Nurses' observations and experiences of problems and adverse effects of medication management in home care

Ellenbecker, Carol Hall; Frazier, Susan C; Verney, Sharon

doi:10.1016/j.gerinurse.2004.04.008

Cited by 62 publications

(76 citation statements)

References 16 publications

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“…Some studies have found that as many as 5 % of patients who were receiving nursing support at home had suffered from an adverse drug event of some kind during the previous week (Ellenbecker et al 2004 ) and 25 % in the past 3 months (Sorensen et al 2005 ). These problems are often due to poor communication between hospital staff, patients and their doctors in primary care (Ellenbecker et al 2004 ). Few studies directly assess medication error caused by patients and family members, though models of human error should be equally applicable to patients and informal caregivers as to professionals (Barber 2002 ).…”

Section: Adverse Drug Eventsmentioning

confidence: 99%

“…Those who had large stocks of medication at home were more exposed to adverse events (Sorensen et al 2005 ). The majority of patients receiving home care services are taking more than fi ve prescription drugs and over a third of patients are taking medications in ways that deviated from the prescribed medication regimen (Ellenbecker et al 2004 ).…”

Section: Adverse Drug Eventsmentioning

confidence: 99%

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Safety Strategies for Care in the Home

Vincent

Amalberti

2016

Safer Healthcare

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Patient safety has evolved and developed in the context of hospital care. The understanding we have of the epidemiology of error and harm, the causes and contributory factors and the potential solutions are almost entirely hospital based. Safety in home care is likely to require different concepts, approaches and solutions. Safety in this context has however been barely addressed and yet care provided in the home will soon become the most important context for healthcare delivery.The term 'home care' can encompass a variety of residential settings in which people are cared for by family, nurses and other professionals. In this chapter we use the term in a more restricted way to refer to the care of people in their own home, with varying degrees of informal and professional support. We focus on people with illnesses, usually chronic conditions, who are either living independently or being supported in their own homes by family or professional carers. Much healthcare is already delivered in the patient's home and this form of provision is growing rapidly. The benefi ts of home based care have been widely discussed, but the risks have not been fully articulated. In this chapter we fi rst briefl y summarise the background to the expansion of home care and then consider the nature and challenges for patient safety and the strategies that might help us manage risk in the home. An Ageing Population and the Expansion of Home CareMore than 20 % of citizens in developed countries will be over 65 in 2020. These people, while enjoying better quality of life than previous generations, will suffer from a variety of long term conditions. As we discussed earlier, patients with cancer, heart disease, dementia, renal and respiratory disorders may now live for decades with their disease. The most common causes of disability however are due to sight and hearing disorders which affect very large numbers of people and are particularly pertinent to safety in the home. As well as an absolute increase in the numbers of older people, there will also be a considerable relative increase. The socalled 'support ratio' -the ratio of people of working age to those over 65 -will

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Section: Adverse Drug Eventsmentioning

confidence: 99%

Section: Adverse Drug Eventsmentioning

confidence: 99%

Safety Strategies for Care in the Home

Vincent

Amalberti

2016

Safer Healthcare

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“…Little attention is paid to the role of home care workers regarding medication safety. Ellenbecker and colleagues [15] demonstrated by means of self reporting that nurses in home care were able to report adverse drugs events from medication errors. Our results are consistent with these findings.…”

Section: Limitations Of the Studymentioning

confidence: 99%

“…Ellenbecker et al [15] showed that more than three quarters of a homecare patient population (n=1467) were at risk for medication errors as a result of taking five or more different drugs.…”

Section: Introductionmentioning

confidence: 99%

Recognition of drug related problems by home healthcare employees: A Dutch observational study with self reports

Sino

Dooren

Haverkamp³

et al. 2013

JNEP

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“…10 Also reported are communication difficulties, 9,23 limited cognitive ability, 3 inability to read, 21,22 and the lack of a caregiver. 22 Mager 2 summarised the causes of errors in home care as polypharmacy, knowledge deficits, errors in communication, confusing hospital discharge instructions, brand versus generic names, medications that look alike and sound alike, incorrect use of medication boxes, and cognitive and visual problems. The actions taken and recommendations given for the prevention of errors reflected the causes of the errors.…”

Section: Articlementioning

confidence: 99%