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 (2021). Quality standards for safe medication in nursing homes: development through a multistep approach including a Delphi consensus study. BMJ open, 11(10), e054364. BMJ Publishing Group 10.1136/bmjopen-2021-054364

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Schwappach, David

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Funders:

[191] Federal Office of Public Health = Bundesamt für Gesundheit

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

14 Oct 2021 17:29

Last Modified:

14 Oct 2021 17:52

Publisher DOI:

10.1136/bmjopen-2021-054364

PubMed ID:

34635533

Uncontrolled Keywords:

geriatric medicine health & safety quality in health care

BORIS DOI:

10.48350/160064

URI:

https://boris.unibe.ch/id/eprint/160064

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