Document Detail


Medication safety: using incident data analysis and clinical focus groups to inform educational needs.
MedLine Citation:
PMID:  22070161     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Rationale, aims and objectives  Medication-related safety incidents are a source of concern to patients, policy makers and clinicians. The role of education in improving safety-critical practices in health care is poorly appreciated. This pilot study aimed to initiate collective discussion among professional groups of clinical staff about a range of medicine-related patient safety issues which were identified from a local incident reporting system. In engaging staff to collectively reflect on reported medication incidents we attempted to uncover a deeper understanding of local contextual issues and potential educational needs. Methods  A mixed method study was conducted involving categorical analysis of 1058 medication incident reports (Phase 1) and the use of three mixed focus groups of clinical staff (Phase 2) in three acute hospitals in one locality in NHS Scotland. Results  Focus group transcript analysis produced four main themes (e.g. the medical role) and 12 related sub-themes (e.g. pharmacological education and skill mix for administration of medicines) concerning medication-related practices and possible educational interventions. Conclusions  While it is necessary to review reported incident data and disseminate the educational messages for the improvement of quality, this traditional risk management process is inadequate on its own. Reporting systems can be enhanced by collective examination of reported information about medicines by local clinical teams. We identified a strong message from the focus groups for learning about each other and from each other, and that the method piloted may be an important inter-professional mechanism for improvement.
Authors:
Hannah Hesselgreaves; Anne Watson; Andy Crawford; Murray Lough; Paul Bowie
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-9
Journal Detail:
Title:  Journal of evaluation in clinical practice     Volume:  -     ISSN:  1365-2753     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9609066     Medline TA:  J Eval Clin Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Blackwell Publishing Ltd.
Affiliation:
Research Fellow Assistant Director of Pharmacy Director of Educational Research Associate Adviser in CPD and Educational Research, NHS Education for Scotland, Glasgow, UK Head of Clinical Governance, NHS Greater Glasgow and Clyde, Glasgow, UK.
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