title: Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services.
abstract: BACKGROUND
  Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.
  
  
  OBJECTIVE
  The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.
  
  
  METHODS
  Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.
  
  
  RESULTS
  According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.
  
  
  CONCLUSIONS
  Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.
  
  
  CONCLUSIONS
  This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Aging Research Center (ARC) Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Asa
authors.identifier: http://orcid.org/0000-0002-0553-199X
authors.initials: A
authors.lastname: Gransjön Craftman
authors.affiliation: Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet, Stockholm.|School of Health Care and Social Welfare, Mälardalen University, Västerås, Sweden.
authors.forename: Lena M
authors.initials: LM
authors.lastname: Hammar
authors.affiliation: Aging Research Center (ARC) Karolinska Institutet and Stockholm University, Stockholm, Sweden.|The Swedish Red Cross University College, Stockholm, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: von Strauss
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Pernilla
authors.initials: P
authors.lastname: Hillerås
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Division of Caring Science, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Westerbotn
mesh_terms: D000368:Aged; D004358:Drug Therapy / Q000451:nursing*; D005260:Female; D017144:Focus Groups; D018576:Home Health Aides; D006801:Humans; D008004:Licensure; D008297:Male; D032024:Personnel Delegation; D011361:Professional Competence; D013548:Sweden
keywords: administration of medication; delegation; district nurse; home-care assistants; knowledge