Exploring barriers to the sustainability of an electronic administration system in long-term care facilities: A case study approach

Karsan, Yasmin; Anderson, Claire; Boyd, Matthew J.; Thornley, Tracey

Abstract

Background
The safe provision of medicines administration is a fundamental challenge faced in long-term care facilities (LTCFs). Many residents of LTCFs are frail older persons with multiple morbidities, and in addition to polypharmacy, are particularly at risk of harm due to concomitant disease and disability. One potential method to optimise medication safety and facilitate medicines administration within LTCFs is the introduction of technology.

Objective
This paper explores the barriers to long-term sustainability concerning the use of an electronic administration system (eMAR) in LTCFs.

Methods
Fifteen in depth, semi-structured interviews were conducted with LTCF staff (9), eMAR service commissioners (2), members of the implementation team (2) and care home strategy managers (2) across three LTCF sites. The study participants were purposefully sampled and each interview audio-recorded, transcribed verbatim and analysed using Nvivo 11. In addition to interviews, observational notes were taken by the lead researcher from visits to the LCTFs as a form of data collection. The analysis process consisted of a two-stage process of thematic analysis then theoretical mapping.

Results
Barriers identified were split into four main overarching areas: structural, implementation team, system user and operational barriers. The adoption of eMAR within this setting was welcomed by top-level stakeholders, however, LTCF staff displayed concerns over its usability. The lack of co-development and on-going training need highlighted barriers to its sustainability, in addition to risks associated with current legislation. The themes identified throughout the framework highlight challenges faced when exploring the sustainability of eMAR in LTCF.

Conclusions
The use of technology in health care is evolving. Awareness of actors relating to its introduction can have significant impact on success and service sustainability.

Citation

Karsan, Y., Anderson, C., Boyd, M. J., & Thornley, T. (2020). Exploring barriers to the sustainability of an electronic administration system in long-term care facilities: A case study approach. Research in Social and Administrative Pharmacy, https://doi.org/10.1016/j.sapharm.2020.08.003

• Journal Article Type: Article
• Acceptance Date: Aug 4, 2020
• Online Publication Date: Aug 30, 2020
• Publication Date: 2020-08
• Deposit Date: Sep 4, 2020
• Publicly Available Date: Aug 31, 2021
• Journal: Research in Social and Administrative Pharmacy
• Print ISSN: 1551-7411
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1016/j.sapharm.2020.08.003
• Keywords: Pharmaceutical Science; Pharmacy
• Public URL: https://nottingham-repository.worktribe.com/output/4881793
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S1551741120301807