[Implementation of a new prescription system. A qualitative survey of organizational barriers].
BACKGROUND
The aim of this study was to identify organisational difficulties faced by physicians and nurses when using drug prescribing sheets for the recording of both drug prescriptions and drug administration.


METHODS
Qualitative interviews with seven physicians and eight nurses from two general internal medicine wards. Main outcome measures were the difficulties explicitly identified during the interviews.


RESULTS
The implementation of procedures conflicted with existing structure, culture, and routines. Insufficient competence within the system to use the drug prescribing sheets created resistance and made people create their own solutions to the problems they faced. A total of nine difficulties were identified: 1) insufficient knowledge and uncertainty about procedures, 2) ignorance of sources of error, 3) unclear responsibilities, 4) low community spirit, 5) insufficient communication, 6) clinician autonomy and low acceptance of change, 7) strong professional identity, 8) low priority task, and 9) logistic problems.


CONCLUSIONS
Unawareness of procedures, insufficient dissemination of knowledge, and insufficient cooperation and skepticism among those who put drug handling into practice is likely to have an impact on the quality of health care. The identification of these obstacles may help managers to improve the quality of the drug handling process and make it possible to select a framework for changing the clinical behavior of doctors and nurses.
D003144:Communication Barriers; D003718:Denmark; D011307:Drug Prescriptions / Q000592:standards*; D017723:Drug Utilization Review; D005568:Forms and Records Control; D006748:Hospital Departments / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D007388:Internal Medicine / Q000458:organization & administration* / Q000592:standards; D007398:Interpersonal Relations; D008505:Medical Staff, Hospital / Q000523:psychology; D008510:Medication Systems, Hospital / Q000458:organization & administration* / Q000592:standards; D009741:Nursing Staff, Hospital / Q000523:psychology; D015279:Organizational Culture; D009936:Organizational Innovation; D019555:Physician-Nurse Relations; D011795:Surveys and Questionnaires; D000078329:Workforce
Implementering af et nyt ordinationssystem. En kvalitativ undersøgelse af organisatoriske barrierer.