The population of Taiwan is aging, and the proportion of patients with chronic diseases is increasing annually. To reduce wastage of medical insurance drug resources and avoid repeated drug administration, patients usually self-prepare drugs and bring them to the hospital. The aim of our cross-sectional quantitative study was to investigate the factors that affect the accurate management of self-prepared drugs by inpatients. We also aimed to provide a basis for improving intervention strategies to achieve safe drug administration in inpatients.
Methods:
Purposive sampling was performed in August 2016. The enrolled subjects were from 9 emergency wards. Eight nurses who took care of patients with self-prepared medications were randomly selected from each ward (total=72 nurses). A self-prepared structured questionnaire “Management of self-prepared drugs by inpatients” was used for the investigation.
Results:
The accuracy rate for management of self-prepared medications by inpatients was only 44% (4/9×100%). This may be due to the following reasons: 1) Lack of specifications for external packaging labels on self-prepared medications (93.1%); 2) Lack of specifications for nurses to place self-prepared medications on the work trolley (88.9%); 3) Forgetting to return self-prepared medications (86.1%); 4) Lack of awareness of procedure manuals for management of self-prepared medications (84.7%); 5) Lack of reminder mechanisms for self-prepared medications (83.3%); and 6) Cabinet for self-prepared medications being too small (80.6%).
Conclusion:
In this study, we identified factors that affect correct management of self-prepared drugs, through questionnaires. These factors were human- and system-related. In addition, the existing equipment is insufficient to manage the types and quantity of self-prepared drugs by inpatients. Given that some hospitals in Taiwan have a system in which the pharmacy will collect, assess, and manage self-prepared drugs from inpatients, and the UD system will dispense drugs daily, we hope that the pharmacy in this study can jointly serve as a gatekeeper for safe drug administration for inpatients and include self-prepared drugs by patients into pharmacy management as soon as possible.