Concealment of drugs in food and beverages in nursing homes: cross sectional study

Kirkevold, Øyvind; Engedal, Knut

doi:10.1136/bmj.38268.579097.55

Cited by 54 publications

(41 citation statements)

References 20 publications

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“…Kirkevold and Engedal (2005), in their large survey of Norwegian nursing homes, reported 11% of patients in regular nursing homes and 17% in special units for people with dementia had medicines mixed with food or drink at least once a week and, as in our study, in only 40% of cases was the practice documented. But in a study of non-specialist nursing homes in south-east England, staff reported that only 5% of residents had ever had to be given their medication covertly (Macdonald et al, 2004).…”

Section: Covert Administrationsupporting

confidence: 56%

Administration of medicines in food and drink: a study of older inpatients with severe mental illness

Haw

Stubbs

2010

Int. Psychogeriatr.

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Administration of medication in food or drink and covert medication were common in this group of hospitalized patients with severe mental illness. Before administering medication covertly it is important to discuss the matter with the multidisciplinary team and, where appropriate, with the patient's relatives. It is also important to ensure that supporting documentation has been completed in order to avoid medico-legal difficulties.

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Section: Covert Administrationsupporting

confidence: 56%

Administration of medicines in food and drink: a study of older inpatients with severe mental illness

Haw

Stubbs

2010

Int. Psychogeriatr.

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“…As identified in this study, the use of enteral tubes as a route for medicine administration can interfere with nutritional intake either because of the time taken for the medicines to be administered through the tube or because the medicines block the tube. Also, although only alluded to, medicines are hidden in food to aid their administration and, in addition to the ethical issue of the covert administration of medicines [19,[50][51][52], the taste of the food itself may be affected with a negative effect on nutritional intake.…”

Section: Nutritionmentioning

confidence: 99%

“…Unfortunately, in most cases patients need their medicines and there are no alternative formulations. A frequent response to this is to crush tablets or open capsules and to mix the residue with food or put it down the enteral tube [12][13][14][15][16]. However, in altering the formulation of a medicine there are legal implications because Marketing Authorisation is granted to a pharmaceutical company on the basis that the medicine will be taken by the patient in the form in which it was manufactured and through the tested route.…”

mentioning

confidence: 99%

A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia

Kelly¹,

D’Cruz

Wright

2008

Dysphagia

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Swallowing dysfunction in the elderly is common and affects not only nutrition but also the ingestion of medicines. This qualitative study used a focus group to collect data from ten healthcare professionals who are involved in the care of people with swallowing difficulties. The group discussed their experiences of the problems associated with and solutions to the administration of medicines to patients with dysphagia. The focus group was audiotaped, and the data analysed using Colaizzi’s technique. Six themes were identified, three main ones: (1) the wide spectrum of dysphagia; (2) medicine formulation, which affects how drugs can be administered; (3) problems with data flow, i.e., the correct information being with the right person at the right time and in the right place; and three minor ones which arose from the major themes: (4) the primary function of swallowing is nutrition rather than taking medication; (5) cost of medicines; and (6) therapeutic dilemmas. The study concludes that improvements in interprofessional communication are needed to improve medicine administration to dysphagic patients

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“…While the legacy of prior regulatory arrangements may help to explain this apparent anomaly, a limited engagement with standardised instruments and the low response rate to this question raise cause for concern. For example, weak or inadequate record keeping has often been associated with covert administration of medicines Stubbs, 2010a &2010b;Kirkevoid and Engedal, 2005;Treloar et al, 2000).…”

Section: Discussionmentioning

confidence: 99%

Standardising assessment instruments and care planning in Ireland

Lente

Power²

2014

Quality in Ageing and Older Adults

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-In recent decades there has been a move internationally toward increased standardisation of assessment and care planning for older people in residential care. In the Republic of Ireland, this trend is manifest within national standards governing care for older people that were introduced in mid-2009. This study was conducted approximately one year after the introduction of these national standards and sought to survey providers (n=106) around the standardised instruments in use for assessment and the processes that surrounded assessment and care planning in residential centres.It found that there were substantial variations in the use of standardised instruments between domains of care. Within some domains standardised instruments were common, while in other domains they were largely absent or external professional input was the preferred option. In contrast, assessment and care planning processes and practices displayed little variation and were almost exclusively the preserve of medical professionals.There can be little doubt that the ageing of populations has become a matter of growing interest. Across many nations increased life expectancy coupled with diminishing birth rates have contrived to alter dependency ratios in a manner that poses significant challenges for care systems, especially long-term care (Bower et al., 2009; European Commission, 2008; OECD, 2005;Tsolova and Mortensen, 2006).Moreover, it is a set of circumstances that must be confronted against a backdrop of raised consumer expectations and diluted traditional family ties, which have contributed to a ratcheting upward of demand (European Commission, 2008;Guberman et al., 2012;Kroger, 2003). At the same time, supply side factors offer cold comfort to decision makers charged with managing health and social care systems.Socio-cultural shifts for instance, have encouraged increased female engagement with education and labour markets, depleting supplies both of formal and informal carers, which many nations have relied upon in the past (European Commission, 2008;Fujisawa and Colombo, 2009;Kroger, 2003;Pavolini and Ranci, 2008;Simonazzi, 2009;Walsh and O'Shea, 2009).While the particular configuration of these challenges is peculiar to each individual nation, a similarity in response is apparent. Many states have responded by introducing or updating regulations and standards governing residential care for older people, with particular attention devoted to assessment and care planning. In the U.S.A., for instance, a Minimum Data Set -Resident Assessment Instrument (MDS-RAI) was introduced in 1990, as part of major reforms aimed at improving quality of care in nursing homes (Morris et al., 1990). It is an approach that has been embraced by many other nations since that time. Sweden, Denmark, Norway, France, Germany, the U.K. and Japan have all moved toward increasingly standardised systems based upon MDS type instruments (Bernabei et al., 2008). Designed to improve quality through facilitating problem identification, integration of care, ...

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Concealment of drugs in food and beverages in nursing homes: cross sectional study

Cited by 54 publications

References 20 publications

Administration of medicines in food and drink: a study of older inpatients with severe mental illness

Administration of medicines in food and drink: a study of older inpatients with severe mental illness

A Qualitative Study of the Problems Surrounding Medicine Administration to Patients with Dysphagia

Standardising assessment instruments and care planning in Ireland

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