A Multicentre Study on the Effects of Self-administration of Medication During Hospitalization on Medication Safety, Adherence, and Patient Satisfaction in Dutch Hospitals
Trial Snapshot
- Phase
- Not Applicable
- Status
- Terminated
- Enrollment
- 193
- Locations
- 8
- Primary Endpoint
- Proportion of medication administration errors
Study Overview
Brief Summary
During hospitalization, medication administration errors (MAEs) occur daily in health care and can lead to serious harm. Improvement of medication safety is a major concern to policymakers and health care workers. Inpatient self-administration of medication (SAM) during hospital admission could be a way to reduce MAEs. Therefore the aim of this study is to determine the effect of inpatient self-administration of medication on the number of medication administration errors during hospitalization.
Detailed Description
Objective: the main objective of this study is to determine the effect of inpatient self-administration of medication on the number of medication administration errors during hospitalization. The secondary objectives of this study are to determine:
- The effect of inpatient self-administration of medication on the severity of medication administration errors during hospitalization
- The effect of inpatient self-administration on medication adherence after hospitalization
- The effect of inpatient self-administration of medication on patient satisfaction during hospitalization
- The effect of inpatient self-administration of medication on staff satisfaction during hospitalization
Study design: multicentre prospective quasi-experimental study with a pre-post design
Study population: hospitalized ≥ 16 years old patients
Intervention: the implementation of self-administration of medication by hospitalized patients. SAM will be compared to standard care.
Study Design
- Study Type
- Interventional
- Allocation
- Non Randomized
- Intervention Model
- Sequential
- Primary Purpose
- Health Services Research
- Masking
- Single (Outcomes Assessor)
Masking Description
The subject, staff and investigators are aware of which method of medication administration the patient is given, SAM or standard care. Only the data analysis is blinded by anonymizing and coding all data. Furthermore, an independent person will perform the data analyses.
Eligibility Criteria
- Ages
- 16 Years to — (Child, Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •All patients (≥ 16 years old) admitted to the ward who use medication or will be using medication at home after hospital discharge and are able to administer (part of) this medication themselves
Exclusion Criteria
- •Not providing informed consent
- •The use of a medication box without original medication boxes
- •The use of medication pre-packaged by automated dispensing system
- •The need of homecare support to administer medication
- •The need of an informal caretaker to help with medication administration
- •Admitted from a nursing home and medication is under supervision of the staff
- •Not understanding the Dutch language, written or spoken
- •The subject is not capable of managing SAM (due to mental or physical state)
Arms & Interventions
Standard care
Based on an (electronic) order placed by a physician, nurses collect medication and provide patients with the ordered medication in a timely matter. Nurses document the administration either in an electronic medical record or on paper.
Self-administration of medication (SAM)
During SAM medication is stocked at the patient's bedside. When medication is scheduled to be administered, patients collect those form their own stock, administer, and document the administration by themselves. Once daily nurses check whether patients succeeded in administration for all prescriptions of the last 24 hours. Each day, patients are qualified for SAM. In the case patients do not meet the criteria of SAM, they will be excluded from SAM.
Intervention: Self-administration of medication (SAM) (Behavioral)
Outcomes
Primary Outcomes
Proportion of medication administration errors
Time Frame: 2 weeks
The doctor's prescriptions as noted in the CPOE system will be compared to the observed medication administration and any discrepancy will be marked as an MAE. The number of erroneous medication administrations (containing 1 or more errors) will be divided by the number of observed drug administrations plus the number of omissions (concept of opportunities).
Secondary Outcomes
- Patient satisfaction during hospitalization(7 days)
- Severity of MAEs(2 weeks)
- Medication adherence after hospitalization(1 year)
- Staff satisfaction(1 year)
- Medication adherence after hospitalization(3 months)