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Development and clinical gains of nurse‐led medication monitoring profiles
Author(s) -
Gabe Marie E.,
Jordan Sue E.
Publication year - 2014
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1111/jonm.12067
Subject(s) - medicine , adverse effect , adverse drug reaction , reliability (semiconductor) , content validity , nursing management , drug , harm , intensive care medicine , nursing , cognition , validity , emergency medicine , psychiatry , psychology , clinical psychology , psychometrics , pharmacology , social psychology , power (physics) , physics , quantum mechanics
Aim This paper reports on the development of an instrument for nurse‐led medication monitoring, the W est W ales A dverse D rug R eaction profile for respiratory medicines, as part of a strategy to reduce avoidable adverse drug reactions. Background Preventable adverse drug reactions account for 3.7% hospital admissions. Nurse‐led medication monitoring may reduce drug‐related harm. However, development of medication monitoring strategies is not reported elsewhere. Methods The profile was developed by: (1) cognitive interviews ( n = 4), (2) the content validity index ( n = 10) involving academics, clinicians and service users prescribed respiratory medicines, (3) inter‐rater reliability ( n = 48) and clinical gains in a nurse‐led outpatient clinic. Results Cognitive interviews prompted more profile changes than either the content validity index or inter‐rater reliability testing. C ohen's κ for inter‐rater reliability for each item ranged from 0.73–1.00 (good to complete agreement). The profile identified previously unsuspected problems in all participants, including muscular weakness, skin and mouth problems. Conclusions The W est W ales A dverse D rug R eaction profile was valid and reliable, and helped to detect and ameliorate drug‐related harm. Implications for nursing management The W est W ales A dverse D rug R eaction profile offers opportunities to improve care. Medication monitoring provides the structure to concurrently monitor known adverse drug reactions. Practice‐based adverse drug reaction profiles benefit from cognitive, content validity and inter‐rater reliability testing.