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Registered nurses’ use of computerised decision support in medication reviews: Implications in Swedish nursing homes
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0001-7490-6735
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-5976-5193
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-8793-6084
2018 (English)In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, E-ISSN 1758-6542, Vol. 31, no 6, p. 531-544Article in journal (Refereed) Published
Abstract [en]

Purpose: The purpose of this paper is to explore the implications of registered nurses’ (RNs) use of a computerized decision support system (CDSS) in medication reviews. Design/methodology/approach: The paper employs a quasi-experimental, one-group pre-test/post-test design with three- and six-month follow-ups subsequent to the introduction of a CDSS. In total, 11 RNs initiated and prepared a total of 54 medication reviews. The outcome measures were the number of drug-related problems (DRPs) as reported by the CDSS and the RNs, respectively, the RNs’ views on the CDSS, and changes in the quality of drug treatment. Findings: The CDSS significantly indicated more DRPs than the RNs did, such as potential adverse drug reactions (ADRs). The RNs detected additional problems, outside the scope of the CDSS, such as lack of adherence. They considered the CDSS beneficial and wanted to continue using it. Only minor changes were found in the quality of drug treatments, with no significant changes in the drug-specific quality indicators (e.g. inappropriate drugs). However, the use of renally excreted drugs in reduced renal function decreased. Practical implications: The RNs’ use of a CDSS in medication reviews is of value in detecting potential ADRs and interactions. Yet, in order to have an impact on outcomes in the quality of drug treatment, further measures are needed. These may involve development of inter-professional collaboration, such as established procedures for the implementation of medication reviews, including the use of CDSS. Originality/value: This is, to the best of the authors’ knowledge, the first study to explore the implications of medication reviews, initiated and prepared by RNs who use a CDSS. The paper adds further insight into the RNs’ role in relation to quality of drug treatments.

Place, publisher, year, edition, pages
Emerald Group Publishing Ltd. , 2018. Vol. 31, no 6, p. 531-544
Keywords [en]
Computerized decision support systems, Drug-related problem, Medication review, Nurse, Nursing home, Pharmacovigilance
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-40235DOI: 10.1108/IJHCQA-01-2017-0009ISI: 000436807000009PubMedID: 29954263Scopus ID: 2-s2.0-85049225913OAI: oai:DiVA.org:mdh-40235DiVA, id: diva2:1232642
Available from: 2018-07-12 Created: 2018-07-12 Last updated: 2019-06-18Bibliographically approved

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Johansson-Pajala, Rose-MarieMartin, LeneJorsäter Blomgren, Kerstin

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