Background Medication‐related errors are common in elderly care. Most are detected during the preparation and administration stages of the medication process. Nursing staff have a key role in preventing errors, and it is based on adherence to guidelines. Aim The aim was to determine nursing staff's self‐assessments of how they adherence to guidelines on safe medication preparation, administration and asepsis in the medication process in long‐term elderly care and to identify factors affecting this adherence. Method Cross‐sectional study was conducted by total sampling at the communal long‐term elderly care wards of one healthcare district in Finland in November 2016. Data were collected from nursing staff by using a previously developed web‐based questionnaire. The response rate was 39.4% (n = 492). Results One‐third of the nurses stated that they do not always follow guidelines when preparing medication, and around a half deviate from them occasionally, when administering medication. The most serious deviation on preparation stage was crushing of sustained release and enteric‐coated tablets and mixing of crushed tablets together. On administration stage, the deviation of guidelines of giving medicine in recommended time or in relation to food was common. Associations were detected between the adherence to guidelines and the nurses’ experience about the adequacy of their knowledge of pharmacology and infection control, and their skill at performing medication calculations. Conclusion Deviation from guidelines often causes an error. There is a need to review the teaching of pharmacology, infection control and medication calculations during undergraduate and continuing education. In addition, nursing staff must be reminded about the ethical aspects of safe medication processes and the appropriate attitudes to these processes. Nurses must understand why it is important to follow guidelines when preparing and administering medications, in order to avoid errors.

Objective: Elderly people often use several medicines, which increases risks for side effects and adverse effects. Moreover, most reported adverse events in healthcare are associated with medication. The aim was to describe nursing staffs’ perceptions about and the factors related to the actualization of safety checks, monitoring and documentation in the medication process in long-term elderly care.Methods: This was a cross-sectional quantitative, questionnaire-based study. The response rate, among all nurses working in long-term elderly care wards in a Finnish healthcare district, was 39.4% (n = 492).Results: The results indicate that some safety checks and monitoring guidelines are often violated during the medication administration process, but most nurses self-reportedly maintained good practice in medication documentation.Conclusions: The results suggest needs to review training in pharmacology, infection control, and medication calculations during pre-qualification and continuing education, and to ensure nurses’ awareness of attitudes and ethical considerations for medication safety.

Tutkimuksen tarkoituksena oli kehittää turvallisen lääkehoidon toteuttamista arvioi va mittari. Mittarin sisältö laadittiin turvallisen lääkehoidon toteuttamisen osa-alueiden mukaisesti kirjallisuuskatsauksen avulla. Osa-alueita ovat: oikea lääke, oikea tarve lääkkeelle, oikea annos, oikea potilas, oikea lääkkeen antotapa, oikea lääkkeen käyttökuntoon saattaminen, oikea lääkkeen antoaika, oikea potilaan ohjaus, oikea lääkehoidon seuranta ja vaikutusten arviointi, oikea lääkehoidon dokumentointi ja kirjaaminen, oikea aseptiikka. Osa-alueista laadittiin mittari, joka kä-sitti 123 kysymystä. Asiantuntijapaneeli (n=7) arvioi mittarin sisältöä ja väittämien rakenteita. Pilot-testauksen aineisto kerättiin webropol-kyselynä yhden kaupungin kunnallisissa ikääntyneiden pitkäaikaishoidon yksiköissä lääkehoitoon osallistuvalta hoitohenkilökunnalta (N = 294). Vastausprosentti oli 24 %. Pilot-testauksessa ar vioitiin vastaamiseen kuluvaa aikaa ja sähköisen kyselyn toimivuutta. Mittarin sisäi sen johdonmukaisuuden arvioinnissa käytettiin Tarkkonen Rho -kerrointa, joka osoitti mittarin sisäisen johdonmukaisuuden hyväksi. Asiantuntijapaneelin arvioinnissa ja pilot-testauksessa saatiin tärkeää tietoa kehitetyn mittarin sisällöstä, selkeydestä, vastaamiseen kuluvasta ajasta ja käytettävyydestä. Turvallinen lääke-hoito -mittari todettiin muokkauksen jälkeen turvallisen lääkehoidon toteuttamisen periaatteet hyvin huomioivaksi, toimivaksi ja luotettavaksi. JohdantoLääkehoidon turvallisuus on tärkeä osa potilasturvallisuutta ja hoitotyötä. Suurin osa terveydenhuollon haittatapahtumista raportoidaan silti lääkehoidon osa-alueilta (Härkänen, Turunen, Saano & Vehviläinen-Julkunen 2015).