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District nurses’ experiences of using a clinical decision support system and an assessment tool at elderly care units in primary health care: a qualitative study
Ersta Sköndal Bräcke University College, Department of Health Care Sciences.ORCID iD: 0000-0002-5784-1092
Karolinska institutet; Akademiskt primärvårdscentrum (APC), Region Stockholm.
Karolinska institutet.
Karolinska institutet; Akademiskt primärvårdscentrum (APC), Region Stockholm.ORCID iD: 0000-0003-2605-8131
2021 (English)In: Primary Health Care Research and Development, ISSN 1463-4236, E-ISSN 1477-1128, Vol. 22, article id e45Article in journal (Refereed) Published
Abstract [en]

Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres.

Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults' medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults' ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients' medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions.

Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts.

Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults' medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.

Place, publisher, year, edition, pages
2021. Vol. 22, article id e45
Keywords [en]
Clinical decision support system, District nurse, Medication, Older adult, Primary health care, Tool
National Category
Nursing
Identifiers
URN: urn:nbn:se:esh:diva-9120DOI: 10.1017/S1463423621000530ISI: 000695713600001PubMedID: 34521503OAI: oai:DiVA.org:esh-9120DiVA, id: diva2:1594344
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-04990Available from: 2021-09-15 Created: 2021-09-15 Last updated: 2023-11-22Bibliographically approved

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Lagerin, Annica

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