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Retrospective survey of long-term care staff: 12 conditions identified, evaluated, and reported as suspected adverse drug reactions.

OBJECTIVE
To examine the identification of conditions, the evaluation of these conditions as adverse drug reactions (ADRs), and the communication practices regarding suspected ADRs in a long-term care (LTC) facility.


DESIGN AND SETTING
Health care providers completed a survey containing nine questions covering 13 conditions, about residents of a 99-bed LTC facility.


PARTICIPANTS
Twenty-five health care providers (i.e., CNAs, LPNs, RNs, RPh, social workers, and an activities worker) reviewed residents on their units. A total of 67 residents were reviewed.


RESULTS
The RPh was aware of fewer of the residents' conditions (16% of all conditions) compared with CNAs (34%), LPNs (38%), and RNs (45%). RNs and the RPh identified an equal percent of conditions that could be caused by a resident's medications (66.5% and 66.7% of all conditions, respectively). This was greater than LPNs (36%) or CNAs (9.9%). However, RNs and the RPh actually attributed a lower percentage of these conditions to the medications (43.9% and 41.7%, respectively) compared with LPNs (57.4%) and CNAs (90.0%). CNAs notified others in a higher percentage of the cases where they suspected an ADR (81.5%) compared with the RPh (60%), RNs (57.4%), or LPNs (10.3%). No notification was primarily attributed to "nothing could be done," the condition is an expected effect, others were aware of the condition, and the condition currently is being treated.


CONCLUSIONS
These results illustrate the importance of a team approach to ensure that all health care providers are aware of conditions to properly evaluate and resolve them.