242 results found
Wheeler C, Blencowe A, Jacklin A, et al., 2021, Combining research and design: A mixed methods approach aimed at understanding and optimising inpatient medication storage systems, PLOS ONE, Vol: 16, ISSN: 1932-6203
Harkanen M, Vehvilainen-Julkunen K, Franklin BD, et al., 2021, Factors Related to Medication Administration Incidents in England and Wales Between 2007 and 2016: A Retrospective Trend Analysis, JOURNAL OF PATIENT SAFETY, Vol: 17, Pages: E850-E857, ISSN: 1549-8417
Jani YH, Franklin BD, 2021, Interruptive alerts: only one part of the solution for clinical decision support, BMJ QUALITY & SAFETY, Vol: 30, Pages: 933-936, ISSN: 2044-5415
Jani YH, Chumbley GM, Furniss D, et al., 2021, The Potential Role of Smart Infusion Devices in Preventing or Contributing to Medication Administration Errors: A Descriptive Study of 2 Data Sets., J Patient Saf, Vol: 17, Pages: e1894-e1900
OBJECTIVES: Errors in medication administration are common, with many interventions suggested to reduce them. For intravenous infusion-related errors, "smart infusion devices" incorporating dose error reduction software are widely advocated. Our aim was to explore the role of smart infusion devices in preventing or contributing to medication administration errors using retrospective review of 2 complementary data sets that collectively included a wide range of errors with different levels of actual or potential harm. METHODS: We reviewed 216 medication administration errors identified from an observational study in clinical practice and 123 medication incidents involving infusion devices reported to a national reporting system. The impact of smart infusion devices in preventing or contributing to these errors was assessed by the research team and an expert panel. RESULTS: The data suggest that use of any infusion device rather than gravitational administration may have prevented 13% of observed errors and 8% of reported incidents; additional reductions may be possible with standalone smart infusion devices, and further potential reductions with smart infusion devices integrated with electronic prescribing and barcode administration systems. An estimated 52% to 73% of errors that occurred with traditional infusion pumps could be prevented with such integrated smart infusion devices. In the few cases where smart infusion devices were used, these contributed to errors in 2 of 58 observed errors and 7 of 8 reported incidents. CONCLUSIONS: Smart infusion devices not only prevent some medication administration errors but can also contribute to them. Further evaluation of such systems is required to make recommendations for policy and practice.
Black A, Gage H, Norton C, et al., 2021, Patient satisfaction with medication consultations and medicines information provided by nurses working autonomously in sexual health services: A questionnaire study, JOURNAL OF ADVANCED NURSING, ISSN: 0309-2402
Subakumar K, Franklin BD, Garfield S, 2021, Analysis of the third WHO Global Safety Challenge 'Medication Without Harm' patient-facing materials: exploratory descriptive study, EUROPEAN JOURNAL OF HOSPITAL PHARMACY, Vol: 28, Pages: E109-E114, ISSN: 2047-9956
Jones MD, Clarke J, Feather C, et al., 2021, Use of pediatric injectable medicines guidelines and associated medication administration errors: a human reliability analysis, Annals of Pharmacotherapy, Vol: 55, Pages: 1333-1340, ISSN: 1060-0280
Background:In a recent human reliability analysis (HRA) of simulated pediatric resuscitations, ineffective retrieval of preparation and administration instructions from online injectable medicines guidelines was a key factor contributing to medication administration errors (MAEs).Objective:The aim of the present study was to use a specific HRA to understand where intravenous medicines guidelines are vulnerable to misinterpretation, focusing on deviations from expected practice (discrepancies) that contributed to large-magnitude and/or clinically significant MAEs.Methods:Video recordings from the original study were reanalyzed to identify discrepancies in the steps required to find and extract information from the NHS Injectable Medicines Guide (IMG) website. These data were combined with MAE data from the same original study.Results:In total, 44 discrepancies during use of the IMG were observed across 180 medication administrations. Of these discrepancies, 21 (48%) were associated with an MAE, 16 of which (36% of 44 discrepancies) made a major contribution to that error. There were more discrepancies (31 in total, 70%) during the steps required to access the correct drug webpage than there were in the steps required to read this information (13 in total, 30%). Discrepancies when using injectable medicines guidelines made a major contribution to 6 (27%) of 22 clinically significant and 4 (15%) of 27 large-magnitude MAEs.Conclusion and Relevance:Discrepancies during the use of an online injectable medicines guideline were often associated with subsequent MAEs, including those with potentially significant consequences. This highlights the need to test the usability of guidelines before clinical use.
