Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management.
Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management.
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DOI：
10.3109/02813432.2015.1132891
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发表时间：
2016
影响因子：
2.1
通讯作者：
Martin L
中科院分区：
文献类型：
--
作者：
Johansson-Pajala RM;Jorsäter Blomgren K;Bastholm-Rahmner P;Fastbom J;Martin L
探讨瑞典老年人市政护理中注册护士的药物管理经验，重点是他们的药物警戒活动。为了提供深入的信息，选择了使用焦点小组讨论的定性方法。数据采用定性内容分析法进行分析。瑞典两个地区五个不同长期护理机构的五个重点小组。共有21名注册护士（RNs），4名男性和17名女性，年龄在27-65岁之间，具有4-34年的护理经验。研究结果表明，RNs在市政长期护理设置可以被视为“警惕中介”在患者的药物治疗。他们不断控制工作人员和医生的工作，在他们之间进行调解，并弥补现有的缺陷，无论是在组织上还是在卫生保健专业人员的工作中。RN依赖于其他医疗保健专业人员能够监测药物治疗并确保药物安全。他们承担更多的责任，有时超出了他们的正式权限，并试图掩盖在能力、经验、可接触性和责任承担方面的不足。RN可以被认为是老年患者药物治疗中的“警惕中介”，与工作人员、医生和患者保持一定距离。注册护士偶尔会承担超出其正式权限的责任，并考虑到患者的最佳利益。为了预防老年人市政护理中的药物不良事件，新的策略是合理的，以促进RNs的药物警戒活动。本研究有助于了解注册护士（RN）在老年人市政护理药物管理中的作用（即检测，评估和预防药物不良事件或任何药物相关问题）。 注册护士在药物监测过程中，包括在责任问题上，作为“警惕的中间人”，发挥着核心但也是复杂的作用。提高RN监测患者药物治疗的可能性将使他们能够在日常实践中预防药物不良事件。新的策略是合理的，以促进RN的药物警戒活动。
To explore registered nurses’ experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis. Five focus groups in five different long-term care settings in two regions in Sweden. A total of 21 registered nurses (RNs), four men and 17 women, aged 27–65 years, with 4–34 years of nursing experience. The findings reveal that RNs in municipal long-term care settings can be regarded as “vigilant intermediaries” in the patients’ drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking. RNs can be considered to be “vigilant intermediaries” in elderly patients’ drug treatments, working at a distance from staff, physicians, and patients. RNs occasionally take on responsibilities that exceed their formal competence, with the patients’ best interests in mind. In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs’ pharmacovigilant activities. This study contributes to the understanding of registered nurses’ (RNs’) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems). The RNs play a central but also complex role as “vigilant intermediaries” in the medication monitoring process, including the issue of responsibility. Improving RNs’ possibility to monitor their patients’ drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs’ pharmacovigilant activities.