Governance and health promotion: a case study of medication education

Abstract

Findings from a research study investigating nurses' educational preparation for and practice of their role in educating patients about medication identified that the inclusion of patient education in clinical interactions has implications for the governance of clinical practice - an agenda now being implemented in UK health contexts. A review of patient education, concordance (compliance), health promotion and pharmacology literature was undertaken to illuminate the current status of the evidence for effective medication interactions. Obser vation (n =48) and audio-recordings (n = 37) of nurse-patient interactions about medication were collected in seven different contexts focusing on adult and older-person, mental-health and community-nursing settings. Post-inter action interviews with nurse (n = 29) and patient (n = 39) participants were conducted to explore views on the observed interaction and to attempt to identify intended outcomes of the interactions. Issues highlighted by the research concern: the need for a pluralistic understanding of what might constitute the evidence base for practice; a requirement to recognise the com plexities of professionals' and patients' perspectives on what constitutes qual ity ; the need for caution in the application of generic 'standards' to individualised care contexts, coupled with the problem of what counts as effective outcomes. The recognition of such concerns is posited as a critical ingredient in the process of clinical governance.