The RNs struggled to maintain a safe medication management process in the home healthcare setting. They incorporated bridging strategies through trade-offs and workarounds, while still maintaining the patient’s autonomy and integrity. Older adults, informal caregivers, and healthcare professionals’ perspectives highlighted several potential opportunities for improving safe medication management in municipal home health care through nurse-led, interprofessional, collaborative, patient-centered practices.
Educating Patients And Caregivers
Home Health care nurses often work closely with patients’ doctors to ensure that symptoms are controlled and medications are taken as prescribed. When a patient’s condition or medication changes, the nurse will notify the doctor so that the physician can amend his or her orders accordingly. Home healthcare patients commonly have multi-morbidity and polypharmacy and are in contact with multiple specialists who prescribe their drugs. Consequently, it is important for home healthcare organizations and providers to promote long-lasting improvements that reduce medication errors and adverse drug events in their patient population.
Research exploring the relationship between the work environment and patient safety in home health care has been limited. However, Kroposki and Alexander57 found that high patient satisfaction scores were more likely in home health agencies where the nurses had good working relationships with their supervisors, the opportunity for shared decision-making was present, and formalized organizational and professional guidelines existed. Educating patients and caregivers on proper medication management practices in the home can help reduce the likelihood of medication errors. This includes creating a medication schedule and documenting all of the patients’ prescriptions and over-the-counter medicines.
Using Electronic Medication Lists
Providing patients with a simple way to track their medications helps prevent mistakes, especially when they move between different home health care agencies. Using electronic medication lists is a safe and convenient way to do this. Many home healthcare agencies have eHealth systems that allow nurses to view patient medical records and make medication orders electronically. However, the use of eHealth systems for the exchange of information on medications between service levels is not yet standardized.
This is problematic because it increases the risk that nurses receive inaccurate medication prescription lists. Having an accurate medication list can save lives during annual check-ups, sick visits to your doctor or even in emergency situations where you may not be able to communicate your needs clearly. Ensure that someone you trust has access to your medication list, such as a family member or friend. This person could accompany you to appointments or speak for you if you are unable.
Using Medication Dispensers
In some municipalities, digital medication dispensers are now used in home health care. These devices dispense a set amount of medicine at each time slot and notify the user when they have a dose. If the user does not remove the medication within a given timeframe, the device sends a notice to home service central, and a home health care professional calls the user. The implementation of the digital dispenser posed new challenges for home health professionals. They had to negotiate the technological script, which conflicted with their personal and professional standards for patient security. Furthermore, they had to learn how to work with the device and reconstruct new arrangements for medication management.
Medication dispensers can help to reduce the risk of misunderstood verbal physician orders and decrease medication errors. Many devices also have a text, email or connected phone application system to keep caregivers in the loop when there are issues with dosages. This can make it easier for your loved one to stick with their medication schedule and stay safe.
Using Medication Labels
Although medication labeling may seem like a simple and mundane task, the research shows that it plays a key role in preventing and reducing medical errors. For instance, a recent study of external icon found that the color and design of drug labels can help reduce errors, such as selecting the wrong medication by accident. A well-designed label can also make the difference between a medication being administered orally or via injection, which can have significant implications for patient safety.
The nurses interviewed emphasized the importance of having clear communication between hospital and home health care to ensure patient safety. This was especially challenging when working in a home health setting, where the nurses often had limited access to their patients’ medication lists. Our findings suggest the need to develop and implement routines for ensuring quality in the transfer of medication information between service levels, including electronic exchanges of medication lists. This would reduce the need for nurses to request medication lists from hospitals or healthcare centers.
During the assessment visit, your home health RN will make a medication list and provide you with instructions on how to take your medications. This is to ensure proper and safe medication management. Drawing on Schutz’s phenomenologically based sociology, we used vignette-based interviews to gain first-order information about experiences on safe MMP in Home Health care. Our findings indicate that a safe MMP in specialized home healthcare requires good communication and cooperation between all involved.