During hospitalization, medication administration errors (MAEs) occur daily in health care and can lead to serious harm. Improvement of medication safety is a major concern to policymakers and health care workers. Inpatient self-administration of medication (SAM) during hospital admission could be a way to reduce MAEs. Therefore the aim of this study is to determine the effect of inpatient self-administration of medication on the number of medication administration errors during hospitalization.
Objective: the main objective of this study is to determine the effect of inpatient self-administration of medication on the number of medication administration errors during hospitalization. The secondary objectives of this study are to determine: 1. The effect of inpatient self-administration of medication on the severity of medication administration errors during hospitalization 2. The effect of inpatient self-administration on medication adherence after hospitalization 3. The effect of inpatient self-administration of medication on patient satisfaction during hospitalization 4. The effect of inpatient self-administration of medication on staff satisfaction during hospitalization Study design: multicentre prospective quasi-experimental study with a pre-post design Study population: hospitalized ≥ 16 years old patients Intervention: the implementation of self-administration of medication by hospitalized patients. SAM will be compared to standard care. Main study parameters: The primary outcome measure of the study is the proportion of medication administrations with one or more medication administration errors (MAEs). Secondary outcome measures will be: severity of MAEs, medication adherence after hospitalization, patient satisfaction during hospitalization, and staff satisfaction. For all outcome measures the effect of SAM will be compared to standard care. Nature and extent of the burden and risks associated with participation, benefit and group relatedness: all subjects have to fulfil two questionnaires, one during hospitalization and one approximately three months after leaving the studied ward, e.g. hospital discharge or transfer. The subjects that are included in de post study period have to self-administrate medication that's suitable for SAM. The risk of SAM during hospitalization is estimated as the risk patients are at home when using medication. The burden of SAM is classified as low because results of a recent questionnaire shows that admitted patients have the urge to act in SAM schemes.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE
Enrollment
193
Patients use medication from their own stock, self-administered.
Radboudumc
Nijmegen, Gelderland, Netherlands
Sint Maartenskliniek
Ubbergen, Gelderland, Netherlands
MUMC+
Maastricht, Limburg, Netherlands
Jeroen Bosch Ziekenhuis
's-Hertogenbosch, North Brabant, Netherlands
Catharina Ziekenhuis
Eindhoven, North Brabant, Netherlands
ETZ
Tilburg, North Brabant, Netherlands
Groene Hart Ziekenhuis
Gouda, South Holland, Netherlands
Meander Medisch Centrum
Amersfoort, Netherlands
Proportion of medication administration errors
The doctor's prescriptions as noted in the CPOE system will be compared to the observed medication administration and any discrepancy will be marked as an MAE. The number of erroneous medication administrations (containing 1 or more errors) will be divided by the number of observed drug administrations plus the number of omissions (concept of opportunities).
Time frame: 2 weeks
Severity of MAEs
Severity of MAEs will be determined by two healthcare professionals, a physician and a pharmacist.To classify the severity of MAEs the NCC MERP Index for categorizing medication errors will be used. Thereafter consensus will be reached. The experts will be blinded to the period (usual care or intervention) during which the problem occurred.
Time frame: 2 weeks
Medication adherence after hospitalization
Medication adherence after hospitalisation will be measured using the Medication Adherence Reasons Scale (MAR-Scale). The MAR-Scale measures medication non-adherence based on the reasons for non-adherence so that each reason can be matched with a corresponding intervention. Approximately three months after hospitalization, a questionnaire consisting of six questions concerning the patient's medication use will be sent to all included patients by email.
Time frame: 3 months
Medication adherence after hospitalization
With the use of the pharmacy refill dates the Medication Refill Adherence (MRA) is calculated. \- 1 year after inclusion: pharmacy refill data will be collected
Time frame: 1 year
Patient satisfaction during hospitalization
Patient satisfaction will be measured by the visual analogue scale (VAS) for patient satisfaction.
Time frame: 7 days
Patient satisfaction during hospitalization
Patient satisfaction will be measured by the Beliefs about Medicine Questionnaire (BMQ).
Time frame: 7 days
Staff satisfaction
Staff satisfaction will be measured using The Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM). These are four-item measures of implementation outcomes that are often considered "leading indicators" of implementation success. These measures can be administered to a wide range of stakeholders to determine the extent to which they believe an intervention or an implementation strategy is acceptable, appropriate, and feasible. At the end of the study hospital staff will be asked to complete the questionnaires.
Time frame: 1 year
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