Patient engagement in admission and discharge medication communication: A systematic mixed studies review

Tobiano, Georgia; Chaboyer, Wendy; Teasdale, Trudy; Raleigh, Rachael; Manias, Elizabeth

doi:10.1016/j.ijnurstu.2019.04.009

Cited by 33 publications

(58 citation statements)

References 42 publications

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“…We detected 28 communication pairs. Surprisingly, the majority of the communication pairs were within the same unit, whereas previous literature states that most medication errors occur during the transition phase (Gracie, Randall, & Alexander, 2014;Petersen et al, 2018;Tobiano et al, 2019). Even if our study revealed that patient transfers between units were the most common scenarios in which communication errors occurred, the number of cases between organisations (primary‐tertiary healthcare units) was low.…”

Section: Discussionmentioning

confidence: 71%

“…In the PuBMed database, a search using the keywords medication incident OR medication error AND communication yielded 11 hits in the year 2000, 97 hits in 2010 and 127 hits in 2018. Errors in medication communication being linked with medication incidents have been studied from specific viewpoints, such as within diverse care‐provider settings or between them (Petersen, Foged, Madsen, Andersen, & Nørholm, 2018), in speciality practices (Keers et al, 2018;Liu, Manias, & Gerdtz, 2014;Manias, Cranswick, et al, 2019;Tobiano, Chaboyer, Teasdale, Raleigh, & Manias, 2019) or among specific patient age group settings (Borrott et al, 2017). Evidence of medication communication exists for a variety of care process situations (Braaf, Rixon, Williams, Liew, & Manias, 2015a;Liu, Manias, & Gerdtz, 2012;Manias, Braaf, et al, 2019;Yu, Li, Gao, Liu, & Lin, 2018), and concerning a diverse range of communication methods (Foged, Nørholm, Andersen, & Petersen, 2017;Redley & Botti, 2013).…”

Section: Introductionmentioning

confidence: 99%

“…Evidence of medication communication exists for a variety of care process situations (Braaf, Rixon, Williams, Liew, & Manias, 2015a;Liu, Manias, & Gerdtz, 2012;Manias, Braaf, et al, 2019;Yu, Li, Gao, Liu, & Lin, 2018), and concerning a diverse range of communication methods (Foged, Nørholm, Andersen, & Petersen, 2017;Redley & Botti, 2013). Medication communication has been assessed ethnographically from the interplay viewpoint between nurses, patients, physicians and students (Liu, Gerdtz, & Manias, 2015, 2016;Rutledge, Retrosi, & Ostrowski, 2018;Schoenthaler, Allegrante, Chaplin, & Ogedegbe, 2012;Tobiano et al, 2019), but also concerning professionals’ tendency to follow communicated guidelines (Karttunen et al, 2020). Studies of medication communication have been conducted on emergency situations concerning language barriers (Pun, Chan, Murray, Slade, & Matthiessen, 2016), racial issues affecting medication communication (Schoenthaler et al, 2012) and environmental issues of communication (Liu et al, 2014;Manias, Cranswick, et al, 2019;Yu et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

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Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Syyrilä

Vehviläinen‐Julkunen

Härkänen

2020

Journal of Clinical Nursing

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Aim To identify the types and frequencies of communication issues (communication pairs, person related, institutional, structural, process and prescription‐related issues) detected in medication incident reports and to compare communication issues that caused moderate or serious harm to patients. Background Communication issues have been found to be among the main contributing factors of medication incidents, thus necessitating communication enhancement. Design A sequential exploratory mixed‐method design. Methods Medication incident reports from Finland (n = 500) for the year 2015 in which communication was marked as a contributing factor were used as the data source. Indicator phrases were used for searching communication issues from free texts of incident reports. The detected issues were analysed statistically, qualitatively and considering the harm caused to the patient. Citations from free texts were extracted as evidence of issues and were classified following main categories of indicator phrases. The EQUATOR’s SRQR checklist was followed in reporting. Results Twenty‐eight communication pairs were identified, with nurse–nurse (68.2%; n = 341), nurse–physician (41.6%; n = 208) and nurse–patient (9.6%; n = 48) pairs being the most frequent. Communication issues existed mostly within unit (76.6%, n = 383). The most commonly identified issues were digital communication (68.2%; n = 341), lack of communication within a team (39.6%; n = 198), false assumptions about work processes (25.6%; n = 128) and being unaware of guidelines (25.0%; n = 125). Collegial feedback and communication from patients and relatives were the preventing issues. Moderate harm cases were often linked with lack of communication within the unit, digital communication and not following guidelines. Conclusions The interventions should be prioritised to (a) enhancing communication about work‐processes, (b) verbal communication about digital prescriptions between professionals, (c) feedback among professionals and (f) encouraging patients to communicate about medication. Relevance to clinical practice Upon identifying the most harmful and frequent communication issues, interventions to strengthen medication safety can be implemented.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Syyrilä

