Use of medicines in nursing homes for older people

Furniss, Lee

doi:10.1192/apt.8.3.198

Cited by 18 publications

(16 citation statements)

References 34 publications

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“…Research has found that residents living in residential aged care homes (RACHs) were prescribed significantly more medications than those living independently [2]. International studies found that residents in…”

Section: Introductionmentioning

confidence: 99%

The impact of electronic medication administration records in a residential aged care home

Qian¹,

Yu²,

Hailey³

2015

International Journal of Medical Informatics

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This study aimed to compare between electronic medication administration records and paper-based records in the nursing time spent on various activities in a medication round and the medicationadministration processes followed by nurses in an Australian residential aged care home. It also aimedto identify the benefits and unintended adverse consequences of using the electronic medication admin-istration records.Methods: Time-motion observation, taking of field notes, informal conversation and document reviewwere used to collect data in two units of a residential aged care home. Each unit had one nurse admin-ister medication. Seven nurses were observed over 12 morning shifts. Unit 1 used electronic medicationadministration records and Unit 2 used paper-based records.Results: No significant difference between the two units was found in the nursing time spent on variousactivities in a medication round, including documentation, verbal communication, medication adminis-tration, infection control and transit.Comparison of the medication administration processes between the electronic and paper-basedmedication administration records identified a procedural problem which violated the organization'sdocumentation requirement. This problem was documenting before providing medication to a residentwhen using the paper-based records. It was not observed with the electronic medication administrationrecords.Benefits of introducing the electronic medication administration records included improving nurses'compliance with documentation requirements, freedom from the error of signing twice, reducing thepossibility of forgetting to medicate a resident, facilitating nurses to record the time of medicationadministration to a resident and increasing documentation space. Unintended adverse consequencesof introducing the electronic medication administration records included inadequate information aboutresidents, late addition of a new resident's medication profile in the records and nurses' forgetting tomedicate a resident due to power outage of the portable device.Conclusions: The electronic medication administration records may not change nursing time spent onvarious activities in a medication round or substantially alter the medication administration processes,but can generate both benefits and unintended adverse consequences. Future research may investigatewhether and how the adverse consequences can be prevented.

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Section: Introductionmentioning

confidence: 99%

The impact of electronic medication administration records in a residential aged care home

Qian¹,

Yu²,

Hailey³

2015

International Journal of Medical Informatics

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“…The need to improve safety in the management of medication in care homes has been identified by several authors (Furniss 2002, Simonson and Feinberg 2005, Snowdon et al 2006. In England, over 18,000 homes currently provide care for more than 453,000 residents.…”

Section: Literature Reviewmentioning

confidence: 99%

How social care staff working in residential homes perceive their professional status

Wild

Szczepura

Nelson

2011

Nursing Older People

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research team at the University of the West of England, Bristol and Warwick Medical School, evaluated the impact upon medication administration of a pharmacy-led barcode medication management system (PBMS), in the care home setting (with or without on-site registered nursing staff). This system self generates automatic real-time alerts to draw the medication administrator's attention to inappropriate or unsafe attempts to administer drugs. A hand-held device holds data on the resident and the prescribed medication. The medication administrator uses the device to scan each resident's barcode identifier to access the correct file. The system provides visual confirmation of the resident (photograph) and then carries out a number of checks to ensure the following are correct: medication, time, dose, quantity and date. If the proposed drug administration is incorrect, the system alerts the medication administrator immediately. At the end of each week a report is sent to the care home manager with details of any potential mistakes and the identity of members of staff involved. Where administration of a particular medicine within the correct time frame is entirely missed, the system enters this as a 'missing record'.

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“…Banning (2004) confirms this arguing that older people desist from adhering to care plans for the same practical, economical, logistical, social and belief reasons as the rest of the us. It is interesting that much polypharmacy among older people has been found to exist in nursing homes where paternalistic models of medicine management are still in place and residents were not involved in the review or evaluation of their treatment profiles (Furniss, 2002).…”

Section: Concordance and Older Peoplementioning

confidence: 99%

Pursuing concordance: moving away from paternalism

McKinnon

2014

Br J Nurs

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In the second of two articles exploring the value and application of concordance across nursing practice the discussion is aimed at clinical settings and patient groups where concordance may have been viewed as impractical. The author harnesses Cribb and Entwhistle's broader conception of shared decision making and the notion of decision-making capacity as a continuum to argue that concordance can be pursued effectively in challenging settings such as childcare practice, mental health and the care of older people. As in the first paper ( McKinnon, 2013 ) the discussion is not limited to medicines management but remains engaged with all aspects of nursing practice. Legal and ethical frameworks, social participation theory and research across healthcare practice are sourced to argue for concordant approaches in the care of patients who may at times have compromised decision-making capacity. Ideas of direct and indirect concordance are explored.

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Use of medicines in nursing homes for older people

Cited by 18 publications

References 34 publications

The impact of electronic medication administration records in a residential aged care home

The impact of electronic medication administration records in a residential aged care home

How social care staff working in residential homes perceive their professional status

Pursuing concordance: moving away from paternalism

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