Rikke Nørgaard Hansen, Danish College Of Pharmacy Practice, Pharmakon, Hillerød, Denmark
Mira El-Souri, Danish College of Pharmacy Practice, Pharmakon, Hillerød, Denmark
Sofie Brøndal Grünfeld, Danish College of Pharmacy Practice, Pharmakon, Hillerød, Denmark
Bjørn Klinke, The Danish Association of Pharmaconomists, Denmark
Birthe Søndergaard, The Association of Danish Pharmacies, Denmark
Rikke Lundal Nielsen, The Association of Danish Pharmacies, Denmark
Mette Lisbeth Johansen, The Danish Association of Pharmaconomists, Denmark
Charlotte Rossing, Pharmakon, Hillerød, Denmark
ABSTRACT
Background
The Danish Patient Safety Authority has reported an increase in the number of registered unintentional accidents from 2017 to 2019. This increase is especially observed in municipal institutions such as nursing homes, home care and residential facilities, where 66 % of the registered accidents are due to medicine management. Until now no studies have identified which challenges with medicine-related tasks are experienced in the municipalities.
Purpose
The aim of the study was to map challenges with medicine-related tasks in the municipalities identified by municipal managers and further explored by municipal employees. The aim of the study was also to use the results in investigating how pharmacy technicians from community pharmacies (CP) can contribute to strengthen medication safety in the municipalities.
Method
To understand the experience with medicine-related tasks, semi-structured, in-depth qualitative interviews with two-three municipal managers from ten different municipalities were conducted. Six major themes were identified from these interviews, and they were further explored by visual storytelling by municipal employees. All interviews were transcribed verbatim before conducting a content analysis using NVivo version 2020. The results were presented at a workshop with stakeholders where pharmacy technicians from CP contribution to medication safety in municipalities was discussed. The workshop was designed by using Appreciative Inquiry.
Results
The following major themes were identified from interviews with 27 municipal managers and visual storytelling with 17 municipal employees:
- Challenges in several steps in the medication process. Municipal managers and municipal employees experience challenges in ordering, storage, and dispensing medicines for patients in municipal institutions.
- Compliance with existing procedures and instructions related to medication handling is difficult. Procedures and instructions exist, but it is difficult to follow them on an everyday basis.
- Observation of effects and side effects of medicine in patients in nursing homes, home care and residential facilities for adults and children with physical and mental disabilities can be difficult.
- Medicine during transitions is a challenge. The municipal employees are faced with a time-consuming and difficult task in identifying which medicine the patient should be given and how to get the medicine delivered from hospital or CP.
- Medicine-related issues in disease-preventing and health-promoting activities at municipal health centres, e.g., non-adherence in patients due to fear of side effects.
- The right competence for the right task. Municipal managers and some employees are worried about whether the employees who solve medicine-related tasks always have the right qualifications to do so. At the workshop with stakeholders results were presented and stakeholders generated ideas on how pharmacy technicians from CP can contribute to strengthen the medication safety in municipalities.
Conclusion
This study identified six major themes that illustrate the challenges with medicine-related tasks as they are experienced by municipal managers and employees and generated ideas of how pharmacy technicians from CP can contribute to medication safety in municipalities. The ideas will be further qualified by The Danish Association of Pharmaconomists and The Association of Danish Pharmacies who also decide if one or more of the ideas will be tested in a future study.