Lääkehoidon turvallinen toteuttaminen ikääntyneiden pitkäaikaishoidossa hoitohenkilöstön arvioimana

• Main Author: Karttunen, M. (Markus)
• Other Authors: Elo, S. (Satu), Sneck, S. (Sami), Männikkö, N. (Niko)
• Format: Doctoral or Postdoctoral Thesis
• Language: Finnish
• Published: Oulun yliopisto 2019
• Subjects: elderly care; medication administration process; medication safety; nursing; ikääntyneiden lääkehoito; lääkehoidon toteuttaminen; lääkitysturvallisuus; Northern Finland
• Online Access: http://urn.fi/urn:isbn:9789526223421

Abstract The aim of the study was to determine nursing staff’s self-assessment of how they adhere to guidelines on safe medication administration during the medication process in long-term elderly care. In the first phase of this quantitative study, a Safe Medication Management Scale was developed and its reliability was evaluated. A panel of experts (n = 7) determined the scale’s content and the structure of its items. A pilot study was conducted with nursing staff from long-term elderly care wards in one town in northern Finland. The response rate was 24 % (n = 69). In the second phase, a cross-sectional study was conducted among nursing staff from long-term elderly care wards in one hospital district in Finland. The response rate was 39 % (n = 492). The majority of the nurses reported always adhering to guidelines during the medication process. However, one third of the nurses stated that they do not always follow guidelines when preparing medication, and approximately half stated that they do not always follow guidelines when administering medication. Shortcomings were identified in medication documentation, especially in the recording of the effects of medicine and the reason for administration. Routine checks were not always performed at different stages of the medication administration process. Also, patient involvement in the medication administration process was not always completed. Statistically significant associations were detected between the responses and the nurses’ self-assessment of how well they follow recommendations in general, as well as their knowledge of pharmacology and infection control, and their skill in performing medication calculations. A statistically significant association was detected in the age of the nurses; older age groups followed guidelines more thoroughly than younger age groups. When nurses self-assessed their activities in general at a higher level, they seemed to also follow guidelines better. Deviation from instructions and recommendations relating to the ...