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Examining nurses' decision process for medication management in home care
Christine Kovner1, Joyce Menezes, Judith D Goldberg
1Division of Nursing, Steinhardt School of Education, New York University, New York City, New York, USA. ctk1@nyu.edu
Joint Commission Journal on Quality and Patient Safety
|September 1, 2005
Summary
Home health nurses (HHNs) manage medication processes, identifying potential errors and improving patient safety. Analyzing medication management systems can reduce adverse drug events and enhance care delivery.
Area of Science:
- Nursing
- Patient Safety
- Healthcare Systems
Background:
- Prospective description of medication management in home care agencies.
- Focus on the nurse's role and critical process points.
- Includes medication preparation, administration, knowledge updates, effectiveness monitoring, adverse reaction reporting, and patient education.
Purpose of the Study:
- Identify steps home health nurses (HHNs) take with families.
- Determine system changes to decrease medication errors.
- Analyze the medication management process using Failure Mode and Effects Analysis (FMEA).
Main Methods:
- Prospective description of medication management.
- Application of Failure Mode and Effects Analysis (FMEA).
- Divided the process into drug utilization review (DUR), drug administration, and side effects.
Main Results:
- Identified failure modes for DUR, focusing on duplicative and harmful interactions.
- Highlighted the process steps HHNs follow with families.
- Recognized the need for system changes to reduce errors.
Conclusions:
- Home health agencies must analyze their medication management processes and implement system solutions.
- Difficulty in contacting physicians for drug regimen changes is an ongoing issue.
- Close monitoring by HHNs can mitigate adverse drug effects.