What are Medication Reviews?
Medication reviews involve a critical evaluation of a patient’s medications with the aim of optimising the impact of the medication regimen, minimising the number of medication-related problems, and reducing risk. The process necessitates a thorough understanding of pharmacology, clinical judgement, and a collaborative approach involving various healthcare professionals.
Why are Medication Reviews Important?
In Australia, there are over 185,000 people aged 65+ that are in residential aged care facilities (AIHW, 2023). It is estimated that each patient experiences 2.7-3.9 medication related problems (Chen, et al, 2019) which equates to approximately 500,000-720,000 medication related problems in residential aged care alone.
Medication reviews play a critical role in ensuring patient safety and optimising medication management practices. By thoroughly evaluating a patient’s medication regimen, healthcare professionals can identify and address potential medication-related problems, reducing the risk of adverse drug reactions and improving patient outcomes.
What is the "Medication Review" Training Requirement?
Ensuring the competency of healthcare professionals in medication management is a critical responsibility of healthcare organisations. Under the NSQHS standards and Aged Care Quality Standards, organisations are mandated to provide comprehensive training in medication management, ensuring that staff members are not just familiar with, but excel in various facets of medication administration, adverse reaction monitoring, and medication reviews. These training programs should be regularly updated to reflect the latest in pharmaceutical research and best practices in patient care, ensuring that all staff members are equipped with the knowledge and skills necessary to provide the highest standard of care.
Relevant Standards
Action 4.10: Medication review:
The healthcare organisation has processes to:
- Apply evidence-based and best-practice principles when performing patient medication reviews
- Consider the clinical needs and minimise risk of medication-related problems when prioritising medication reviews
- Document and specify requirements (including actions taken as a result) of medication reviews
National Safety and Quality Health Service (NSQHS) Standards
Requirement 3.3 (b): High-impact or high-prevalence risks:
Effective management of high-impact or high-prevalence risks associated with the care of each consumer
Action 5.3.2: Medication review:
Health professionals must review, plan, and make changes to medicines when they are acutely unwell
Action 5.3.3: Medication review processes:
The providers has medication review processes to ensure reviews occur:
- a) at the commencement and transition of care, and annually (when the care is ongoing)
- b) when a change in diagnosis, deterioration in behaviour, cognition, mental, or physical conditions are presented
- c) when there are multiple medications prescribed (polypharmacy), and the potential to deprescribe
- d) when new medication commences, when an existing medication is changed, or when a change occurs to the medication management plan
- e) when an adverse event arises related to medicines
Action 5.3.7: Medication system review:
The system is regularly reviewed and improvements of effectiveness are made by the provider for the safe and quality use of medicines
Strengthened Quality Standards framework analysis - Aged Care Quality Standards
Failure to comply with the requirements could lead to an organisation being penalised or reprimanded.
Related Training Requirements Guides
The following Training Requirement guides can be used to support and facilitate the medication review training requirement:
What Skills Do Staff Need for Medication Reviews?
Conducting medication reviews requires a multifaceted skill set, going beyond mere clinical knowledge. While an in-depth understanding of pharmacology is crucial, staff must also possess strong analytical skills, allowing them to critically evaluate a patient’s medication regimen and identify any potential issues. This includes an ability to recognise potential drug interactions, understand the implications of polypharmacy, and assess the appropriateness of prescribed medications for each individual patient.
| Skill | Key Elements |
|---|---|
| Drug interactions and Polypharmacy | Staff should be skilled in recognising potential drug interactions, understand the implications of polypharmacy, and assess the appropriateness of prescribed medications for each individual patient. |
| Communication | Staff must be able to effectively convey their findings and recommendations to other members of the healthcare team, as well as to patients and their families. They must also possess the empathy and patience required to understand each patient’s unique situation, concerns, and preferences. |
| Attention to detail | Staff must be meticulous in their review of medication regimens, ensuring that nothing is missed and that all potential issues are identified and addressed. |
| Analytical skills | Staff must be able to analyse a patient’s medication regimen critically to identify potential issues. |
| Critical Thinking | Staff must be able to evaluate information critically and make informed decisions during the medication review process. |
| Continuous learning and improvement | The field of medicine is constantly evolving, and staff must be proactive in staying up-to-date with the latest research, treatment guidelines, and best practices in medication management. |
How to Assess Staff Competency on Medication Reviews
Assessing staff competency in medication reviews is a multi-faceted process that should encompass both theoretical knowledge and practical skills.
