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Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study
OBJECTIVES: The aim of the study was to develop quality standards reflecting minimal requirements for safe medication processes in nursing homes. DESIGN: In a first step, relevant key topics for safe medication processes were deducted from a systematic search for similar guidelines, prior work and d...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BMJ Publishing Group
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506865/ https://www.ncbi.nlm.nih.gov/pubmed/34635533 http://dx.doi.org/10.1136/bmjopen-2021-054364 |
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author | Brühwiler, Lea Domenica Niederhauser, Andrea Fischer, Simone Schwappach, David L B |
author_facet | Brühwiler, Lea Domenica Niederhauser, Andrea Fischer, Simone Schwappach, David L B |
author_sort | Brühwiler, Lea Domenica |
collection | PubMed |
description | OBJECTIVES: The aim of the study was to develop quality standards reflecting minimal requirements for safe medication processes in nursing homes. DESIGN: In a first step, relevant key topics for safe medication processes were deducted from a systematic search for similar guidelines, prior work and discussions with experts. In a second step, the essential requirements for each key topic were specified and substantiated with a literature-based rationale. Subsequently, the requirements were evaluated with a piloted, two-round Delphi study. SETTING: Nursing homes in Switzerland. PARTICIPANTS: Interprofessional panel of 25 experts from science and practice. PRIMARY AND SECONDARY OUTCOME MEASURES: Each requirement was rated for its relevance for a safer and resident-oriented medication on a 9-point Likert-Scale based on the RAND/UCLA method. The requirements were considered relevant if, in the second round, the median relevance rating was ≥7 and the proportion of ratings ≥7 was ≥80%. RESULTS: Five key topics with a total of 87 requirements were elaborated and rated in the Delphi study. After the second round (response rate in both rounds 100%), 85 requirements fulfilled the predefined criteria and were therefore included in the final set of quality standards. The five key topics are: (I) ‘The medication is reviewed regularly and in defined situations’, (II) ‘The medication is reviewed in a structured manner’, (III) ‘The medication is monitored in a structured manner’, (IV) ‘All healthcare professionals are committed to an optimal interprofessional collaboration’ and (V) ‘Residents are actively involved in medication process’. CONCLUSIONS: We developed normative quality standards for a safer and resident-oriented medication in Swiss nursing homes. Altogether, 85 requirements define the medication processes and the behaviour of healthcare professionals. A rigorous implementation may support nursing homes in taking a step towards safer and resident-oriented medication. |
format | Online Article Text |
id | pubmed-8506865 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-85068652021-10-22 Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study Brühwiler, Lea Domenica Niederhauser, Andrea Fischer, Simone Schwappach, David L B BMJ Open Geriatric Medicine OBJECTIVES: The aim of the study was to develop quality standards reflecting minimal requirements for safe medication processes in nursing homes. DESIGN: In a first step, relevant key topics for safe medication processes were deducted from a systematic search for similar guidelines, prior work and discussions with experts. In a second step, the essential requirements for each key topic were specified and substantiated with a literature-based rationale. Subsequently, the requirements were evaluated with a piloted, two-round Delphi study. SETTING: Nursing homes in Switzerland. PARTICIPANTS: Interprofessional panel of 25 experts from science and practice. PRIMARY AND SECONDARY OUTCOME MEASURES: Each requirement was rated for its relevance for a safer and resident-oriented medication on a 9-point Likert-Scale based on the RAND/UCLA method. The requirements were considered relevant if, in the second round, the median relevance rating was ≥7 and the proportion of ratings ≥7 was ≥80%. RESULTS: Five key topics with a total of 87 requirements were elaborated and rated in the Delphi study. After the second round (response rate in both rounds 100%), 85 requirements fulfilled the predefined criteria and were therefore included in the final set of quality standards. The five key topics are: (I) ‘The medication is reviewed regularly and in defined situations’, (II) ‘The medication is reviewed in a structured manner’, (III) ‘The medication is monitored in a structured manner’, (IV) ‘All healthcare professionals are committed to an optimal interprofessional collaboration’ and (V) ‘Residents are actively involved in medication process’. CONCLUSIONS: We developed normative quality standards for a safer and resident-oriented medication in Swiss nursing homes. Altogether, 85 requirements define the medication processes and the behaviour of healthcare professionals. A rigorous implementation may support nursing homes in taking a step towards safer and resident-oriented medication. BMJ Publishing Group 2021-10-11 /pmc/articles/PMC8506865/ /pubmed/34635533 http://dx.doi.org/10.1136/bmjopen-2021-054364 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Geriatric Medicine Brühwiler, Lea Domenica Niederhauser, Andrea Fischer, Simone Schwappach, David L B Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study |
title | Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study |
title_full | Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study |
title_fullStr | Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study |
title_full_unstemmed | Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study |
title_short | Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study |
title_sort | quality standards for safe medication in nursing homes: development through a multistep approach including a delphi consensus study |
topic | Geriatric Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8506865/ https://www.ncbi.nlm.nih.gov/pubmed/34635533 http://dx.doi.org/10.1136/bmjopen-2021-054364 |
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