JMIR Publications

ABSTRACT

Background:

Medication safety is increasingly of scope to face the challenge of patient safety in growing ageing populations. Developing positive patient safety cultures is acknowledged a primary goal to improve patient safety, but evidence on interventions to do so is inconclusive. Nursing home residents are often cognitively and physically impaired, therefore highly reluctant on frontline health care providers. Thus, interventions to improve medication safety of nursing home residents through patient safety culture among providers are needed. Using co-creative partnerships integrating knowledge of residents- and their relatives and ensuring managerial support could be beneficial.

Objective:

The primary aim of the SAME study is to improve medication safety for elderly nursing home residents through developing an intervention based on experiential knowledge of patient safety culture in co-creative partnerships integrating knowledge of residents- and their relatives and ensuring managerial support.

Methods:

The fully integrated mixed method study will be conducted using an integrated knowledge translational approach (IKT). Patient safety culture within nursing homes will firstly be explored through qualitative focus groups (Stage 1) including nursing home residents, their relatives and frontline health care providers. This will inform the development of an intervention in a multidisciplinary panel (Stage 2) including co-creators representing the medication management process across the health care system. Evaluation of the intervention will be done in a randomised controlled trial (RCT) set at nursing homes (Stage 3). The primary outcome will be changes in mean scale score of an adapted version of the Danish “Safety Attitudes Questionnaire” (SAQ-DK) for use in nursing homes. Patient safety related outcomes will be collected through Danish health registers to assess safety-issues and effect, including medication, contacts to health care, diagnoses, and mortality. Finally, a mixed methods analysis on patient safety culture in nursing homes will be done (stage 4), integrating qualitative data (Stage 1) and quantitative data (Stage 3) to comprehensively understand patient safety culture as a key to medication safety.

Results:

The SAME study is ongoing. Idea-and experience-groups (Stage 1) were carried out from April to September 2021 and the workshop in September 2021. Baseline SAQ-DK-data was collected in January 2022 with expected follow-up in January 2023. We expect to finalize data-analysis in spring 2024.

Conclusions:

The SAME study will help generate evidence not only on interventions to improve medication safety of nursing home residents through patient safety culture but also give insight into possible impacts of using co-creativity to guide the development. Thus, findings will address multiple gaps in evidence, including on medication safety and patient safety culture in nursing homes. This could help to inform- and guide future improvement-efforts within primary care settings, within political- and scientifical scope. Clinical Trial: This study is registered at The North Denmark Region (2021-015), at Aalborg University (2021-068-01412) and in ClinicalTrials.gov (Identifier: NCT04990986).