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Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services
Sophiahemmet University; Aging Research Center (ARC) Karolinska Institutet and Stockholm University.
Division of Nursing, Department of Neurobiology, Care Science and Society, Karolinska Institutet; School of Health Care and Social Welfare, Mälardalen University; .
The Swedish Red Cross University College, Department of Public Health and Medicine. Aging Research Center (ARC) Karolinska Institutet and Stockholm University.ORCID iD: 0000-0001-5800-6454
Sophiahemmet University; Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet.
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2015 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, 201-210 p.Article in journal (Refereed) Published
Abstract [en]

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.

AIM: 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.

IMPLICATIONS FOR PRACTICE: 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.

Place, publisher, year, edition, pages
2015. Vol. 10, no 3, 201-210 p.
Keyword [en]
administration of medication; delegation; district nurse; home-care assistants; knowledge
National Category
Nursing
Identifiers
URN: urn:nbn:se:rkh:diva-1970DOI: 10.1111/opn.12073PubMedID: 25515934OAI: oai:DiVA.org:rkh-1970DiVA: diva2:872330
Available from: 2015-11-18 Created: 2015-11-18 Last updated: 2016-05-30Bibliographically approved

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Citation style
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