| Status | 已發表Published |
| Developing a logic model for the adoption of electronic medication administration records to improve quality of care in long-term care facilities: a key stakeholder interview study | |
Lei, K. C. ; Liang, Z.; Hu, H. ; Ung, O. L. C.
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| 2021-07-14 | |
| Source Publication | Shaping the future for health management education and research in a time of flux and uncertainty
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| Abstract | Residents living in long-term care facilities (LTCFs) are often frail having multiple comorbidities with a high prevlanece of polypharmacy.1 Preventing adverse drug events (ADEs), medication errors and other drug-related problems is highly challenging as errors may easily happen during prescribing, dispensing, documenting, monitoring, and administering.1,2 In an attempt to improve safety practices, electronic medication administration records (eMARs) are widely adopted in LTCFs.3,4 While the benefits of eMARs in reducing ADEs, enhancing efficiency, and improving safety of care have been widely reported5, little is known about the implementation process of eMARs in LTCFs. This study aimed to (1) develop a logic model for adopting eMARs in LTCFs and (2) explore the contextual factors relevant to the implementation process. Such model may be used to inform the implementation of health information technology alike in the LTCF setting, and to facilitate evaluation that drives continuous improvement. Fifty-seven in-depth, semi-structured interviews were conducted with LTCFs staff in Macao including 11 managers, 7 resident doctors, 7 pharmacists and pharmacy technicians,19 nurses, 12 health assistants and 1 nutritionist between February and March 2021. Purposive sampling was used to recruit LTCFs staff who had direct experiences with eMARs. Interview questions followed the theoretical framework of the logic model and explored participants' perspectives on the resources, activities, outputs, outcomes, and the contextual factors related to the adoption of eMARs at LTCFs. All participants were generally positive about adopting eMARs in LTCFs believing in the potential benefits of alleviating their work pressure and improving the quality of care. While financial resources – such as sufficient funding to acquire internet access and to procure hardware and software - were deemed important, nonfinancial resources – such as high-level commitment, the process of transforming from paper-base to eMARs, and training and communication – were also perceived critical to incorporating eMARs into daily practice. The mostly adopted eMARs functions included documentation, e-prescribing, reminders and real-time monitoring of administration, medication alert, data-sharing, and inventory checking. The most important output observed included: (1) simplied drug administration process, (2) reduced manual transcription errors, (3) reduced prescribing, dispensing and administration errors, (4) closer monitoring of residents’ health and functional conditions, and (5) timely communication among staff. The outcomes of adopting eMARs were at least 4-fold: improving efficiency, enhancing safety and quality of care, avoiding workload redundancy, and promoting data unification. For the sustainability and improvement of eMARs, gaps in the following areas had been suggested: flexibility to adjust the design and infrastructure of eMARs to meet the changing needs of LTCFs, stability of the internet connectivity, reliable technical support, burden of having paper-based and electronic documentation systems in parallel, data sharing between LTCFs and other healthcare settings, and technology literacy of frontline staff. Adopting eMARs is highly resources consuming and the benefits in supporting staff and improving quality of care can only be realized with appropriate implementation, precise execution, regular evaluation and responsive adjustment. For this, the proposed logic model framework may be a valuable roadmap for LTCFs, both current and future users of eMARs. |
| Keyword | logic model electronic medication administration records long-term care facilities quality of care key stakeholder interview study |
| Language | 英語English |
| The Source to Article | PB_Publication |
| PUB ID | 60943 |
| Document Type | Conference paper |
| Collection | Institute of Chinese Medical Sciences |
| Corresponding Author | Ung, O. L. C. |
| Recommended Citation GB/T 7714 | Lei, K. C.,Liang, Z.,Hu, H.,et al. Developing a logic model for the adoption of electronic medication administration records to improve quality of care in long-term care facilities: a key stakeholder interview study[C], 2021. |
| APA | Lei, K. C.., Liang, Z.., Hu, H.., & Ung, O. L. C. (2021). Developing a logic model for the adoption of electronic medication administration records to improve quality of care in long-term care facilities: a key stakeholder interview study. Shaping the future for health management education and research in a time of flux and uncertainty. |
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