Subject(s)
Caregivers/education , Health Education , Patient Safety , Workflow , Education, Medical, Graduate , Female , HumansABSTRACT
AIM: To compare medication adherence and readmissions in patients who received usual care vs. patient-centred interventions. BACKGROUND: Medication adherence is a complex behaviour that may be improved with patient-centred strategies. METHOD: A non-concurrent convenience sample of 303 hospitalised patients received either usual care (n = 98) or patient-centred interventions (n = 205). Intervention patients received teach-back and medication tools (n = 137) or motivational interviewing (n = 68). Data were collected at discharge (T1), at 48-72 hours (T2) and 30 days after discharge (T3). RESULTS: No significant differences were found in medication adherence, therapeutic alliance, patients' experience and readmissions between groups. Patients in the motivational interview group reported lower confidence with medication adherence at T1 (P = 0.01) and T2 (P = 0.00) than the patient-centred intervention group. Motivational interviewing was a significant predictor (ß = -1.55, P = 0.01, OR 0.21, 95% CI 0.06, 0.72) of fewer readmissions. CONCLUSION: Overall, patients reported very low levels of non-adherence and very high levels of confidence and importance of medication adherence. IMPLICATIONS FOR NURSING MANAGEMENT: Medication adherence continues to be an important area for clinical inquiry. For those patients who lack confidence for medication adherence, comprehensive patient-centred strategies such as motivational interviewing may improve treatment outcomes.
Subject(s)
Medication Adherence/psychology , Motivational Interviewing/methods , Patient Education as Topic/methods , Patient Readmission , Primary Health Care , Self Medication/standards , Treatment Outcome , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle AgedSubject(s)
Leadership , Nurse Administrators/organization & administration , Nurse's Role , Nursing Services/organization & administration , Professional Competence , Evidence-Based Practice , Health Facility Environment/organization & administration , Humans , Interprofessional Relations , Nurse Administrators/psychology , Nurse's Role/psychology , Nursing, Supervisory/organization & administration , Outcome and Process Assessment, Health Care , Social SupportABSTRACT
AIM: This article describes the foundation of an emerging care delivery model based on partnership. It also reflects on and synthesizes the findings of earlier concept analyses of its core concept. BACKGROUND: Changes in the delivery of health care services in the United States have been driven significantly by cost containment over the last 20 years. This has resulted in an unprecedented pace of work, fragmentation of care, and medical errors. Fundamental changes are needed to meet the needs of today's health care environment. METHODS: A literature search was done in electronic data bases. Concept analysis papers were reviewed and synthesized. Results The antecedents, attributes and consequences of partnership are described and linked to the supporting literature and theoretical models. CONCLUSIONS: Engaging and empowering the patient through partnership seem to be crucial to developing a cohesive and effective model of care delivery. Partnerships among patients, their families, physicians, nurses and other clinicians positively impact on safety, quality of care, satisfaction, outcomes and job fulfillment. IMPLICATIONS FOR NURSING MANAGEMENT: Managers need to foster an environment that allows for stronger reciprocal relationships. They need to facilitate changes in practice that support the development of partnerships among patients, their families and all care providers.
