The patients medication list and summary care record in nursing homes and home based care
Description
Correct information about a patient's medication use makes it possible to treat and prevent many medical conditions. Today, health professionals do not have immediate access to an updated, complete and correct list of the patient's prescribed medication, which increases the risk of medicine-related problems (MRP). MRPs such as side effects, and incorrect use or wrong medicine have serious impacts on patient safety, it may reduce patients quality of life, cause illness, death and increased healthcare costs. The health authorities in Norway are investing in several digital interventions to increase patient safety, the quality of the health services and the efficiency of the medication management process. Sharing updated medicine information throughout the entire patient process, between the various organizations and levels of care, is one of the prioritized areas in the Norwegian e-health strategy, and a national shared medication list (Pasientens Legemiddelliste-PLL) is the overall goal.
The national e-health solutions Kjernejournal (KJ) and PLL are being implemented in the primary and specialized health and care services. The PLL (and KJ) who provides direct access to GPs, health personnel in nursing homes, home care services, and hospitals, is expected to lead to major changes in the performance of services and with regard to patient safety and quality.
This study focuses on experiences and effects for health professionals and patients in nursing homes and home care before, during and after the introduction of PLL and KJ. This includes their interaction with GPs, pharmacists, hospital staff, other relevant actors as well as patients and relatives. Seven municipalities are included in the study as of 2023.
Goals
The overall aim of the study is to produce research-based knowledge about the experiences and effects of healthcare personnel and patients before, during and after the introduction of the national solutions PLL and KJ in nursing homes and home care. The main focus is patient safety and quality.
In 2021, the project was expanded to also include PLL in hospital. This includes Haukeland and Haraldsplass hospitals, which are testing PLL from 2022/2023, before a national introduction of PLL from 2024-.
The described sub-goals include the main project and PLL in hospital.
Sub-goals:
- Investigate how healthcare personnel work to obtain and share information about patients' medication lists
- Investigate time spent on medication reconciliation (at patients hospital admittance)
- Map the degree of discrepancies in the patient's medication list upon admission/discharge from hospital
- Investigate healthcare personnel's interaction between the various parts of the nursing and care service; including GPs - home care-nursing homes, pharmacists and hospitals (as well as other relevant actors)
- Map what inhibits and promotes healthcare personnel's use of PLL and KJ
- Gain knowledge about patients' experiences and benefits of access to their own health information, information, interaction with healthcare personnel and own medication management
Method
The study(s) is divided into 3 sub-studies: before, during and after implementation of PLL.
Each sub-study has a cross-sectional design where we investigate health personnel (doctors, nurses and pharmacists) from nursing homes, home care and hospitals as well as patients', experiences before, during and after the introduction of PLL and KJ.
In order to gain an in-depth and broad understanding of the research questions in the study, both qualitative and quantitative methods are used.