Black A, Courtenay M, Norton C, et al., 2021, Independent nurse medication provision: A mixed method study assessing impact on patients' experience, processes, and costs in sexual health clinics, JOURNAL OF ADVANCED NURSING, Vol: 78, Pages: 239-251, ISSN: 0309-2402
Garfield S, Wheeler C, Boucher C, et al., 2021, Medicines management at home during the COVID-19 pandemic: a qualitative study exploring the UK patient/carer perspective, INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Vol: 29, Pages: 458-464, ISSN: 0961-7671
Cresswell K, Sheikh A, Franklin BD, et al., 2021, Interorganizational Knowledge Sharing to Establish Digital Health Learning Ecosystems: Qualitative Evaluation of a National Digital Health Transformation Program in England, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 23, ISSN: 1438-8871
Jones MD, Franklin BD, Raynor DK, et al., 2021, Costs and Cost-Effectiveness of User-Testing of Health Professionals' Guidelines to Reduce the Frequency of Intravenous Medicines Administration Errors by Nurses in the United Kingdom: A Probabilistic Model Based on Voriconazole Administration, APPLIED HEALTH ECONOMICS AND HEALTH POLICY, Vol: 20, Pages: 91-104, ISSN: 1175-5652
Charani E, McKee M, Ahmad R, et al., 2021, Optimising antimicrobial use in humans-review of current evidence and an interdisciplinary consensus on key priorities for research, The Lancet Regional Health - Europe, Vol: 7, Pages: 1-10, ISSN: 2666-7762
Addressing the silent pandemic of antimicrobial resistance (AMR) is a focus of the 2021 G7 meeting. A major driver of AMR and poor clinical outcomes is suboptimal antimicrobial use. Current research in AMR is inequitably focused on new drug development. To achieve antimicrobial security we need to balance AMR research efforts between development of new agents and strategies to preserve the efficacy and maximise effectiveness of existing agents.Combining a review of current evidence and multistage engagement with diverse international stakeholders (including those in healthcare, public health, research, patient advocacy and policy) we identified research priorities for optimising antimicrobial use in humans across four broad themes: policy and strategic planning; medicines management and prescribing systems; technology to optimise prescribing; and context, culture and behaviours. Sustainable progress depends on: developing economic and contextually appropriate interventions; facilitating better use of data and prescribing systems across healthcare settings; supporting appropriate and scalable technological innovation. Implementing this strategy for AMR research on the optimisation of antimicrobial use in humans could contribute to equitable global health security.
Ahmed M, Wheeler C, Franklin BD, et al., 2021, Resilience of Medication Adherence Practices in Response to Life Changes: Learning from Qualitative Data Obtained during the COVID-19 Pandemic, HEALTHCARE, Vol: 9
Williams R, Sheikh A, Franklin BD, et al., 2021, Using Blueprints to promote interorganizational knowledge transfer in digital health initiatives-a qualitative exploration of a national change program in English hospitals., J Am Med Inform Assoc, Vol: 28, Pages: 1431-1439
OBJECTIVE: The Global Digital Exemplar (GDE) Program is a national attempt to accelerate digital maturity in healthcare providers through promoting knowledge transfer across the English National Health Service (NHS). "Blueprints"-documents capturing implementation experience-were intended to facilitate this knowledge transfer. Here we explore how Blueprints have been conceptualized, produced, and used to promote interorganizational knowledge transfer across the NHS. MATERIALS AND METHODS: We undertook an independent national qualitative evaluation of the GDE Program. This involved collecting data using semistructured interviews with implementation staff and clinical leaders in provider organizations, nonparticipant observation of meetings, and key documents. We also attended a range of national meetings and conferences, interviewed national program managers, and analyzed a range of policy documents. Our analysis drew on sociotechnical principles, combining deductive and inductive methods. RESULTS: Data comprised 508 interviews, 163 observed meetings, and analysis of 325 documents. We found little evidence of Blueprints being adopted in the manner originally conceived by national program managers. However, they proved effective in different ways to those planned. As well as providing a helpful initial guide to a topic, we found that Blueprints served as a method of identifying relevant expertise that paved the way for subsequent discussions and richer knowledge transfers amongst provider organizations. The primary value of Blueprinting, therefore, seemed to be its role as a networking tool. Members of different organizations came together in developing, applying, and sustaining Blueprints through bilateral conversations-in some circumstances also fostering informal communities of practice. CONCLUSIONS: Blueprints may be effective in facilitating knowledge transfer among healthcare organizations, but need to be accompanied by other evolving methods, such as
