Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management
Objective: To explore registered nurses’ experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. Design: A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were anal...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2016-01-01
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| Series: | Scandinavian Journal of Primary Health Care |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.3109/02813432.2015.1132891 |
| _version_ | 1818025604610523136 |
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| author | Rose-Marie Johansson-Pajala Kerstin Jorsäter Blomgren Pia Bastholm-Rahmner Johan Fastbom Lene Martin |
| author_facet | Rose-Marie Johansson-Pajala Kerstin Jorsäter Blomgren Pia Bastholm-Rahmner Johan Fastbom Lene Martin |
| author_sort | Rose-Marie Johansson-Pajala |
| collection | DOAJ |
| description | Objective: To explore registered nurses’ experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. Design: A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis. Setting: Five focus groups in five different long-term care settings in two regions in Sweden. Subject: A total of 21 registered nurses (RNs), four men and 17 women, aged 27–65 years, with 4–34 years of nursing experience. Results: The findings reveal that RNs in municipal long-term care settings can be regarded as “vigilant intermediaries” in the patients’ drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking. Conclusion: The RNs play a central but also complex role as “vigilant intermediaries” in the medication monitoring process, including the issue of responsibility. Improving RNs’ possibility to monitor their patients’ drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs’ pharmacovigilant activities.Key points This study contributes to the understanding of registered nurses’ (RNs’) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems).RNs can be considered to be “vigilant intermediaries” in elderly patients’ drug treatments, working at a distance from staff, physicians, and patients. RNs occasionally take on responsibilities that exceed their formal competence, with the patients’ best interests in mind. In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs’ pharmacovigilant activities. |
| first_indexed | 2024-12-10T04:18:45Z |
| format | Article |
| id | doaj.art-dd4d57229a0e4576b482fa4f231bf527 |
| institution | Directory Open Access Journal |
| issn | 0281-3432 1502-7724 |
| language | English |
| last_indexed | 2024-12-10T04:18:45Z |
| publishDate | 2016-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Scandinavian Journal of Primary Health Care |
| spelling | doaj.art-dd4d57229a0e4576b482fa4f231bf5272022-12-22T02:02:32ZengTaylor & Francis GroupScandinavian Journal of Primary Health Care0281-34321502-77242016-01-01341374510.3109/02813432.2015.11328911132891Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication managementRose-Marie Johansson-Pajala0Kerstin Jorsäter Blomgren1Pia Bastholm-Rahmner2Johan Fastbom3Lene Martin4School of Health, Care and Social Welfare, Mälardalen UniversitySchool of Health, Care and Social Welfare, Mälardalen UniversityMedical Management CentreAging Research Center, Karolinska Institutet and Stockholm UniversitySchool of Health, Care and Social Welfare, Mälardalen UniversityObjective: To explore registered nurses’ experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. Design: A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis. Setting: Five focus groups in five different long-term care settings in two regions in Sweden. Subject: A total of 21 registered nurses (RNs), four men and 17 women, aged 27–65 years, with 4–34 years of nursing experience. Results: The findings reveal that RNs in municipal long-term care settings can be regarded as “vigilant intermediaries” in the patients’ drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking. Conclusion: The RNs play a central but also complex role as “vigilant intermediaries” in the medication monitoring process, including the issue of responsibility. Improving RNs’ possibility to monitor their patients’ drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs’ pharmacovigilant activities.Key points This study contributes to the understanding of registered nurses’ (RNs’) role in medication management in municipal care of the elderly (i.e. detecting, assessing, and preventing adverse drug events or any drug-related problems).RNs can be considered to be “vigilant intermediaries” in elderly patients’ drug treatments, working at a distance from staff, physicians, and patients. RNs occasionally take on responsibilities that exceed their formal competence, with the patients’ best interests in mind. In order to prevent adverse drug events in municipal care of the elderly, new strategies are justified to facilitate RNs’ pharmacovigilant activities.http://dx.doi.org/10.3109/02813432.2015.1132891Adverse drug eventdrug monitoringelderlygeneral practicenurse’s rolepatient safetypharmacovigilancequalitative researchSweden |
| spellingShingle | Rose-Marie Johansson-Pajala Kerstin Jorsäter Blomgren Pia Bastholm-Rahmner Johan Fastbom Lene Martin Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management Scandinavian Journal of Primary Health Care Adverse drug event drug monitoring elderly general practice nurse’s role patient safety pharmacovigilance qualitative research Sweden |
| title | Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management |
| title_full | Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management |
| title_fullStr | Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management |
| title_full_unstemmed | Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management |
| title_short | Nurses in municipal care of the elderly act as pharmacovigilant intermediaries: a qualitative study of medication management |
| title_sort | nurses in municipal care of the elderly act as pharmacovigilant intermediaries a qualitative study of medication management |
| topic | Adverse drug event drug monitoring elderly general practice nurse’s role patient safety pharmacovigilance qualitative research Sweden |
| url | http://dx.doi.org/10.3109/02813432.2015.1132891 |
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