Nursing home staff's experiences with the implementation of an automated blister packaging system for solid, orally ingestible drugs: a qualitative study in Northern Italy

Objectives: To explore nursing home (NH) staff's experiences implementing an automated blister packaging system for solid, orally ingestible drugs.

Design: This was a descriptive qualitative study. Semistructured interviews were used for data collection, and qualitative content analysis was applied for data analysis.

Setting: Four NHs in a region in Northern Italy participated in the piloting of an automated blister packaging system.

Participants: The purposive sample comprised 40 NH staff (seven registered nurses, 11 certified nursing assistants, three nursing aids, seven nursing managers, four directors and eight physicians) RESULTS: Six main categories emerged from the data analysis: (1) impacting safety, including improved medication process, perceived insecurities and remaining error sources; (2) creating free spaces, including time, individualised care and drug storage and logistics; (3) serving residents, (4) meeting expectations, including met and unmet expectations; (5) generating efforts and (6) producing waste. They all merged into one theme 'It pays off!'

Conclusions: As experienced by NH staff, the automated blister packaging system improved medication safety and reduced the workload of registered nurses, but it is not an 'all-around carefree package'. Continuous quality improvement and risk management strategies are recommended to accompany and sustain implementation, as well as further clarification of roles and duties among the different care workers involved in medication management. Further research is needed to gain a better understanding of the impact of an automated blister packaging system on registered nurses' competencies in NHs regarding medication management and residents' therapies and safety.