scholarly journals Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

2020 ◽  
Author(s):  
Patrick Redmond ◽  
Khalid Munir ◽  
Oludare Alabi ◽  
Tamasine Grimes ◽  
Barbara Clyne ◽  
...  
Keyword(s):  
Medication Error ◽  
Healthcare Professionals ◽  
Community Pharmacists ◽  
Information And Communications Technology ◽  
Barriers And Facilitators ◽  
Transitions Of Care ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Medicines Reconciliation ◽  
Wide Range

Abstract Background: Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process.Methods: Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Thematic analysis was undertaken using an adaptation of a combined theoretical framework of Grol, Cabana and Sluisveld to classify the barriers and facilitators to implementation of medicines reconciliation.Results : Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review).Conclusions: Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.

scholarly journals Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

2020 ◽  
Author(s):  
Patrick Redmond ◽  
Khalid Munir ◽  
Oludare Alabi ◽  
Tamasine Grimes ◽  
Barbara Clyne ◽  
...  
Keyword(s):  
Medication Error ◽  
Healthcare Professionals ◽  
Community Pharmacists ◽  
Information And Communications Technology ◽  
Barriers And Facilitators ◽  
Transitions Of Care ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Medicines Reconciliation ◽  
Wide Range

Abstract Background Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. Aim The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process. Design Setting Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Method Thematic analysis was undertaken using an existing theoretical framework previously applied to implementation of medicines reconciliation. Results and conclusion Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review). Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.

scholarly journals Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

2020 ◽  
Author(s):  
Patrick Redmond ◽  
Khalid Munir ◽  
Oludare Alabi ◽  
Tamasine Grimes ◽  
Barbara Clyne ◽  
...  
Keyword(s):  
Medication Error ◽  
Healthcare Professionals ◽  
Community Pharmacists ◽  
Information And Communications Technology ◽  
Barriers And Facilitators ◽  
Transitions Of Care ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Medicines Reconciliation ◽  
Wide Range

Abstract Background Medication error at transitions of care is common. The implementation of medicines reconciliation processes to improve this issue has been recommended by many regulatory and safety organisations. The aim of this study was to gain insight from healthcare professionals on the barriers and facilitators to the medicines reconciliation implementation process. Methods Semi-structured interviews were conducted in Ireland with a wide range of healthcare professionals (HCPs) involved with medicines reconciliation at transitions of care. Thematic analysis was undertaken using an adaptation of a combined theoretical framework of Grol, Cabana and Sluisveld to classify the barriers and facilitators to implementation of medicines reconciliation. Results Thirty-five participants were interviewed, including eleven community pharmacists (CPs), eight hospital pharmacists (HPs), nine hospital consultants (HCs), five general practitioners (GPs), and two non-consultant hospital doctors (NCHDs). Themes were categorized into barriers and facilitators. Barriers included resistance from existing professional cultures, staff interest and training, poor communication and minimal information and communications technology (ICT) support. Solutions (facilitators) suggested included supporting effective multidisciplinary teams, greater involvement of pharmacists in medicines reconciliation, ICT solutions (linked prescribing databases, decision support systems) and increased funding to provide additional (e.g. admission and discharge reconciliation) and more advanced services (e.g. community pharmacist delivered medicines use review). Conclusions Medicines reconciliation is advocated as a solution to the known problem of medication error at transitions of care. This study identifies the key challenges and potential solutions that policy makers, managers and HCPs should consider when reviewing the practices and processes of medicines reconciliation in their own organisations.

