivered as intended in real world RACFs. OSP intervention delivery was influenced by a range of moderating factors, some of which posed barriers and others which facilitated the OSP intervention being delivered as intended. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-023-10172-9. BioMed Central 2023-10-27 /pmc/articles/PMC10604517/ /pubmed/37891564 http://dx.doi.org/10.1186/s12913-023-10172-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Batten, Miranda
Koerner, Jane
Kosari, Sam
Naunton, Mark
Lewis, Joanne
Strickland, Karen
Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study
title Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study
title_full Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study
title_fullStr Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study
title_full_unstemmed Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study
title_short Assessing implementation fidelity of an on-site pharmacist intervention within Australian residential aged care facilities: A mixed methods study
title_sort assessing implementation fidelity of an on-site pharmacist intervention within australian residential aged care facilities: a mixed methods study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10604517/
https://www.ncbi.nlm.nih.gov/pubmed/37891564
http://dx.doi.org/10.1186/s12913-023-10172-9
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