Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions.
Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions.
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DOI：
10.1186/s12913-021-06518-w
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发表时间：
2021-06-07
影响因子：
2.8
通讯作者：
Johansson L
中科院分区：
文献类型：
--
作者：
Holmqvist M;Thor J;Ros A;Johansson L
患有多种药物的老年人受到药物伤害的风险增加。因此，重要的是，医生和护士，与人一起，评估药物，以避免危险的多药治疗。目前尚不清楚医疗保健专业人员如何进行此类评估。本研究的目的是探讨医生和护士的经验，从老年人的药物评价，以及他们的相关行动，以管理与评价有关的问题。从29名医生和护士的个人访谈数据收集和分析，根据关键事件技术。对老年人的药物评价受到工作条件（例如，保健专业人员的临床知识、经验和环境条件）和合作关系（例如，围绕老年人和与老年人合作）的影响。为管理这些评价而采取的行动涉及按计划工作（例如开展日常工作和规划继续治疗）和合作解决问题（例如寻找解决办法、让老年人参与和与同事沟通）。工作条件以及与同事、老年人及其正式或非正式照顾者的合作，成为与药物评价有关的重要因素。通过根据这些条件的变化调整他们的表现，医疗保健专业人员通过其预防、注意和减轻药物问题的能力，为医疗保健系统的恢复力做出了贡献。基于这些发现，我们假设，一个联合的持续治疗计划可以促进这种弹性，如果它阐明了观察什么，什么时候采取行动，谁应该采取行动，以及在偏离预期的情况下采取什么行动。在线版本包含补充材料，可通过10.1186/s12913-021-06518-w获得。
Older persons with polypharmacy are at increased risk of harm from medications. Therefore, it is important that physicians and nurses, together with the persons, evaluate medications to avoid hazardous polypharmacy. It remains unclear how healthcare professionals experience such evaluations. This study aimed to explore physicians’ and nurses’ experiences from evaluations of older persons’ medications, and their related actions to manage concerns related to the evaluations. Individual interview data from 29 physicians and nurses were collected and analysed according to the critical incident technique. The medication evaluation for older persons was influenced by the working conditions (e.g. healthcare professionals’ clinical knowledge, experiences, and situational conditions) and working in partnership (e.g. cooperating around and with the older person). Actions taken to manage these evaluations were related to working with a plan (e.g. performing day-to-day work and planning for continued treatment) and collaborative problem-solving (e.g. finding a solution, involving the older person, and communicating with colleagues). Working conditions and cooperation with colleagues, the older persons and their formal or informal caregivers, emerged as important factors related to the medication evaluation. By adjusting their performance to variations in these conditions, healthcare professionals contributed to the resilience of the healthcare system by its capacity to prevent, notice and mitigate medication problems. Based on these findings, we hypothesize that a joint plan for continued treatment could facilitate such resilience, if it articulates what to observe, when to act, who should act and what actions to take in case of deviations from what is expected. The online version contains supplementary material available at 10.1186/s12913-021-06518-w.
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影响因子：
2.1
作者：
Johansson-Pajala RM;Jorsäter Blomgren K;Bastholm-Rahmner P;Fastbom J;Martin L
通讯作者：
Martin L
影响因子：
4.4
作者：
Cabir, Caitriona;Wallace, Emma;Fahey, Tom
通讯作者：
Fahey, Tom
影响因子：
2.9
作者：
Pohontsch, Nadine Janis;Heser, Kathrin;Scherer, Martin
通讯作者：
Scherer, Martin
影响因子：
2.6
作者：
Braithwaite, Jeffrey;Wears, Robert L.;Hollnagel, Erik
通讯作者：
Hollnagel, Erik
影响因子：
4.2
作者：
Olsen, Rose M.;Ostnor, Bjorg H.;Hellzen, Ove
通讯作者：
Hellzen, Ove