A qualitative study of students' perspective on e-learning adoption in India

2020 ◽  
Vol 12 (4) ◽  
pp. 545-559 ◽  
Author(s):  
Nidhi Phutela ◽  
Sunita Dwivedi
Keyword(s):  
Further Education ◽  
Information And Communications Technology ◽  
Primary Data ◽  
Educational Institutions ◽  
Structured Interviews ◽  
Content Type ◽  
Education Industry ◽  
Wide Range ◽  
E Learning ◽  
The Impact

PurposeThis paper will try to uncover how e-learning is giving a new shape to the education industry. Also, it will encompass the students' perspective and experience of e-learning.Design/methodology/approachThe present study employed interpretative phenomenological analysis (IPA) to intensely scrutinize the lived-in experiences of the participants. In the present study, the respondents were selected from Delhi NCR of India. Semi-structured interviews were conducted to collect the primary data to understand the student's perspectives on the impact of information and communications technology (ICT) in education industry.FindingsThe findings have been grouped under two sections referred to as “themes,” which include “drivers for e-learning adoption” and “inhibitors which restrict the adoption of e-learning.”Practical implicationsAt present, India does not have a big market for e-learning, but there is huge potential in the country. The present study may be helpful for the educational institutions in India and in similar developing countries in understanding the students' perspectives on e-learning adoption. The educational institutions may improve their systems accordingly so that they can not only retain the students of their own countries but also attract students from other countries for further education.Social implicationsE-learning can be employed to give users quick access to ideas and experiences from a wide range of people, communities, and the cultures to increase the tangibility.Originality/valueThe study will be useful to the policymakers in the higher education sector of developing nations like India, in understanding the students' mindsets. This study makes a contribution to the growing literature on e-learning, where the researchers have determined the relative importance of various motivating and inhibiting factors which influence the adoption of e-learning. Additionally, the study has used IPA as the methodology to determine the factors, which is a novel contribution.

scholarly journals How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience

2020 ◽  
Vol 29 (9) ◽  
pp. 764-773 ◽  
Author(s):  
Sara Garfield ◽  
Dominic Furniss ◽  
Fran Husson ◽  
Mike Etkind ◽  
Marney Williams ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mixed Methods ◽  
Distributed Cognition ◽  
Healthcare Professionals ◽  
Healthcare Settings ◽  
Medicines Reconciliation ◽  
Wide Range ◽  
Semistructured Interviews ◽  
Enhance Patient Safety ◽  
Key Barrier

BackgroundPatients often carry medication lists to mitigate information loss across healthcare settings. We aimed to identify mechanisms by which these lists could be used to support safety, key supporting features, and barriers and facilitators to their use.MethodsWe used a mixed-methods design comprising two focus groups with patients and carers, 16 semistructured interviews with healthcare professionals, 60 semistructured interviews with people carrying medication lists, a quantitative features analysis of tools available for patients to record their medicines and usability testing of four tools. Findings were triangulated using thematic analysis. Distributed cognition for teamwork models were used as sensitising concepts.ResultsWe identified a wide range of mechanisms through which carrying medication lists can improve medication safety. These included improving the accuracy of medicines reconciliation, allowing identification of potential drug interactions, facilitating communication about medicines, acting as an aide-mémoire to patients during appointments, allowing patients to check their medicines for errors and reminding patients to take and reorder their medicines. Different tools for recording medicines met different needs. Of 103 tools examined, none met the core needs of all users. A key barrier to use was lack of awareness by patients and carers that healthcare information systems can be fragmented, a key facilitator was encouragement from healthcare professionals.ConclusionOur findings suggest that patients and healthcare professionals perceive patient-held medication lists to have a wide variety of benefits. Interventions are needed to raise awareness of the potential role of these lists in enhancing patient safety. Such interventions should empower patients and carers to identify a method that suits them best from a range of options and avoid a ‘one size fits all’ approach.

scholarly journals Barriers and facilitators of medicines reconciliation at transitions of care in Ireland – a qualitative study

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Patrick Redmond ◽  
Khalid Munir ◽  
Oludare Alabi ◽  
Tamasine Grimes ◽  
Barbara Clyne ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Barriers And Facilitators ◽  
Transitions Of Care ◽  
Medicines Reconciliation

scholarly journals Understanding the role of hospice pharmacists: a qualitative study

2021 ◽  
Author(s):  
Zoe Edwards ◽  
Emma Chapman ◽  
Simon Pini ◽  
Michael I. Bennett
Keyword(s):  
Geographical Area ◽  
Clinical Information ◽  
Barriers And Facilitators ◽  
Multidisciplinary Teams ◽  
Structured Interviews ◽  
Framework Analysis ◽  
Standards Of Practice ◽  
Team Working ◽  
The Hours

