Bakgrund: Att varje patient har en god kännedom om sin läkemedelsbehandling leder till en minskad risk för felmedicinering, bättre livskvalitet på individnivå samt till att stora samhällskostnader reduceras[1]. Det finns flera olika informationsunderlag som patienter kan använda sig av för att hålla ordning på sin ordinerade läkemedelsbehandling. Dessa underlag innehåller information om förskrivna läkemedel. Dock är inget informationsunderlag heltäckande och informationen kan ibland vara inaktuell vilket kan bli problematiskt för patienten och leda till att aktuell ordination inte följs[19]. Syfte: Syftet med detta examensarbete var att genom strukturerade intervjuer på apotek undersöka vilket underlag kunder med minst fem eller fler receptordinerade läkemedel använder för att hålla ordning på sin aktuella läkemedelsbehandling. Hur många kunder som kände till och hur ofta de på apotek fått en utskrift av receptlistan ”Mina sparade recept på apoteket”. Hur många kunder som kände till och hur ofta de via personlig inloggning på internet granskat sin receptlista. Metod: Studien är en uppföljning av ”Patients’ information on their prescribed current treatment” som genomfördes år 2012[25].Strukturerade intervjuer med läkemedelsavstämningar genomfördes på 8 olika apotek i Sverige. Totalt inkluderade 167 apotekskunder. Resultat: Studien visade att 55% använde sig av utskriften av receptlistan ”Mina sparade recept på apoteket”, 39% använde sig av läkemedelsförpackningarna med apoteksetiketter med doseringsanvisning, 13% uppgav att de använde läkemedelslistan och 8% uppgav att de använde sig utav personlig inloggning med e-legitimation (receptlistan). Studien visar att en stor andel apotekskunder inte använder nödvändiga informationsunderlag som behövs för en säker läkemedelsanvändning. Slutsats: För att en patient ska kunna sköta sin läkemedelsbehandling på ett optimalt sätt krävs det att kunskap finns om vilka skriftliga underlag som finns att tillgå, vad de innefattar samt dess begränsningar. / Background If patients have access to an adequate and updated list of prescribed drugs it will lead to reduced risk of medication error and thus to better quality of life at the individual level, as well as reduced public spending for medical care. In drug treatment, patient compliance is extremely important, as incorrect medical use can lead to severe consequences. For patients prescribed long-term treatment with drugs, compliance is estimated to be only 50% [1]. There are several different sources patients can utilize to keep updated with their prescribed drugs; The Medication List (ML) from the physicians’ electronic medical record[14]. The Prescription List (PL) with all prescriptions stored in the Swedish National Prescription Repository (NPR) accessible from any pharmacy in Sweden [19]. The Pharmacy Record List (PR) of the purchases on prescriptions made over the past 15-month period[15]. Paper prescriptions[20]. The pharmacy packaging labels[11]. Patients may also access their PL over the internet. Objective The purpose of the study was to investigate, via questionnaire interviews in pharmacies, what sources of information customers used to keep updated in their prescribed drugs. Patients with at least five or more prescription drugs (data from the NPR) were included in the survey. It was also investigated how many customers that had knowledge of and had received a printout of the PL "My stored prescription at the pharmacy" at visits in the pharmacies. It was also investigated to what extent customers had visited a public website, through personal login, to take part of their PL, and how often. Methods This survey is a follow-up of another study "Patients' information on their prescribed current treatment" published in 2012 [25]. In this study customers were recruited from 8 different pharmacies in Sweden. Customers where asked to answer questions from a questionnaire and a drug reconciliation was done. A total of 167 customers, with at least five prescribed drugs, were included. Key findings The majority, 55%, stated that they used the PL printout "My stored prescription at the pharmacy". 39% relied on instructions given on the of drug packages and the pharmacy labels with dosage instructions. 13% of the customers reported that they used the ML handed over from their physician. 8% stated that they used the website via personal login with e-ID to get to the PL ”My stored prescription at the pharmacy”. Conclusion On March 1, 2018, the government decided on the draft bill for a national pharmaceutical list. The list should provide a complete and up-to-date picture of the individual patient's drugs, regardless of who prescribed the drug and where in the country this occurred[19]. Thus, modernity development should lead to a reduced necessity of using several different sources for prescribed drugs, which can hopefully reduce the risk of errors in drug use and increase the overall patient safety.

