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Denys Tsz-Wai Lau, PhD, Buehler Center on Aging, Northwestern University, 750 North Lake Shore Drive, Suite 601, Chicago, IL 60611, 312-503-1231, D-Lau@northwestern.edu and Jane Banaszak-Holl, PhD, School of Public Health, University of Michigan, 109 S. Observatory, SP-II, Ann Arbor, MI 48109.
Quality of medication use is a recognized concern for elderly nursing home residents. This study uses a qualitative approach to explore factors that may influence medication delivery in nursing homes and understand how quality of medication use can be improved. Eighteen semi-structured, open-ended interviews were conducted with experienced staff members (medical directors, attending physicians, supervisory nurses, nurse assistants, and consultant pharmacists) from four nursing homes in Michigan that were purposefully selected based on ownership type and size. Factors identified to influence medication delivery were related to (1) clinical staff members, (2) residents and family members, (3) nursing facility, and (4) external factors. Factors associated with clinical staff members included knowledge and perception of guidelines, clinical experience, attitude toward changing drug regimens, perceptions of risk-benefit in treatment options for the elderly, practice groups among physicians and consultant pharmacists, and accountability for citations. Factors related to residents and family members included current health condition, demand for medications, prescriptions from community providers, and reaction to previous other medications. Nursing facility factors included working culture, nursing staff patterns regarding pooled nurses and turnover rate, care planning process for residents, time devoted to patient care and administrative duties, and in-service training availability. External factors included restrictive formularies, types of health insurance, and acceptability of guidelines on medication use for the elderly. Findings of this study will generate a better understanding of what influence medication delivery, and inform the formulation of future research and policy initiatives to improve the quality of pharmaceutical services in nursing homes.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to
Keywords: Nursing Homes, Quality of Care
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.