AbstractBackground Pharmacists are important members of multidisciplinary teams but, despite surveys of provision, the role of the hospice pharmacist is not well described. Objective To explore the role of the hospice pharmacist and identify barriers and facilitators to the role. Setting Hospices offering in-patient services caring for adults towards the end of life in one geographical area of northern England. Method Pharmacists providing services to hospices were invited to take part in qualitative semi-structured interviews asking about experience, patient contact, team working and barriers and facilitators to the role. These were recorded verbatim and data were analysed thematically using framework analysis. Main outcome measure The hospice pharmacist’s perceptions of their role and barriers and facilitators to it. Results Fifteen pharmacists took part. Two themes and ten subthemes were identified focused on tasks and communication. Practise was varied and time limited the quantity and depth of services carried out but was often spent navigating complex drug supply routes. Participants found methods of communication suited to the hours they spent in the hospice although communication of data was a barrier to effective clinical service provision. Participants identified the need for appropriate training and standards of practice for hospice pharmacists would enable better use of their skills. Conclusion Barriers to the role of hospice pharmacist include time, access to role specific training, access to clinical information and complex medicines supply chains. The role would benefit from definition to ensure that hospices are able to use hospice pharmacists to their greatest potential.

scholarly journals P1 “She used to be Tigger and then she was Eeyore”: A qualitative study with children and young people with CFS/ME, exploring predictors of recovery and future treatment needs

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Philippa Clery ◽  
Jennifer Starbuck ◽  
Amanda Laffan ◽  
Esther Crawley ◽  
Philippa Clery
Keyword(s):  
Young People ◽  
Healthcare Professionals ◽  
Holistic Approach ◽  
Chronic Fatigue ◽  
Barriers And Facilitators ◽  
Structured Interviews ◽  
Treatment Needs ◽  
Children And Young People ◽  
Children And Parents ◽  
Definition Of

Abstract Introduction Paediatric Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) is relatively common and severely disabling. At least 15% of children do not recover by 12 months. We do not know why some children recover and others do not. This study aimed to explore the barriers to recovery experienced by adolescents with CFS/ME. Methods I recruited adolescents (aged 11-17 years old, with CFS/ME, who were still disabled by CFS/ME after 12 months of treatment), their parents and specialist healthcare professionals were recruited from a single specialist CFS/ME service in the UK. I conducted semi-structured interviews and focus groups to explore views on treatment received including barriers and facilitators, as well as views on their future. I used thematic analysis grounded in the views of the patients to identify patterns (themes) in the data. Results I recruited 12 children and young people, 11 parents and 7 specialist healthcare professionals. The following themes were identified (with barriers and facilitators apparent in each theme): 1. “awareness and support” from CFS/ME services, GPs, schools and family. Poor awareness resulted in increased time-to-diagnosis, school disengagement, stigmatising experiences, and significant stress for children and parents; family support, school understanding, and validation from the service was a ‘life saver’. 2. “CFS/ME is bigger than the fatigue” described the importance of managing CFS/ME as a ‘long and hard’ chronic illness with secondary health, social and educational consequences. Participants called for holistic therapies that focus on the broader definition of recovery and facilitate re-integration into ‘normal life’. 3. “Balancing routine and control in adolescents”: Children differed on whether routines and pacing were helpful or exacerbated low mood. 4. “Individualised” treatment was important: treatment combinations were helpful in different ‘phases of recovery’, which varied depending on social context, motivations, school input, and co-morbidities. Conclusion Adolescents identified common facilitators and barriers to recovery and a desire for treatment that takes social factors into account, with a holistic approach using a broader definition of recovery. Children and parents identified a need for better awareness, communication and integration within and between services, including GPs and schools.