- Written Exams and Case Studies: Utilise these to assess a staff member’s clinical knowledge and analytical skills.
- Practical Assessments and Role Plays: Employ these to evaluate communication skills and the ability to apply knowledge in real-world scenarios.
- Peer Reviews: Gain feedback from other healthcare team members to provide insights into a staff member’s competency, highlighting strengths and areas needing improvement.
- Patient Feedback: Utilise patient-centered perspectives to gauge the effectiveness of the medication review process.
- Regular Audits: Conduct these on medication management practices, ensuring adherence to best practices and identifying any systemic issues.
Combining these methods with ongoing education and training helps maintain a high standard of competency in medication reviews across the organisation.
Strategies to Support Healthcare Staff Reinforce and Develop their Medication Review Skills
To support employees in developing medication review skills, adopt a comprehensive approach:
- Ongoing Education: Provide access to up-to-date resources and training programs to keep staff informed of the latest developments in medication management.
- Practical Experience: Offer opportunities for shadowing experienced colleagues and conducting supervised medication reviews, allowing staff to apply their knowledge in real-world settings.
- Mentoring Programs: These can provide less experienced staff with necessary guidance and support.
- Regular Feedback Sessions: Ensure staff are aware of their strengths and areas for improvement.
- Continuous Learning Culture: Encourage a learning environment where staff are motivated to develop their skills and improve their practice.
- Interdisciplinary Learning Opportunities: Promote collaboration with colleagues from different disciplines, fostering a holistic approach to patient care.
Sample Training Plan for the Medications Review Training Requirement
The ability of staff to perform medication reviews can be reinforced through an effective training program upon identifying the areas of lacking skills (via needs assessments).
Using the above needs assessment survey as an example - The medication review skills that require the most attention are attention to detail and drug interactions and polypharmacy skills. We can target learning initiatives to fill these gaps to enhance staff competency.
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Contact Ausmed today and see how we can support with your medication review training requirements!
Staff Competency Assessment for Medication Reviews - Example
To assess a staff member's competence in conducting medication reviews, consider the following survey questions:
Staff Survey - Medication Reviews Competency
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Can you describe the process of conducting a medication review?
- [Answer here]
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How do you ensure all relevant patient information is collected and considered during a medication review?
- [Answer here]
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What steps do you take if you identify a potential medication-related problem?
- [Answer here]
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How do you involve other healthcare professionals in the medication review process?
- [Answer here]
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How do you communicate medication changes to patients and their families?
- [Answer here]
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How do you stay up-to-date with current best practices in medication management?
- [Answer here]
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Can you provide an example of a challenging medication review you have conducted and how you handled it?
- [Answer here]
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How do you assess the effectiveness of a medication regimen?
- [Answer here]
Conclusion
Developing a comprehensive training program for medication reviews is crucial in ensuring patient safety and optimising medication management practices. By aligning training with national standards, ensuring staff possess the necessary skills, and implementing strategies to support ongoing development, healthcare organisations can enhance the quality of care provided to patients.
References
- Australian Institute of Health and Welfare, 2023. 'Older Australians'
- Chen EYH, Wang KN, Sluggett JK, Ilomäki J, Hilmer SN, Corlis M, Bell JS. Process, impact and outcomes of medication review in Australian residential aged care facilities: A systematic review. Australas J Ageing. 2019 Sep;38 Suppl 2:9-25. doi: 10.1111/ajag.12676. PMID: 31496065.
- Australian Commission on Safety and Quality in Health, 2023. 'NSQHS Action 4.10'
- Aged Care Quality and Safety Commission, 2023. Aged Care Quality Standards, ' Standard 3. Personal care and clinical care - Requirement 3.3.(b)'
- Aged Care Quality and Safety Commission, 2023. 'Stronger Standards, Better Aged Care Program - Action 5.3.2'
- Aged Care Quality and Safety Commission, 2023. 'Stronger Standards, Better Aged Care Program - Action 5.3.3'
- Aged Care Quality and Safety Commission, 2023. 'Stronger Standards, Better Aged Care Program - Action 5.3.7'