Sheikh A, Anderson M, Albala S, et al., 2021, Health information technology and digital innovation for national learning health and care systems, LANCET DIGITAL HEALTH, Vol: 3, Pages: E383-E396
Anderson M, Pitchforth E, Asaria M, et al., 2021, LSE-Lancet Commission on the future of the NHS: re-laying the foundations for an equitable and efficient health and care service after COVID-19, The Lancet, Vol: 397, Pages: 1915-1978, ISSN: 0140-6736
Garfield S, Begum A, Toh KL, et al., 2021, Do patients and family carers have different concerns about the use of medicines compared with healthcare professionals? A quantitative secondary analysis of healthcare concerns relating to adults with complex needs., Patient Educ Couns
OBJECTIVE: To identify concerns related to the use of medicines for adults with complex needs and explore whether these differed between healthcare professionals and patients/carers, in order to inform development of interventions to increase medication adherence. METHODS: A quantitative secondary analysis of a database of healthcare professionals' and patients'/carers' healthcare concerns, related to adults with complex needs. Categories of concerns related to medicines use were identified and concerns related to medication use coded against these. Data were analysed descriptively, and a Chi-square test conducted to test for differences in responses from healthcare professionals versus patients/carers. RESULTS: There was a significant difference in the types of medication concern raised by healthcare professionals versus those raised by patients/carers. Patients/carers expressed more concerns about side effects and interactions; healthcare professionals identified more concerns related to patient support and carers' knowledge/training. CONCLUSION: Healthcare professionals had significantly different concerns about medicines to patients; this may be a potential barrier to medication adherence. PRACTICE IMPLICATIONS: Healthcare professionals may need to adopt an approach to non-adherence that goes beyond education and counselling and adopts a wider patient perspective. Findings suggest that a greater focus on addressing side effects and interactions may be beneficial in increasing medication adherence.
Lichtner V, Prgomet M, Gates P, et al., 2021, Automatic dispensing cabinets and governance of controlled drugs: an exploratory study in an intensive care unit, EUROPEAN JOURNAL OF HOSPITAL PHARMACY, ISSN: 2047-9956
Ocloo J, Garfield S, Franklin BD, et al., 2021, Exploring the theory, barriers and enablers for patient and public involvement across health, social care and patient safety: a systematic review of reviews, HEALTH RESEARCH POLICY AND SYSTEMS, Vol: 19, ISSN: 1478-4505
Jones MD, McGrogan A, Raynor DK, et al., 2021, User-testing guidelines to improve the safety of intravenous medicines administration: a randomised in situ simulation study, BMJ QUALITY & SAFETY, Vol: 30, Pages: 17-26, ISSN: 2044-5415
Hinder S, Cresswell K, Sheikh A, et al., 2021, Promoting inter-organisational knowledge sharing: A qualitative evaluation of England's Global Digital Exemplar and Fast Follower Programme, PLOS ONE, Vol: 16, ISSN: 1932-6203
Franklin BD, Puaar SJ, 2020, What is the impact of introducing inpatient electronic prescribing on prescribing errors? A naturalistic stepped wedge study in an English teaching hospital, HEALTH INFORMATICS JOURNAL, Vol: 26, Pages: 3152-3162, ISSN: 1460-4582
Grimes TC, Garfield S, Kelly D, et al., 2020, Household medication safety practices during the COVID-19 pandemic: a descriptive qualitative study protocol, BMJ Open, Vol: 10, Pages: 1-6, ISSN: 2044-6055
