gms | German Medical Science

Background: The introduction of a daily unit dose dispensing system (UDDS) in hospital wards marks a significant turning point in healthcare. This change is accompanied by far-reaching changes in everyday ward life and raises numerous questions regarding its acceptance and feasibility. It has been shown that the introduction of computerized systems specifically the switch from a ward stock system (WSS) to UDDS help to reduce medication-related problems and improve the safety and efficiency of medication administration in healthcare facilities [1]. This is especially important in elderly patients who are at higher risk for developing drug-related problems due to polymedication and inadequate prescribed medications. However, a successful implementation of a daily UDDS is often facing the challenge of addressing the acceptance and attitudes of ward staff. The willingness of staff to embrace new ways of working can have a critical impact on the success of this amendment. Therefore, it is critical to understand the reasons for acceptance or rejection and to develop appropriate measures to support employees.

In this investigation, we introduce a questionnaire, which for the first time, enables to examine the changes in medication management on wards and to determine attitudes and opinions of medical staff regarding the switch from WSS to UDDS.

Materials and methods: Since there is no comparable survey on this topic so far, we conducted exploratory interviews with nursing staff and physicians at the Clinic for Geriatrics at Jena University Hospital before developing the questionnaire to prioritize the relevant topics for the survey. For the creation of the questionnaire, we mainly used questions with a 4-point or 5-point likert scale. To ensure the reliability and validity of the questionnaire, a pre-test is conducted. Among other things, we will make use of the “think-aloud method”. The pre-test aims to identify problems regarding comprehension, consistence and motivation when answering the questionnaire. In this investigation we will survey all professions working in the ward, physicians, nursing staff and administrative staff. In addition to age and gender, professional degree, position in the ward, work experience, and knowledge of the care principle of the UDDS will also be considered in the evaluation.

Results: As a result of these interviews, we have determined that the introduction of a unit dose dispensing system will have a major impact on the day-to-day work of both nurses and physicians. Therefore, we developed a questionnaire that maps the specific occupational challenges to the change from WSS to UDSS. We created a questionnaire with 8 major topic areas about 60 questions. The questions are distributed among the following topic blocks: Ward stock (addressing the issue of sufficient availability of drugs), prescription timing and delivery times, drug therapy safety, handling unit dose on wards (highlighting changes in the setting process and application to patient), information on the introduction of unit dose supply, communication and accessibility of the pharmacy, discharge management, packaging/waste (addresses the issue of sustainability). The information from the interviews conducted in advance with the ward staff was used to create a comprehensive questionnaire. This questionnaire covers all relevant aspects of the changes in everyday ward life associated with the switch from conventional drug logistics to unit-dose supply.

Conclusion: The results of the investigation will help to deepen the understanding of the acceptance of change in healthcare and will offer concrete recommendations for the successful implementation of a UDSS. Thus, this investigation leads to further optimize the implementation of a UDDS and thereby minimize drug-related problems in health care facilities. In addition, the findings of this investigation contribute to further improving patient safety and increasing efficiency in the hospital system.