title: Patient participation in medication safety during an acute care admission.
abstract: BACKGROUND
  Patient participation in medication management during hospitalization is thought to reduce medication errors and, following discharge, improve adherence and therapeutic use of medications. There is, however, limited understanding of how patients participate in their medication management while hospitalized.
  
  
  OBJECTIVE
  To explore patient participation in the context of medication management during a hospital admission for a cardiac surgical intervention of patients with cardiovascular disease.
  
  
  METHODS
  Single institution, case study design. The unit of analysis was a cardiothoracic ward of a major metropolitan, tertiary referral hospital in Melbourne, Australia. Multiple methods of data collection were used including pre-admission and pre-discharge patient interviews (n = 98), naturalistic observations (n = 48) and focus group interviews (n = 2).
  
  
  RESULTS
  All patients had changes made to their pre-operative cardiovascular medications as a consequence of surgery. More patients were able to list and state the purpose and side-effects of their cardiovascular medications at pre-admission than prior to discharge from hospital. There was very little evidence that nurses used opportunities such as medication administration times to engage patients in medication management during hospital admission.
  
  
  CONCLUSIONS
  Failure to engage patients in medication management and provide opportunities for patients to learn about changes to their medications has implications for the quality and safety of care patients receive in hospital and when managing their medications once discharged. To increase the opportunity for patients to participate in medication management, a fundamental shift in the way nurses currently provide care is required.
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: McTier
authors.affiliation: Epworth/Deakin Centre for Nursing Research, Epworth HealthCare and School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Mari
authors.initials: M
authors.lastname: Botti
authors.affiliation: School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Maxine
authors.initials: M
authors.lastname: Duke
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D006348:Cardiac Surgical Procedures; D005260:Female; D017144:Focus Groups; D006761:Hospitals; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010351:Patient Discharge; D010358:Patient Participation; D061214:Patient Safety
keywords: acute care; medication safety; patient participation