scholarly journals Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Abdulrhim ◽  
Sowndramalingam Sankaralingam ◽  
Mohamed Izham Mohamed Ibrahim ◽  
Mohammed Issam Diab ◽  
Mohamed Abdelazim Mohamed Hussain ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Collaborative Care ◽  
Healthcare Professionals ◽  
Barriers And Facilitators ◽  
Easy Access ◽  
Care Model ◽  
Structured Interviews ◽  
Collaborative Care Model ◽  
Patients With Diabetes

Abstract Background Diabetes mellitus is highly prevalent and associated with huge economic burden globally. The conventional care and management of diabetes mellitus is highly fragmented and complex, warranting the need for a comprehensive Collaborative Care Model (CCM). Little is known about the perception of patients with diabetes and their healthcare providers about CCM, its barriers and facilitators. This study aimed to explore the value of CCM in diabetes care at a primary healthcare (PHC) setting from the perspective of patients with diabetes and healthcare professionals (HCPs), in an effort to expand our current knowledge on collaborative care in diabetes at primary care level for the purpose of quality improvement and service expansion. Methods Using an exploratory case study approach, semi-structured interviews were conducted among patients and HCPs who encountered CCM in Qatar during 2019 and 2020. The semi-structured interviews were transcribed verbatim and the data were analysed and interpreted using a deductive-inductive thematic analysis approach. Results Twelve patients and 12 HCPs at a diabetes clinic participated in one-to-one interviews. The interviews resulted in five different themes: the process and components of collaborative care model (four subthemes), current organizational support and resources (three subthemes), impact of collaborative care model on diabetes outcomes (three subthemes), enablers of collaborative care model (three subthemes), and barriers to collaborative care model (three subthemes). The participants indicated easy access to and communication with competent and pleasant HCPs. The patients appreciated the extra time spent with HCPs, frequent follow-up visits, and health education, which empowered them to self-manage diabetes. HCPs believed that successful CCM provision relied on their interest and commitment to care for patients with diabetes. Generally, participants identified barriers and facilitators that are related to patients, HCPs, and healthcare system. Conclusions The providers and users of CCM had an overall positive perception and appreciation of this model in PHC settings. Barriers to CCM such as undesirable attributes of HCPs and patients, unsupportive hospital system, and high workload must be addressed before implementing the model in other PHC settings.

scholarly journals Perceived Burden Due to Registrations for Quality Monitoring and Improvement in Hospitals: A Mixed Methods Study

2020 ◽  
Author(s):  
Marieke Zegers ◽  
Gepke L. Veenstra ◽  
Gerard Gerritsen ◽  
Rutger Verhage ◽  
Hans J.G. van der Hoeven ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Mixed Methods ◽  
Quality Indicators ◽  
Healthcare Professionals ◽  
Information And Communications Technology ◽  
Structured Interviews ◽  
Perceived Burden ◽  
Joy In Work ◽  
Working Day ◽  
Care Of Elderly

Background: Quality indicators are registered to monitor and improve the quality of care. However, the number and effectiveness of quality indicators is under debate, and may influence the joy in work of physicians and nurses. Empirical data on the nature and consequences of the registration burden are lacking. The aim of this study was to identify and explore healthcare professionals’ perceived burden due to quality registrations in hospitals, and the effect of this burden on their joy in work. Methods: A mixed methods observational study, including participative observations, a survey and semi-structured interviews in two academic hospitals and one teaching hospital in the Netherlands. Study participants were 371 healthcare professionals from an intensive care unit (ICU), a haematology department and others involved in the care of elderly patients and patients with prostate or gastrointestinal cancer. Results: On average, healthcare professionals spend 52.3 minutes per working day on quality registrations. The average number of quality measures per department is 91, with 1380 underlying variables. Overall, 57% are primarily registered for accountability purposes, 19% for institutional governance and 25% for quality improvement objectives. Only 36% were perceived as useful for improving quality in everyday practice. Eight types of registration burden were identified, such as an excessive number of quality registrations, and the lack of usefulness for improving quality and inefficiencies in the registration process. The time healthcare professionals spent on quality registrations was not correlated with any measure of joy in work. Perceived unreasonable registrations were negatively associated with healthcare professionals’ joy in work (intrinsic motivation and autonomy). Healthcare professionals experienced quality registrations as diverting time from patient care and from actually improving quality. Conclusion: Registering fewer quality indicators, but more of what really matters to healthcare professionals, is key to increasing the effectiveness of registrations for quality improvement and governance. Also the efficiency of quality registrations should be increased through staffing and information and communications technology solutions to reduce the registration burden experienced by nurses and physicians.

