Medicines in Australian nursing homes: A cross-sectional observational study of the accuracy and suitability of re-packing medicines into pharmacy-supplied dose administration aids

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Abstract

Background: Though staff at Australian nursing homes (NHs) commonly administer medicines that have been re-packed into dose administration aids (DAAs) that organize medicines according to dose schedule, these pharmacy-supplied devices have not been extensively evaluated in the Australian setting. Objective: To audit the accuracy and suitability of re-packing medicines into DAAs (blister packs or sachets) for NHs and identify the proportion of DAAs with inaccurate or unsuitable medicine re-packing. Methods: Between January and June 2011, pharmacist researchers visited 49 randomly and purposively selected NHs from rural, regional, and metropolitan Victoria (Australia) to audit a sample of residents newly prepared DAAs that contained all of their regularly re-packed medicines for 1 week. Over 1 or 2 days, the pharmacy-supplied DAAs were compared with the current prescriber-prepared NH medicine chart. Any occurrences of inaccurately re-packed medicines (discrepancies, with verification as necessary) or unsuitable medicine re-packing were recorded as DAA incidents and descriptive statistics was used to analyze the data. Results: Six hundred and eighty-four incidents occurring in 457 DAAs were detected from a total of 3959 DAAs audited for 1757 residents (incident rate of 11.5 of DAAs) from 49 participating NHs. Incidents were detected in 10.5 of blister packs and 14.5 of sachets. The top five incidents were unsuitable re-packing according to pharmaceutical guidelines (50.1 ); added medicine (9.8 ); incorrect quantity re-packed (5.4 ); omitted medicine (5.3 ); and damaged medicine (5.1 ). Conclusions: The incident rate of inaccurate or unsuitable medicine re-packing within DAAs supplied to NHs for use in medicine administration was higher than in previous research. Recommendations include using current findings in conjunction with further research to develop a quality improvement initiative to reduce DAA incident rates and improve NH standard of care.
Original languageEnglish
Pages (from-to)876 - 883
Number of pages8
JournalResearch in Social and Administrative Pharmacy
Volume9
Issue number6
DOIs
Publication statusPublished - 2013

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