Vehviläinen‐Julkunen

Härkänen

2020

Journal of Clinical Nursing

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“…We also identified medication safety as one of the major problems related to patient safety before and after surgery. This is also recognised as a challenge in several studies and by the WHO [14,36,37]. Including medication in a surgical safety checklist can help patients to be more aware of their medications and to guide them to ask the right questions to the healthcare workers before surgery and discharge which is coherent with WHO's five moments for Medication Safety [14] and recent literature [37].…”

Section: Discussionmentioning

confidence: 91%

“…This is also recognised as a challenge in several studies and by the WHO [14,36,37]. Including medication in a surgical safety checklist can help patients to be more aware of their medications and to guide them to ask the right questions to the healthcare workers before surgery and discharge which is coherent with WHO's five moments for Medication Safety [14] and recent literature [37]. Patient checklists with elements on medications might involve the patients more in improving medication safety and reducing adverse drug events and medication errors before surgery and discharge.…”

Section: Discussionmentioning

confidence: 99%

Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist – a qualitative study

Harris

Søfteland

Moi

et al. 2020

BMC Health Serv Res

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Background: Patients' involvement in patient safety has increased in healthcare. Use of checklists may improve patient outcome in surgery, though few have attempted to engage patients' use of surgical checklist. To identify risk elements of complications based on patients' and healthcare workers' experiences is warranted. This study aims to identify what the patients and healthcare workers find to be the risk elements that should be included in a patient-driven surgical patient safety checklist. Method: A qualitative study design where post-operative patients, surgeons, ward physicians, ward nurses, and secretaries from five surgical specialties took part in focus group interviews. Eleven focus groups were conducted including 25 post-operative patients and 27 healthcare workers at one tertiary teaching hospital and one community hospital in Norway. Based on their experiences, participants were asked to identify perceived risks before and after surgery. The interviews were analysed using content analysis.Results: Safety risk factors were categorised as pre-operative information: pre-operative preparations, post-operative information, post-operative plans and follow-up. The subcategories under pre-operative information and preparations were: contact information, medication safety, health status, optimising health, dental status, read information, preparation two weeks before surgery, inform your surgical ward, planning your own discharge, preparation on admission and just before surgery. The subcategories under post-operative information, further plans and follow-up were: prevention and complications, restriction and activity, medication safety, pain relief, stomach functions, further care and appointments. Both healthcare workers and patients express the need for a surgical patient safety checklist. Conclusion:A broad spectre of risk elements for a patient safety checklist were identified. Developing a surgical safety checklist based on these risk elements might reduce complications and unwanted errors. Trail registration: The study is registered as part of a clinical trial in ClinicalTrials.gov: NCT03105713.

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Patients’ perceptions of medicines information received at hospital discharge in Norway: a qualitative interview study

et al. 2020

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Background Insufficient transfer of medicines information is a common challenge at discharge from hospital. Following discharge, home dwelling patients are expected to manage their medicines themselves and adequate counselling is an important prerequisite for patient empowerment and self-efficacy for medicines management. Objective The aim was to identify patients’ needs for medicines information after discharge from hospital, including the patients’ perception and appraisal of the information they received at discharge. Setting The study enrolled patients discharged from three medical wards at a secondary care hospital in Oslo, Norway. Method Patients were included at the hospital, at or close to the day of discharge and qualitative, semi-structured interviews were performed during the first 2 weeks after discharge. Eligible patients were receiving medicines treatment on admission and after discharge, were handling the medicines themselves, and discharged to their own home. Data were collected in 2017. Interviews were analysed with thematic analysis inspired by Systematic Text Condensation. Main outcome measure Patients’ perceptions of medicines information. Results In total, 12 patients were interviewed. They were discharged in equal numbers from the three wards, representing both sexes and a broad age range. Patients perceive medicines information as a continuum and not limited to specific encounters, like the discharge conversation. They gain information in several ways; by receiving information from health care professionals, through observations, and by seeking it themselves. Some thought they could have been better informed about adverse reactions and how to manage life while being a medicines user. Others felt they did not want or need more information. Patients employ various strategies for coping with their use of medicines, influencing their self-efficacy towards medicine management. Conclusion Medicines information should focus on empowering the patients throughout the hospital stay and not solely at discharge, taking into account the individual patient’s needs for information, preferences and prior knowledge.

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Patient engagement in admission and discharge medication communication: A systematic mixed studies review

Cited by 33 publications

References 42 publications

Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Communication issues contributing to medication incidents: Mixed‐method analysis of hospitals’ incident reports using indicator phrases based on literature

Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist – a qualitative study

Patients’ perceptions of medicines information received at hospital discharge in Norway: a qualitative interview study

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