Attitudes of clinicians to safety in medication management: a participatory action research study in an emergency department


This article was originally published here

BMJ Open. September 21, 2021; 11 (9): e047089. doi: 10.1136 / bmjopen-2020-047089.


OBJECTIVES: Medication management is a process in which medications are selected, purchased, delivered, prescribed, reviewed, administered and monitored to ensure high quality patient care and safety. This article explores the attitudes of clinicians toward medication management that is both open to influence and strongly linked to successful changes in mediating behavior. Our objective was to study the effects of engaging in participatory action research to improve the attitudes of emergency medicine clinicians towards safety in medication management.

SETTING: Emergency department of an affiliated teaching hospital.

PARTICIPANTS: A total of 85 clinicians, including nurses and physicians, participated as participants. Eight managers and clinicians participated as representatives.

DESIGN: Data are drawn from the two-round participatory action research. Initially, a situational analysis of current medication management and clinicians’ views on medication management was conducted using three focus groups. The evaluation and reflection data were obtained through qualitative interviews. All qualitative data was analyzed using content analysis.

RESULTS: Clinicians initially expressed negative attitudes towards existing and new medication management plans, in that they were critical of current medication policies and procedures, and were wary of the relevance and appropriateness of the medication. the potential usefulness of potential changes in medication management. Through action research, improvement actions were implemented, including inter-professional courses, interventions led by pharmacists and the development of new guidelines for medication management. The participants and their representatives were involved in all stages of the participatory action research with different levels of involvement. The results extracted from the assessment and reflection stages revealed that by engaging in action research and practicing new interventions, the attitude of clinicians towards medication management has been improved.

CONCLUSIONS: The results confirm the impact of participatory action research on improving the positive attitudes of clinicians through their involvement in the planning and implementation of the safety improvement aspects of medication management.

PMID: 34548346 | DOI: 10.1136 / bmjopen-2020-047089


Paul N. Strickland

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