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Registered nurses’ use of computerised decision support in medication reviews: Implications in Swedish nursing homes

Rose-Marie Johansson-Pajala (Mälardalen University, Västerås, Sweden)
Lene Martin (Mälardalen University, Västerås, Sweden)
Kerstin Jorsäter Blomgren (Mälardalen University, Västerås, Sweden)

International Journal of Health Care Quality Assurance

ISSN: 0952-6862

Article publication date: 9 July 2018

Abstract

Purpose

The purpose of this paper is to explore the implications of registered nurses’ (RNs) use of a computerized decision support system (CDSS) in medication reviews.

Design/methodology/approach

The paper employs a quasi-experimental, one-group pre-test/post-test design with three- and six-month follow-ups subsequent to the introduction of a CDSS. In total, 11 RNs initiated and prepared a total of 54 medication reviews. The outcome measures were the number of drug-related problems (DRPs) as reported by the CDSS and the RNs, respectively, the RNs’ views on the CDSS, and changes in the quality of drug treatment.

Findings

The CDSS significantly indicated more DRPs than the RNs did, such as potential adverse drug reactions (ADRs). The RNs detected additional problems, outside the scope of the CDSS, such as lack of adherence. They considered the CDSS beneficial and wanted to continue using it. Only minor changes were found in the quality of drug treatments, with no significant changes in the drug-specific quality indicators (e.g. inappropriate drugs). However, the use of renally excreted drugs in reduced renal function decreased.

Practical implications

The RNs’ use of a CDSS in medication reviews is of value in detecting potential ADRs and interactions. Yet, in order to have an impact on outcomes in the quality of drug treatment, further measures are needed. These may involve development of inter-professional collaboration, such as established procedures for the implementation of medication reviews, including the use of CDSS.

Originality/value

This is, to the best of the authors’ knowledge, the first study to explore the implications of medication reviews, initiated and prepared by RNs who use a CDSS. The paper adds further insight into the RNs’ role in relation to quality of drug treatments.

Keywords

Acknowledgements

The authors would like to thank the nursing homes who participated in the study, and particularly the RNs. The authors also want to thank Johan Fastbom, Professor at Aging Research Center, Karolinska Institutet, who contributed with his expertise in geriatric pharmacology.

Citation

Johansson-Pajala, R.-M., Martin, L. and Jorsäter Blomgren, K. (2018), "Registered nurses’ use of computerised decision support in medication reviews: Implications in Swedish nursing homes", International Journal of Health Care Quality Assurance, Vol. 31 No. 6, pp. 531-544. https://doi.org/10.1108/IJHCQA-01-2017-0009

Publisher

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Emerald Publishing Limited

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