Inpatients Self‐Administration of Medication: Stakeholders' views and prerequisites

Abstract

Aims and objectives To identify stakeholders' views on inpatient Self‐Administration of Medication and corresponding prerequisites for successful implementation. Background Self‐Administration of Medication allows capable patients to manage their medication regimen throughout hospitalisation. It is assumed to facilitate continuity of care, increase medication safety and patient empowerment. To enable sustainable implementation stakeholders should support it. Knowledge about stakeholders' views regarding Self‐Administration of Medication is currently lacking. Design A qualitative study was conducted among stakeholders using semi‐structured interviews. Methods Using purposive and snowball sampling fourteen representatives from Dutch healthcare associations, organisations and authorities were interviewed between April and July 2019. These stakeholders were asked to reflected on Self‐Administration of Medication and its implementation. Data were examined using inductive thematic content analysis and reported following the COREQ checklist. Results Most stakeholders were positive towards Self‐Administration of Medication and foresaw benefits in terms of the following: improvements to patient‐centred care, contributions to sustainable use of healthcare assets and the need and opportunity for change. Critical concerns included reflecting potential risks for patient safety, concerns about implementation feasibility and questions regarding implementation necessity. Stakeholders highlighted prerequisites pertaining to the implementation process in which the following two themes emerged: (1) initiate a supported change and (2) perform research for best practices and identification of benefits. Other prerequisites concerned distinct levels within healthcare including individual patients (i.e. adequate communication), hospital organisation (i.e. to establish a workflow to secure medication safety) and healthcare system (i.e. to facilitate multidisciplinary collaboration in healthcare). Conclusion Stakeholders were predominantly positive about Self‐Administration of Medication. For successful and sustainable implementation of Self‐Administration of Medication, prerequisites identified in this study should be met. Relevance to clinical practice This study provided knowledge about stakeholders' views which could foster implementation and evaluation of Self‐Administration of Medication, which may, in turn, promote effective deployment and patient empowerment.

Nurses’ support of hospitalized patients’ self-management

“…How can nurses support hospitalized patients' self-management? If we cannot name this, "we cannot control it, finance it, research it, teach it, or put it into public policy" (free after Norma Lang in Clark 50 ). The lack of clarity on this concept hinders the development of evidence-based interventions and the provision of adequate care.…”

“…49 A suggestion for further research is to use a systematic method for the development of interventions, such as the Medical Research Council Framework, and describe the intervention in sufficient detail to allow others to reproduce the intervention. 49,50 A recent concept analysis of self-management, identifying ten attributes delineating self-management, may provide a basis for the development of new self-management programs. 41 We have performed this review of the literature systematically, using the framework of Arksey and O'Malley.…”

“…Therefore, the responsibilities of patients and nurses need to be incorporated into guidelines and quality standards. 50 Before a planned hospital admission, patients can be prepared for selfmanagement tasks during hospitalization, e.g. oral care to reduce oral mucositis.…”