Medication processes in nursing homes: towards an effective, safe and person-centered medicines' pathway

Quality of care in nursing homes (NHs) remains a concern. An important contributor to this quality is the medicines' pathway, for which a framework of processes, key activities and best practices was developed as part of the Come-On study in 2016. Previous research has made clear that the medicines' pathway in NHs is challenging and not automatically person-centered. Hence, a need for quality improvement initiatives is present. The overall objective of the PhD project was to enhance the understanding of the current quality of medication processes in NHs, and to subsequently develop and evaluate strategies to improve this quality, encompassing the effectiveness and safety, as well as the person-centeredness of the entire medicines' pathway. The PhD-project was divided in two parts. Part one aimed to develop a quality assessment instrument for NHs to evaluate the quality of their medicines' pathway in order to set up the necessary quality improvement initiatives. The PhD presents the stepwise development of such an assessment instrument. The final instrument targets all involved healthcare professionals and consists of two performance questionnaires that are to be applied in a sequential approach: a quick scan to set priorities, followed by a detailed scan to detect specific working points. Part two of the PhD (i.e. the RESPECT project) explored opportunities for resident and informal caregiver involvement in the medicines' to further enhance the person-centeredness thereof in NHs. To meet the expectations and preferences of stakeholders (i.e. residents, informal caregivers and healthcare professionals) regarding resident and informal caregiver involvement in the medicines' pathway, an understanding of their experiences and expectations on the matter were performed. Based on interview findings, as well as scoping review findings, two strategies to improve resident and informal caregiver involvement in the medicines' pathway are presented in the PhD: the RESPECT-tool and the RESPECT-brochure. PhD findings indicate that the quality of the medicines' pathway in NHs remains to this day suboptimal. The tools developed have shown positive results, although on a small scale. Several recommendations are presented for future research, as well as for policy and practice, to further invest in the quality of the medicines' pathway in NHs.

Jaar van publicatie:2023

Toegankelijkheid:Embargoed