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Les recherches biomédicales se sont imposées comme une nécessité sociale et leur place n’a pas cessé de prendre de l’importance dans le domaine médical. Leur encadrement juridique commence en 1988 avec la loi « Huriet », qui vient de mettre en place un régime de responsabilité civile régissant cette activité.Ce régime renforce la protection des victimes (et de leurs ayants droit) de recherches biomédicales en simplifiant la procédure d’indemnisation. Seul le tribunal de grande instance est compétent pour connaître des litiges en la matière et ce même s’il s’agit d’un promoteur du secteur public qui relève normalement du juge administratif. Le délai de prescription est de dix ans car les dommages ne peuvent pas apparaître immédiatement après la fin de la recherche. La victime et ses ayants droit peuvent demander l’indemnisation des dommages matériels et moraux subis à l’occasion de la réalisation de la recherche. Dans les cas où la responsabilité du promoteur n’est pas engagée, la victime peut toujours demander une indemnisation à l’ONIAM, en déposant une demande auprès de la CRCI. La loi « Huriet » devrait concilier l’intérêt de la société avec ses valeurs fondamentales, et trouver le juste équilibre permettant d’assurer une protection parfaite aux individus se prêtant à ces recherches, sans entraver leur développement. / Biomedical research has emerged as a social necessity. Its importance has continued to grow in the medical field. Its legal framework began in 1988 with the law "Huriet", which established a civil liability governing this activity.Today’s legal system increases the protection of victims (and their dependents) of biomedical research by simplifying the procedures for plaintiffs to receive compensation. Only the High Court has the jurisdiction to hear disputes in this area and even if he is a proponent of the public sector is normally the administrative judge. The limitation period is ten years since the damage may not appear immediately at the end of the research. The victim and his/her dependents are entitled to compensation for material and moral damages incurred in connection with the conduct of research. In cases where the liability of the promoter is not involved, the victim can still claim compensation from the ONIAM by filing an application with the CRCI.The law "Huriet" should reconcile the interests of the society with its core values, and find the right balance to ensure a perfect protection to individuals suitable for this research, without hindering their development. / لقد فرضت الابحاث الطبية الحيوية كضرورة اجتماعية واتخذت أهمية لا يمكن الاستغناء عنها في المجال الطبي. وحيث ان تنفيذها على الكائن البشري أصبح مطردا، فان إحاطتها بقانون متكامل أصبح امرا لا مفر منه، وقد بدأ ذلك الأمر بتشريع قانون عام 1988 والذي اتى بالجديد عندما أحاط تنفيذ الابحاث الطبية على الكائن البشري بنظام مسؤولية مدنية. هذا النظام هدفه تدعيم حماية المشاركين بالبحث من خلال تعويض المتضرر منهم او خلفه العام من خلال تبسيط اجراءات التعويض. فحدد هذا القانون الاختصاص حصريا بالمحكمة البدائية في النظر بالخصومات المتعلقة بتنفيذ الابحاث الطبية على الكائن البشري، حتى لو كان القائم على تنفيذ البحث شخص من القانون العام. والذي من المفترض ان يكون الاختصاص حينها للقاضي الاداري. هذا وقد حدد قانون عام 1988 مدة التقادم بعشرة سنوات من وقت انتهاء تنفيذ البحث، لان الاضرار قد لا تظهر إلا بعد مدة من تنفيذ البحث. فالمتضرر أو خلفه العام يستطيعون المطالبة بالتعويض على الاضرار المادية والادبية التي نجمت عن تنفيذ البحث الطبي. لكن في حالة اثبات عدم وجود خطا من القائم بالبحث الطبي أي انه غير مسؤول عن الاضرار، فان المتضرر يحق له حينها بموجب هذا القانون اللجوء إلى المطالبة بالتعويض من خلال الهيئة الوطنية للتعويض عن الحوادث الطبية. خلاصة القول، إن قانون عام 1988 سعى لايجاد موازنة ما بين الفائدة التي تعود على المجتمع من تنفيذ البحث وبين ضمان حماية المشارك بالبحث بالشكل الذي يكفل حرمة الجسد البشري دون ان يؤدي ذلك إلى وضع العقبات أمام تنفيذ الابحاث الهامة للمجتمع

Indiana University-Purdue University Indianapolis (IUPUI) / This qualitative study was successful in utilization of grounded theory methodology to ascertain nurses’ decision-making processes following their awareness of having made a medical error, as well as how and/or if they corrected and reported the error. Significant literature documents the existence of medical errors; however, this unique study interviewed thirty nurses from adult intensive care units seeking to discover through a detailed interview process their individual stories and experiences, which were then analyzed for common themes. Common themes led to the development of a theoretical model of thought processes regarding error reporting when nurses made an error. Within this theoretical model are multiple processes that outline a shared, time-orientated sequence of events nurses encounter before, during, and after an error. One common theme was the error occurred during a busy day when they had been doing something unfamiliar. Each nurse expressed personal anguish at the realization she had made an error, she sought to understand why the error happened and what corrective action was needed. Whether the error was reported on or told about depended on each unit’s expectation and what needed to be done to protect the patient. If there was no perceived patient harm, errors were not reported. Even for reported errors, no one followed-up with the nurses in this study. Nurses were left on their own to reflect on what had happened and to consider what could be done to prevent error recurrence. The overall impact of the process of and the recovery from the error led to learning from the error that persisted throughout her nursing career. Findings from this study illuminate the unique viewpoint of licensed nurses’ experiences with errors and have the potential to influence how the prevention of, notification about and resolution of errors are dealt with in the clinical setting. Further research is needed to answer multiple questions that will contribute to nursing knowledge about error reporting activities and the means to continue to improve error-reporting rates