Understanding the implementation of a multidisciplinary intervention using a suite of prescribing safety indicators to improve medication safety in prison healthcare settings: a qualitative study

被引：0

作者：

Jeffries, Mark ^{[1
,2
,3
]}

Abuzour, Aseel S. M. ^{[4
]}

Ashcroft, Darren ^{[1
,3
]}

Avery, Tony ^{[3
,5
]}

Langridge, Mark ^{[6
]}

Francis, Gayle ^{[6
]}

O'Brien, Amber ^{[7
]}

Millington, Tracy ^{[8
]}

Keers, Richard Neil ^{[3
,9
,10
]}

机构：

[1] Univ Manchester, Fac Biol Med & Hlth, Sch Hlth Sci, Fac Biol Med & Hlth, Manchester, England

[2] Univ Manchester, Fac Biol Med & Hlth, Sch Hlth Sci, Div Populat Hlth,Fac Biol Med & Hlth, Manchester, England

[3] Univ Manchester, Natl Inst Hlth & Care Res NIHR, Greater Manchester Patient Safety Res Collaborat G, Manchester, England

[4] Univ Leeds, Acad Unit Ageing & Stroke Res, Leeds, England

[5] Univ Nottingham, Div Primary Care, Nottingham, England

[6] Practice Plus Grp, Reading, England

[7] Steve Cannon Geosci Ltd, 63 Box Lane, Wrexham LL12 8BY, Wales

[8] Univ Manchester, Ctr Womens Mental Hlth, Manchester, England

[9] Univ Manchester, Ctr Pharmacoepidemiol & Drug Safety, Manchester, England

[10] Greater Manchester Mental Hlth NHS Fdn Trust, Suicide Risk & Safety Res Unit, Manchester, England

来源：

BMJ OPEN | 2025年 / 15卷 / 03期

关键词：

Safety; Quality in health care; Prisons; QUALITATIVE RESEARCH; TECHNOLOGY; ENGLAND;

D O I：

10.1136/bmjopen-2024-086309

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives Patients residing in prisons are a vulnerable group with more complex health needs and higher prevalence of inappropriate prescribing than the general population. Overcrowding in prisons, inadequate staffing levels, diversion of medication and substance misuse present challenges to prison healthcare. Interventions that use prescribing safety indicators are one way of helping to reduce the risk of harm by identifying patients at risk of potentially hazardous prescribing. This qualitative study aimed to understand the implementation and impact of a suite of seven prescribing safety indicators, specifically developed for use in prison settings, as part of a multi-disciplinary intervention.Design and setting Semistructured interviews were conducted with a range of prison healthcare staff across 30 different prison sites in England. In addition, an online survey was made available to all healthcare staff in participating prisons. Data analysis of interview transcripts and free-text survey responses was conducted following a thematic approach and informed by normalisation process theory.Participants Interviews were conducted with 9 prison healthcare staff and 40 completed the survey, with 18 staff providing free-text responses.Results Three themes were interpreted from the data: bringing people together and establishing individual and collective roles that facilitated implementation of the intervention; developing new tasks, work processes and practices to make the intervention work in everyday practice; and seeing the benefits and value of the intervention and new work processes within the context of prison healthcare provision.Conclusions New work processes and practices were instigated in order to implement the intervention, often fitting into existing medication safety practices, building on other prescribing work and creating learning across the team. While we found that prison staff reported challenges to implementation, similar interventions may be used for prescribing safety in prison settings.

引用

页数：11

共 43 条

[1] Prisons and health, (2014)
[2] Harris F., Hek G., Condon L., Health needs of prisoners in England and Wales: the implications for prison healthcare of gender, age and ethnicity, Health Soc Care Community, 15, pp. 56-66, (2007)
[3] Sturge G., UK prison population statistics, (2020)
[4] Watson R., Stimpson A., Hostick T., Prison health care: a review of the literature, Int J Nurs Stud, 41, pp. 119-128, (2004)
[5] League T.H., Breaking point: understaffing and overcrowding in prisons - Research briefing, (2014)
[6] Magola-Makina E., Abuzour A.S., Ashcroft D.M., Et al., Exploring the challenges to safer prescribing and medication monitoring in prisons: A qualitative study with health care staff, PLoS One, 17, (2022)
[7] Safer prescribing in prisons – guidance for clinicians, (2019)
[8] Hassan L., Senior J., Webb R.T., Et al., Prevalence and appropriateness of psychotropic medication prescribing in a nationally representative cross-sectional survey of male and female prisoners in England, BMC Psychiatry, 16, (2016)
[9] Hassan L., Senior J., Frisher M., Et al., A comparison of psychotropic medication prescribing patterns in East of England prisons and the general population, J Psychopharmacol, 28, pp. 357-362, (2014)
[10] Abuzour A.S., Magola-Makina E., Dunlop J., Et al., Implementing prescribing safety indicators in prisons: A mixed methods study, Br J Clin Pharmacol, 88, pp. 1866-1884, (2022)

← 1 2 3 4 5 →