scholarly journals Barriers and facilitators to discontinuing long-term use of benzodiazepine receptor agonists: a qualitative study using the Theoretical Domains Framework

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i20-i20
Author(s):  
T Lynch ◽  
C Ryan ◽  
C Cadogan
Keyword(s):  
Systematic Review ◽  
Behaviour Change ◽  
Healthcare Professionals ◽  
Theoretical Domains Framework ◽  
Benzodiazepine Receptor ◽  
Brief Interventions ◽  
Barriers And Facilitators ◽  
Withdrawal Symptoms ◽  
Structured Interviews

Abstract Introduction Long-term use (>3 months) of benzodiazepine receptor agonists (BZRAs) persists in healthcare settings worldwide despite guidelines recommending short-term use (≤4 weeks). Potential harms of long-term BZRA use include dependence and withdrawal symptoms. A systematic review highlighted that brief interventions targeting long-term BZRA use lacked theoretical underpinning and were often poorly described (1). It is advocated that interventions should be systematically developed and reported, use an appropriate theory-base and involve key stakeholders in their development. Semi-structured interviews based on the Theoretical Domains Framework (TDF) can be used to identify patient-level barriers and facilitators that should be targeted by interventions (2). Aim The aim of this study was to explore the views and experiences of individuals who had previously used BZRAs on a long-term basis through semi-structured interviews and to identify key theoretical domains that acted as barriers and facilitators to discontinuing long-term BZRA use. Methods A multi-strand convenience sampling method was used to recruit participants through community pharmacies, general practices and social media (e.g. Twitter, Instagram). Individuals who had successfully discontinued long-term BZRA use were eligible to participate if they were ≥18 years of age, community dwelling and resident in the Republic of Ireland. Individuals with a: cognitive impairment, history of epilepsy, serious mental illness (e.g. prescribed anti-psychotics) or receiving opioid substitution treatment were excluded. Semi-structured interviews were conducted using a TDF-based topic guide (2). Questions covering each TDF domain were used to explore participants’ perceptions of barriers and facilitators to discontinuing long-term BZRA use. Data were recorded and transcribed verbatim. Transcripts were independently checked for accuracy. Data were analysed using the framework method. Interviews continued until data saturation was achieved. Ethical approval was granted by the RCSI Research Ethics Committee. Results Thirteen patients were interviewed (seven female; median age: 43 years; median duration of use: six years). Key barriers to discontinuing BZRA use were identified under the ‘Emotions’ and ‘Reinforcement’ domains. These included participants’ first-hand experience of withdrawal symptoms and resultant fear towards discontinuation of the medication. ‘Intentions’ and ‘Social influences’ were identified as key theoretical domains that facilitated participants in discontinuing BZRA use. For example, participants described having strong intentions to discontinue BZRA use and discussed the positive influence of healthcare professionals such as community pharmacists in supporting them. Conclusion The study findings indicate that individuals who have successfully discontinued long-term BZRA use often have strong intentions to do so, as well as the support of healthcare professionals. However, challenges to discontinuing BZRA use include withdrawal symptoms and negative emotions towards the discontinuation process. The main strength of this study is that it used the TDF to examine barriers and facilitators to discontinuing long-term BZRA use. A notable limitation was that none of the participants were aged ≥65 years which limits the transferability of the findings. Future work will look to examine the views and experiences of current long-term BZRA users, integrate the findings with this study and map key domains to behaviour change techniques to inform the development of an intervention to reduce long-term BZRA use. References 1. Lynch T, Ryan C, Hughes CM, Presseau J, van Allen ZM, Bradley CP, et al. Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis. Addiction. 2020;115(9):1618–39. 2. Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science. 2012;7(1):37.

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