Promoting medication safety with a unit-based safe medication management and use protocol - contents and development

Abstract

Abstract Background Deficiencies in medication safety have been identified as a central challenge to patient safety. In Finland, all health and social care units must establish a unit-based safe medication management and use (MMU) protocol to manage their medication safety risks. This study aimed to investigate the development practices and contents of unit-based safe MMU protocols as a measure for promoting medication safety. Methods The study was conducted as a cross-sectional online survey of Finnish registered nurses and pharmacists working in health and social care units. Frequencies and percentages described the data. Sum variables were formed to describe the comprehensiveness of the contents in the unit-based safe MMU protocols at the respondents’ units. Statistical differences in responses were assessed by t-test, Mann-Whitney-U test, and Kruskal-Wallis H-test. Results A total of 905 professionals responded to the survey (nurses 90.2%, pharmacists 9.8%). A unit-based MMU protocol existed in most respondents’ units (91.5%). In only 11.6% of the units, the protocol was developed as a multi-professional effort, more commonly in healthcare than social care units. On average, respondents rated the content of their MMU protocols as comprehensive, with no significant differences between work environments. The most weakly described areas were medication safety management (mean 3.09, SD 0.95), medication reconciliation and ensuring patient involvement in their medication care (mean 3.13, SD 0.81), and managing risks in the MMU process (mean 3.30, SD 0.68). Conclusions Unit-based safe MMU protocols are key tools in describing the MMU process and other practices related to medication safety in the Finnish health and social care service system. However, the multi-professional development of protocols should increase, especially in social care units, and promote the involvement of doctors and pharmacists in the process. Preventive, systems-based medication safety risk management needs to be strengthened in the protocols and the competencies of healthcare professionals in the present area.