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Tools for Assessing Medication Safety Processes in Nursing Homes: A Systematic Review
Ramesh Sharma Poudel1, Kylie A Williams, Lisa G Pont
1Discipline of Pharmacy, Graduate School of Health, University of Technology Sydney, Sydney, NSW, Australia.
Journal of Patient Safety
|July 23, 2025
Summary
This review identified four tools for measuring medication safety in nursing homes. The Canadian Medication Safety Self-Assessment for Long-Term Care (MSSA-LTC) demonstrated the broadest scope and highest quality.
Area of Science:
- Gerontology
- Health Services Research
- Patient Safety
Background:
- Medication safety in nursing homes is a critical concern for resident well-being.
- Existing tools for assessing medication safety processes vary in scope and quality.
Purpose of the Study:
- To systematically identify and evaluate tools for measuring medication safety-related processes in nursing homes.
Main Methods:
- Systematic search of Medline, Embase, and CINAHL databases up to June 2022.
- Mapping tool items to the medication management pathway (9 steps, 3 background processes).
- Assessing methodological quality using the Appraisal of Indicators through Research and Evaluation (AIRE) Instrument.
Main Results:
- Four tools were identified, exhibiting significant variation in development, content, focus, and quality.
- The Canadian Medication Safety Self-Assessment for Long-Term Care (MSSA-LTC) was the only tool to cover all medication management pathway components.
- MSSA-LTC also received a high overall quality rating according to the AIRE instrument.
Conclusions:
- The Canadian MSSA-LTC tool offers the most comprehensive coverage and highest quality among the identified instruments.
- Selection of a tool should align with the specific assessment purpose, processes of interest, and jurisdictional validity.
- Understanding tool differences and limitations is crucial for effective implementation in nursing home settings.
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