mdh.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Nurses' self-reported medication competence in relation to their pharmacovigilant activities in clinical practice
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (äldres hälsa och välfärd)ORCID iD: 0000-0002-5976-5193
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (äldres hälsa och välfärd)ORCID iD: 0000-0001-7490-6735
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. (äldres hälsa och välfärd)ORCID iD: 0000-0002-8793-6084
Karolinska Institutet, Sweden.
2015 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 21, no 1, p. 145-152Article in journal (Refereed) Published
Abstract [en]

Rationale, aims and objectives

Adverse drug reactions (ADRs) represent a major health problem and previous studies show that nurses can have an active role in promoting medication safety. The aim of this study was to describe and evaluate nurses' self-reported competence and pharmacovigilant activities in clinical practice and also to explore the impact of age, education, workplace and nursing experience on these matters.

Methods

This cross-sectional study was based on a questionnaire covering areas related to nurses' medication competence, including knowledge, assessment and information retrieval, and pharmacovigilant activities within these areas, for example, the detection and assessment of ADRs. A 45-item questionnaire was 2013 sent out to 296 nurses in different settings and counties in Sweden. They were selected on the basis of having applied to a university course including pharmacovigilance during 2008–2011. One hundred twenty-four had participated in the courses (exposed) and 172 had applied to the courses but not participated (unexposed).

Results

Completed questionnaires were obtained from 75 exposed (60%) and 93 unexposed (54%) nurses. Overall nurses rated themselves high in medication competence but low in pharmacovigilant activities. Significant (P ≤ 0.001) differences between groups were observed regarding medication competence. The exposure of completed dedicated courses in pharmacovigilance was the strongest factor for self-reported medication competence when adjusted for age, other education, workplace and experience. No significant differences between the groups were found regarding the number of pharmacovigilant activities during the 6 months prior to answering the questionnaire.

Conclusion

Dedicated university courses improved nurses' self-reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.

Place, publisher, year, edition, pages
2015. Vol. 21, no 1, p. 145-152
Keywords [en]
education, medication management, nurse, patient safety, pharmacology, pharmacovigilance
National Category
Health Sciences
Research subject
Care Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-26745DOI: 10.1111/jep.12263ISI: 000350447800021Scopus ID: 2-s2.0-84923613157OAI: oai:DiVA.org:mdh-26745DiVA, id: diva2:767452
Available from: 2014-12-01 Created: 2014-12-01 Last updated: 2018-02-22Bibliographically approved
In thesis
1. Pharmacovigilance in municipal elderly care: From a nursing perspective
Open this publication in new window or tab >>Pharmacovigilance in municipal elderly care: From a nursing perspective
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Medication management constitutes a large part of registered nurses' (RNs) daily work in municipal elderly care. They are responsible for monitoring multimorbid older persons with extensive treatments, and they often work alone, without daily access to physicians. RNs’ drug monitoring is, in this thesis, based on the concept of pharmacovigilance. Pharmacovigilance is about the science and the activities that aim to improve patient care and safety in drug use, that is, to detect, assess, understand and prevent drug-related problems.

The overall aim was to explore conditions for pharmacovigilance from a nursing perspective, focusing on implications of RNs’ competence and use of a computerized decision support system (CDSS). Both quantitative and qualitative research methods were used, including a questionnaire (I), focus group discussions (II), individual interviews (III) and an intervention study (IV). In total 216 RNs and 54 older persons participated from 13 special accommodations, located in three different regions.

RNs who had completed further training in pharmacovigilance rated their medication competence higher than those who had not. However, there was no difference between groups in the number of pharmacovigilant activities they performed in clinical practice (I). The RNs appeared to act as “vigilant intermediaries” in drug treatment. They depended on the nursing staff's observations of drug-related problems. The RNs continuously controlled the work of staff and physicians, and attempted to compensate for shortcomings in competence, accessibility and continuity (II). RNs’ use of a CDSS was found to affect drug monitoring, including aspects of time, responsibility, standardization of the work, as well as access to knowledge and opportunities for evidence-based care (III). The CDSS detected significantly more drug-related problems when conducting medication reviews, than the RNs did. Nevertheless, this did not result in any significant improvement in the quality of drug use in the follow up, three and six months later (IV).

This thesis contributes to the recognition of pharmacovigilance from a nursing perspective. Increased medication competence seems to be insufficient to generate pharmacovigilant activities. RNs depend on other health care professionals and organizational conditions in order to perform their work. A CDSS has the potential to support RNs, both in structured medication reviews and in daily clinical practice. Inter-professional collaboration is crucial, with or without a CDSS, and the entire team needs to be aware of and take responsibility. Other important conditions is the existence of well-functioning communication channels, competence across the team, and established procedures based on current guidelines.

Place, publisher, year, edition, pages
Eskilstuna: Mälardalen University Press, 2017
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 222
Keywords
competence, computerized decision support systems, content analysis, drug monitoring, inter-professional collaboration, nurse, older person, patient, pharmacovigilance, pharmacovigilant activities, phenomenography
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-34750 (URN)978-91-7485-309-4 (ISBN)
Public defence
2017-03-24, Filen, Mälardalens högskola, Eskilstuna, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2017-01-31 Created: 2017-01-31 Last updated: 2017-03-03Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full textScopus

Authority records BETA

Martin, LeneJohansson-Pajala, Rose-MarieJorsäter Blomgren, Kerstin

Search in DiVA

By author/editor
Martin, LeneJohansson-Pajala, Rose-MarieJorsäter Blomgren, Kerstin
By organisation
Health and Welfare
In the same journal
Journal of Evaluation In Clinical Practice
Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 77 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf