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The Digital Drag and Drop Pillbox: Design and Feasibility of a Skill-based Education Model to Improve Medication
Bradi B Granger1, Susan C Locke, Margaret Bowers
1Bradi B. Granger, PhD, RN, FAHA, FAAN Professor, Duke University School of Nursing and Duke Health System, Durham, North Carolina. Susan C. Locke, PhD Senior Scientific Project Lead, Duke Center for Learning Health Care, Duke Clinical Research Institute, Durham, North Carolina. Margaret Bowers, DNP, FNP-BC, AACC, FAANP Associate Professor, Duke University School of Nursing, Durham, North Carolina. Tenita Sawyer, RN, CNIII Clinical Nurse III, Duke Health System, Durham, North Carolina. Howard Shang Director, IT, Business Information Services, Duke Clinical Research Institute, Center for Applied Genomics and Precision Medicine, Chapel Hill, North Carolina Amy P. Abernethy, MD, PhD Adjunct Professor, Duke University Medical Center, Durham, North Carolina. Richard A. Bloomfield, Jr, MD Adjunct Assistant Professor of Pediatrics, Duke University Health System, Durham, North Carolina. Catherine L. Gilliss, PhD, RN, FAAN Helene Fuld Health Trust Professor of Nursing, Duke University School of Nursing, Duke University, Durham, North Carolina.
Objective:
We present the design and feasibility testing for the "Digital Drag and Drop Pillbox" (D-3 Pillbox), a skill-based educational approach that engages patients and providers, measures performance, and generates reports of medication management skills.
Methods:
A single-cohort convenience sample of patients hospitalized with heart failure was taught pill management skills using a tablet-based D-3 Pillbox. Medication reconciliation was conducted, and aptitude, performance (% completed), accuracy (% correct), and feasibility were measured.
Results:
The mean age of the sample (n = 25) was 59 (36-89) years, 50% were women, 62% were black, 46% were uninsured, 46% had seventh-grade education or lower, and 31% scored very low for health literacy. However, most reported that the D-3 Pillbox was easy to read (78%), easy to repeat-demonstrate (78%), and comfortable to use (tablet weight) (75%). Accurate medication recognition was achieved by discharge in 98%, but only 25% reported having a "good understanding of my responsibilities."
Conclusions:
The D-3 Pillbox is a feasible approach for teaching medication management skills and can be used across clinical settings to reinforce skills and medication list accuracy.
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