Clinician attitude towards safety in medication management: a participatory action research study in an emergency department

• Published in: BMJ open Vol. 11; no. 9; p. e047089
• Main Authors: Bakhshi, Fatemeh, Mitchell, Rebecca, Nikbakht Nasrabadi, Alireza, Javadi, Mostafa, Varaei, Shokoh
• Format: Journal Article
• Language: English
• Published: London British Medical Journal Publishing Group 21.09.2021; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Original research
• Subjects: accident & emergency medicine; Action research; Attitudes; Emergency medical care; health services administration & management; Medical errors; Patient safety; Qualitative Research
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2020-047089

ObjectivesEdication management is a process in which medications are selected, procured, delivered, prescribed, reviewed, administered and monitored to assure high-quality patient care and safety. This paper explores clinicians’ attitudes towards medication management which is both open to influence and strongly linked to successful changes in mediation behaviour. We aimed to investigate effects of engaging in participatory action research to improve emergency medicine clinicians’ attitudes to safety in medication management.SettingEmergency department of one university affiliated hospital.ParticipantsA total of 85 clinicians including nurses and physicians partook as participants. Eight managers and clinicians participated as representatives.DesignData are drawn from two-cycle participatory action research. Initially, a situation analysis on the current medication management and clinician views regarding medication management was conducted using three focus groups. Evaluation and reflection data were obtained through qualitative interviews. All qualitative data were analysed using content analysis.ResultsClinicians initially expressed negative attitudes towards existing and new plans for medication management, in that they were critical of current medication-related policy and procedures, as well as wary of the potential relevance and utility of potential changes to medication management. Through the action research, improvement actions were implemented including interprofessional courses, pharmacist-led interventions and the development of new guidelines regarding medication management. Participants and their representatives were engaged in all participatory action research stages with different levels of involvement. Extracted results from evaluation and reflection stages revealed that by engaging in the action research and practice new interventions, clinicians’ attitude towards medication management was improved.ConclusionsThe results support the impact of participatory action research on enhancing clinicians’ positive attitudes through their involvement in planning and implementing safety enhancing aspects of medication management.