Type of oral solid medication packaging and medication preparation time in nursing homes: A direct observation study

Cready, Cynthia M.; Hudson, Cassie; Dreyer, Kathryn

doi:10.1111/jcpt.12567

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…Additionally, adjustments in the distribution system allows the nursing staff to spend more time in providing direct patient care. Studies have shown that nurses spend a substantial amount of time preparing and administering medications; the greater the number of drugs, the greater the time spent [17][18][19] . In a study conducted in American LTCFs, individualizing doses in a manner similar to that adopted in the present study considerably reduced the time spent preparing the medications 19 .…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown that nurses spend a substantial amount of time preparing and administering medications; the greater the number of drugs, the greater the time spent [17][18][19] . In a study conducted in American LTCFs, individualizing doses in a manner similar to that adopted in the present study considerably reduced the time spent preparing the medications 19 . Although the impact on the time spent preparing the medications was not evaluated in our study, the staff indicated greater availability for patient care provision.…”

Section: Discussionmentioning

confidence: 99%

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A pilot integrated qualification program to improve medication use in a long-term care facility: a hybrid effectiveness-implementation study

Lima

Rezende

Santos³

et al. 2022

Rev. Ciênc. Farm. Básica Apl.

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Objective: to describe the implementation and to assess the effectiveness of a pilot integrated qualification program to improve the medication use in a long-term care facility (LTCF). Methods: This was a type 1 hybrid effectiveness-implementation study. A pilot integrated qualification program to improve the medication use in a LTCF was carried out by implementing a new drug distribution system and a comprehensive medication management (CMM) service according to the following four steps: I) implementation of the drug distribution system followed by the evaluation of the health team's opinion; II) prescription review with the identification of potential drug therapy problems (PDTPs); III) provision of the CMM service according to the framework of Pharmaceutical Care practice within one year; and, IV) evaluation of the effectiveness of the program through the comparison of clinical and laboratory parameters (blood pressure, glycated hemoglobin and lipid fractions) using the t-test or Wilcoxon signed-rank test. Results: In step I, the distribution system was fully outsourced to a company that furnished all solid oral dosage forms in individual boxes containing a plastic coil with multiple envelopes for 30 days. In step II, 180 PDTPs were identified, and all patients presented with at least one of them. In step III, after the first assessment of the CMM Service, 43 actual drug therapy problems (DTPs) were identified. After one year of service provision, 96 DTPs were identified and 75.8% of them were resolved (n=72). In step IV, a statistically significant difference was observed between the initial and final minimum and maximum systolic and diastolic blood pressure (p<0,05). Conclusions: The pilot integrated qualification program had a positive impact on the clinical parameters. The global population is rapidly aging, making this type of study important to exemplify a multifaceted strategy to improve the quality of drug therapy for institutionalized patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A pilot integrated qualification program to improve medication use in a long-term care facility: a hybrid effectiveness-implementation study

Lima

Rezende

Santos³

et al. 2022

Rev. Ciênc. Farm. Básica Apl.

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“…Three metropolitan private, not‐for‐profit RACFs operated by the same South Australian aged care provider organizations participated. Medications were supplied to these RACFs in pre‐packed medication strip packaging 28 . Paper‐based medication administration charts were used for documentation.…”

Section: Methodsmentioning

confidence: 99%

Medication administration in Australian residential aged care: A time‐and‐motion study

Chen

Bell

Ilomäki

et al. 2020

Evaluation Clinical Practice

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Rationale/aim Medication administration is a complex and time‐consuming task in residential aged care facilities (RACFs). Understanding the time associated with each administration step may help identify opportunities to optimize medication management in RACFs. This study aimed to investigate the time taken to administer medications to residents, including those with complex care needs such as cognitive impairment and swallowing difficulties. Method A time‐and‐motion study was conducted in three South Australian RACFs. A representative sample of 57 scheduled medication administration rounds in 14 units were observed by a single investigator. The rounds were sampled to include different times of day, memory support units for residents living with dementia and standard units, and medication administration by registered and enrolled nurses. Medications were administered from pre‐prepared medication strip packaging. The validated Work Observation Method By Activity Timing (WOMBAT) software was used to record observations. Results Thirty nurses were observed. The average time spent on scheduled medication administration rounds was 5.2 h/unit of average 22 residents/day. The breakfast medication round had the longest duration (1.92 h/unit). Resident preparation, medication preparation and provision, documentation, transit, communication, and cleaning took an average of 5 minutes per resident per round. Medication preparation and provision comprised 60% of overall medication round time and took significantly longer in memory support than in standard units (66 vs 49 seconds per resident per round for preparation, 79 vs 58 for provision; P < .001 for both). Almost half (42%) of tablets/capsules were crushed in memory support units. The time taken for medication administration was not significantly different among registered and enrolled nurses. Conclusions Nurses took an average of 5 minutes to administer medications per resident per medication round. Medication administration in memory support units took an additional minute per resident per round, with almost half of tablets and capsules needing to be crushed.

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“…The most common systems are reusable, multi-compartment, cassette-format MODs made from rigid, thermosetting polymers and disposable MODs made from thermoplastics, thus easier to seal. The latter come in the formats of blister pouches (also known as sachets or strip packaging), blister cards with a cardboard frame (also known as punch cards or "bingo" cards) and foil-sealed cups [16][17][18]. Some of the disposable MODs are marketed as capable of accommodating liquids [13].…”

Section: Introductionmentioning

confidence: 99%

Nurse-Filled versus Pharmacy-Filled Medication Organization Devices—Survey on Current Practices and Views of Home Care Nursing Services

et al. 2022

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Medication organization devices (MODs) are widely used among home care nursing services. However, current practices such as the responsibility for filling MODs, different MOD types used and requirements of home care nursing services are largely unknown. The study aimed at analyzing home care nursing services’ current practices regarding MOD use, investigating their requirements and determining whether different practices met these requirements. A survey was administered online to German home care nursing services in February 2021. The importance of requirements and the extent of satisfaction were measured using a five-point scale. Attitudes towards disposable, pharmacy-filled MODs were recorded as free text. In total, 690 nursing services responded (67.5% privately owned and 34.5% based in large cities), 92.2% filled MODs themselves and used predominantly reusable, rigid MODs. Pharmacies filling MODs used primarily disposable MODs. Satisfaction with current practices was generally high. Respondents filling MODs themselves were more satisfied with nurses’ medication knowledge, but less satisfied with cost effectiveness than those who had pharmacies fill MODs. Of all respondents filling MODs themselves who expressed an opinion on disposable, pharmacy-filled MODs, 50.9% were skeptical, primarily due to fear of losing flexibility. However, no difference in satisfaction with flexibility was found between respondents filling MODs themselves and those using pharmacy-filled MODs. In conclusion, employment of MODs in the professional care setting is a complex task with nursing services as key constituents. There is potential for improvement in the inter-professional collaboration between pharmacies and home care nursing services on the use of MODs. Measures for improvement have to address home care nursing services’ requirements with respect to flexibility and medication knowledge.

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Type of oral solid medication packaging and medication preparation time in nursing homes: A direct observation study

Cited by 3 publications

References 19 publications

A pilot integrated qualification program to improve medication use in a long-term care facility: a hybrid effectiveness-implementation study

A pilot integrated qualification program to improve medication use in a long-term care facility: a hybrid effectiveness-implementation study

Medication administration in Australian residential aged care: A time‐and‐motion study

Nurse-Filled versus Pharmacy-Filled Medication Organization Devices—Survey on Current Practices and Views of Home Care Nursing Services

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