MOPPEt
Research type
Research Study
Full title
Medicines Optimisation in Paediatric In-patients - a qualitative multi-centre human factors study.
IRAS ID
266243
Contact name
Adam Sutherland
Contact email
Sponsor organisation
University of Manchester
Duration of Study in the UK
2 years, 0 months, 1 days
Research summary
Hospitals are busy places, and under pressure. We have rules, policies and procedures in place to ensure that medicines are used safely. However, these don’t work very well because they may not reflect how people work. Children and young people are three times more likely to experience harm from medication. These harms can be side-effects from medicines, but also errors. It is important to understand how the way we work may contribute to these harms, so that we can make our processes and systems safer.\n\nTo help us understand this, I will observe how healthcare professionals work in six hospital children’s wards over two years. I will accompany them on their ward rounds and their medication rounds, documenting what I see and hear, and asking questions about why things are done the way they are. I will also talk to healthcare professionals, patients and their parents using group discussions (“focus groups“) or one-to-one interviews about their experiences and perceptions.\n\nAll this information will be brought together in two workshops in winter 2022 where families, healthcare professionals and researchers will work together to develop some new ways that medication safety in hospitals can be improved. These observations and conversations will help researchers, healthcare professionals and the public understand where we can improve services, and support healthcare professionals to improve medication safety in the future.
Lay summary of study results: My research has identified that the way medicines safety work is done in acute children's wards is social and intuitive. Guidelines and policies (the work as imagined) forms useful guidance but otherwise, most medicines safety work is co-created between professionals and families. Parents undertake a lot of safety work for their children which isn't acknowledged by organisations, but is essential in order for healthcare professionals to get the job done. That being said, parents have demonstrated that the way the NHS is broken up means that they have to tell their stories repeatedly to people who often don't believe them. They are judged against rules and preferences that aren't appropriate when they're at home. However, when it comes time for them to leave hospital they are provided with inadequate information or support about their medicines and they have to cope for themselves. This is because NHS priorities (beds and discharges) are probably more important at a systems level than checking parents are okay.
This study is the first generalisable large scale ethnographic study of medicines safety for children, and has shone light on how and why our safety rules may not necessarily work. It has also demonstrated the extent of parental involvement in care. The study has proposed four potential interventions to improve medicines safety, three of which place the family at the centre of medicines related care, from medication lists that follow the patient, to parent involvement in administration of medicines. It also advocates for better skillmix like ensuring that pharmacists are on the ward all the time and not just on a sessional basis because their expertise is needed at all times.REC name
Yorkshire & The Humber - Leeds West Research Ethics Committee
REC reference
19/YH/0430
Date of REC Opinion
2 Jan 2020
REC opinion
Favourable Opinion