Making sure the residents get their tablets: medication administration in care homes for older people.
OBJECTIVE
This paper reports an exploratory study of issues concerning the nursing practice of altering medication dose forms prior to administration of medicines to residents in homes for older people.


BACKGROUND
Medication use and administration is a major issue in residential homes for older people. Research suggests that the alteration of medication dose forms in these homes is a widespread practice. Despite its prevalence, there is limited nursing or pharmaceutical literature exploring the decision-making processes surrounding this practice, the methods by which medicines are altered, or the types of medicines which are modified.


METHODS
Semi-structured interviews were carried out with 11 Registered Nurses working in a purposive sample of 10 residential homes for older people drawn from each of the six regions of South Australia. The data were collected in 2000.


RESULTS
Nurses felt constrained to ensure that prescribed medication was administered to residents, despite their concern that this was not without risk. Nurses were concerned that they were working in an information vacuum, due to limited information resources and informal communication with other healthcare professionals such as speech pathologists, pharmacists and general practitioners. There was also concern about the difficulty of coordinating information and policies about altering medications and of implementing appropriate procedures in individual facilities.


CONCLUSIONS
Clinical guidelines for the processes surrounding the alteration of medication dose forms and relevant pharmaceutical information are needed in all residential homes for older people. Ongoing education for nurses in this area is also required.
Barnes
Lynne
L
School of Nursing & Midwifery, City East Campus, University of South Australia, North Terrace, Adelaide, South Australia, Australia. lyn.barnes@unisa.edu.au
Cheek
Julianne
J
Nation
Roger L
RL
Gilbert
Andrew
A
Paradiso
Lisa
L
Ballantyne
Alison
A
D000368:Aged; D001291:Attitude of Health Personnel; D004304:Dosage Forms; D004333:Drug Administration Routes; D005851:Geriatric Nursing / Q000379:methods*; D006707:Homes for the Aged; D006801:Humans; D024802:Nurse's Role; D009735:Nursing Homes; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D013021:South Australia
D004304:Dosage Forms; D004364:Pharmaceutical Preparations