title: Registered nurses' experience of delegating the administration of medicine to unlicensed personnel in residential care homes.
abstract: OBJECTIVE
  The aim was to describe registered nurses' experience in the context of delegating the administration of medication to unlicensed personnel in residential care homes.
  
  
  BACKGROUND
  The residents in residential care homes have a need for extensive care and nursing, and large amounts of medicines are common practice. Registered nurses' workload and difficulties in fulfilling their duties, such as administration of medicines, have led to frequent delegation of this task between the registered nurses and unlicensed assisting personnel. It is, of course, a great responsibility to ensure that the care of the older people remains safe while maintaining quality in the prevailing situation.
  
  
  METHODS
  A qualitative inductive descriptive study.
  
  
  METHODS
  Data were collected using audio-recorded semistructured interviews with a purposive sample of 18 registered nurses and interpreted using manifest content analysis. The study was approved by the ethical research committee.
  
  
  RESULTS
  Registered nurses found the organisation unsupportive with regard to nursing interventions. The delegation context was experienced as a grey zone; the rules and regulations were not in line with the unspoken expectation to delegate the administration of medicine to unlicensed personnel, in order to be able to manage their daily work.
  
  
  CONCLUSIONS
  The slimmed organisation of residential care homes relies upon registered nurses' use of delegation of medicine administration to unlicensed assistant personnel. It becomes an inevitable assignment entailing a challenging responsibility for patient safety and the quality of care.
  
  
  CONCLUSIONS
  The results of this study may contribute to a better understanding of the complexity of caring for older people in residential care homes and to improving the work environment of all healthcare personnel.
authors.affiliation: Sophiahemmet University, Stockholm, Sweden. asa.craftman@shh.se.
authors.forename: Åsa
authors.initials: Å
authors.lastname: Gransjön Craftman
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Grape
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.
authors.forename: Katarina
authors.initials: K
authors.lastname: Ringnell
authors.affiliation: Sophiahemmet University, Stockholm, Sweden.|Department of Clinical Science and Education, Söodersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Margareta
authors.initials: M
authors.lastname: Westerbotn
mesh_terms: D001291:Attitude of Health Personnel; D032022:Delegation, Professional; D004358:Drug Therapy / Q000451:nursing*; D006801:Humans; D009726:Nurses; D009735:Nursing Homes; D061214:Patient Safety; D036301:Qualitative Research; D016526:Workload
keywords: delegation; medicine administration; older people; registered nurse; residential care homes; unlicensed assistant personnel