Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions.

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 101088677 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-6963 (Electronic) Linking ISSN: 14726963 NLM ISO Abbreviation: BMC Health Serv Res Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Health Personnel* ; Task Performance and Analysis*; Aged ; Aged, 80 and over ; Caregivers ; Delivery of Health Care ; Humans ; Polypharmacy
    • Abstract:
      Background: Older persons with polypharmacy are at increased risk of harm from medications. Therefore, it is important that physicians and nurses, together with the persons, evaluate medications to avoid hazardous polypharmacy. It remains unclear how healthcare professionals experience such evaluations. This study aimed to explore physicians' and nurses' experiences from evaluations of older persons' medications, and their related actions to manage concerns related to the evaluations.
      Method: Individual interview data from 29 physicians and nurses were collected and analysed according to the critical incident technique.
      Results: The medication evaluation for older persons was influenced by the working conditions (e.g. healthcare professionals' clinical knowledge, experiences, and situational conditions) and working in partnership (e.g. cooperating around and with the older person). Actions taken to manage these evaluations were related to working with a plan (e.g. performing day-to-day work and planning for continued treatment) and collaborative problem-solving (e.g. finding a solution, involving the older person, and communicating with colleagues).
      Conclusion: Working conditions and cooperation with colleagues, the older persons and their formal or informal caregivers, emerged as important factors related to the medication evaluation. By adjusting their performance to variations in these conditions, healthcare professionals contributed to the resilience of the healthcare system by its capacity to prevent, notice and mitigate medication problems. Based on these findings, we hypothesize that a joint plan for continued treatment could facilitate such resilience, if it articulates what to observe, when to act, who should act and what actions to take in case of deviations from what is expected.
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    • Contributed Indexing:
      Keywords: Critical incident technique; Healthcare professionals; Medication evaluation; Older persons; Patient safety; Polypharmacy
    • Publication Date:
      Date Created: 20210608 Date Completed: 20210609 Latest Revision: 20210611
    • Publication Date:
      20240104
    • Accession Number:
      PMC8182897
    • Accession Number:
      10.1186/s12913-021-06518-w
    • Accession Number:
      34098957