Introduction Those who are staying at home and reducing contact with other people during the COVID-19 pandemic are likely to be at greater risk of medication-related problems than the general population. This study aims to explore household medication practices by and for this population, identify practices that benefit or jeopardise medication safety and develop best practice guidance about household medication safety practices during a pandemic, grounded in individual experiences.Methods and analysis This is a descriptive qualitative study using semistructured interviews, by telephone or video call. People who have been advised to ‘cocoon’/‘shield’ and/or are aged 70 years or over and using at least one long-term medication, or their caregivers, will be eligible for inclusion. We will recruit 100 patient/carer participants: 50 from the UK and 50 from Ireland. Recruitment will be supported by our patient and public involvement (PPI) partners, personal networks and social media. Individual participant consent will be sought, and interviews audio/video recorded and/or detailed notes made. A constructivist interpretivist approach to data analysis will involve use of the constant comparative method to organise the data, along with inductive analysis. From this, we will iteratively develop best practice guidance about household medication safety practices during a pandemic from the patient’s/carer’s perspective.Ethics and dissemination This study has Trinity College Dublin, University of Limerick and University College London ethics approvals. We plan to disseminate our findings via presentations at relevant patient/public, professional, academic and scientific meetings, and for publication in peer-reviewed journals. We will create a list of helpful strategies that participants have reported and share this with participants, PPI partners and on social media.
Franklin BD, Thomas EJ, 2020, Introduction from the new editors-in-chief, BMJ QUALITY & SAFETY, Vol: 29, Pages: 873-874, ISSN: 2044-5415
Harkanen M, Franklin BD, Murrells T, et al., 2020, Factors contributing to reported medication administration incidents in patients' homes - A text mining analysis, JOURNAL OF ADVANCED NURSING, Vol: 76, Pages: 3573-3583, ISSN: 0309-2402
Garfield S, Furniss D, Husson F, et al., 2020, How can patient-held lists of medication enhance patient safety? A mixed-methods study with a focus on user experience, BMJ Quality & Safety, Vol: 29, Pages: 764-773, ISSN: 2044-5415
Background Patients 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.Methods We 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.Results We 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.Conclusion Our 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.
Barakat S, Franklin BD, 2020, An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital, PHARMACY, Vol: 8
Krasuska M, Williams R, Sheikh A, et al., 2020, Technological Capabilities to Assess Digital Excellence in Hospitals in High Performing Health Care Systems: International eDelphi Exercise, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 22, ISSN: 1438-8871
Lichtner V, Franklin BD, Dalla-Pozza L, et al., 2020, Electronic ordering and the management of treatment interdependencies: a qualitative study of paediatric chemotherapy, BMC MEDICAL INFORMATICS AND DECISION MAKING, Vol: 20
Garfield S, Teo V, Chan L, et al., 2020, To what extent is the World Health Organization's medication safety challenge being addressed in English hospital organizations? a descriptive study., Journal of Patient Safety, ISSN: 1549-8417
OBJECTIVES: Our study aimed to explore to what extent the priority areas and domains of the World Health Organization (WHO)'s third Global Patient Safety Challenge were being addressed in a sample of hospital organizations. METHODS: A qualitative approach was taken using a combination of focus groups, semistructured interviews, and documentary analysis in 4 UK teaching hospital organizations. A purposive sampling strategy was adopted with the aim of recruiting health care professionals who would be likely to have knowledge of medication safety interventions that were being carried out at the hospital organizations. Medication safety group meeting notes from 2017 to 2019 were reviewed at the hospital organizations to identify interventions recently implemented, those currently being implemented, and plans for the future. A content analysis was undertaken using the WHO's third Global Patient Safety Challenge priority areas and domains as deductive themes. RESULTS: All the domains and priority areas of the WHO Medication Safety Challenge were being addressed at all 4 sites. However, a greater number of interventions focused on "health care professionals" and "systems and practices of medication management" than on "patients and the public." In terms of the priority areas, the main focus was on "high-risk situations," particularly high-risk medicines, with fewer interventions in the areas of "transitions of care" and "polypharmacy." CONCLUSIONS: More work may be needed to address patient and public involvement in medication safety and the priority areas of transitions of care and polypharmacy. Comparative global studies would help build an international picture and allow shared learning.
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