Øyvind Kirkevold1, Knut Engedal. 1. Norwegian Centre for Dementia Research, Vestfold Mental Health Care Trust, Tønsberg, Postbox 64, N-3107 SEM, Norway. oyvind.kirkevold@nordemens.no
Abstract
OBJECTIVE: To examine the practice of concealing drugs in patients' foodstuff in nursing homes. DESIGN: Cross sectional study with data collected by structured interview. SETTING: All five health regions in Norway. PARTICIPANTS: Professional carers of 1362 patients in 160 regular nursing home units and 564 patients in 90 special care units for people with dementia. MAIN OUTCOME MEASURES: Frequency of concealment of drugs; who decided to conceal the drugs; how this practice was documented in the patients' records; and what types of drugs were given this way. RESULTS: 11% of the patients in regular nursing home units and 17% of the patients in special care units for people with dementia received drugs mixed in their food or beverages at least once during seven days. In 95% of cases, drugs were routinely mixed in the food or beverages. The practice was documented in patients' records in 40% (96/241) of cases. The covert administration of drugs was more often documented when the physician took the decision to hide the drugs in the patient's foodstuff (57%; 27/47) than when the person who made the decision was unknown or not recorded (23%; 7/30). Patients who got drugs covertly more often received antiepileptics, antipsychotics, and anxiolytics compared with patients who were given their drugs openly. CONCLUSIONS: The covert administration of drugs is common in Norwegian nursing homes. Routines for such practice are arbitrary, and the practice is poorly documented in the patients' records.
OBJECTIVE: To examine the practice of concealing drugs in patients' foodstuff in nursing homes. DESIGN: Cross sectional study with data collected by structured interview. SETTING: All five health regions in Norway. PARTICIPANTS: Professional carers of 1362 patients in 160 regular nursing home units and 564 patients in 90 special care units for people with dementia. MAIN OUTCOME MEASURES: Frequency of concealment of drugs; who decided to conceal the drugs; how this practice was documented in the patients' records; and what types of drugs were given this way. RESULTS: 11% of the patients in regular nursing home units and 17% of the patients in special care units for people with dementia received drugs mixed in their food or beverages at least once during seven days. In 95% of cases, drugs were routinely mixed in the food or beverages. The practice was documented in patients' records in 40% (96/241) of cases. The covert administration of drugs was more often documented when the physician took the decision to hide the drugs in the patient's foodstuff (57%; 27/47) than when the person who made the decision was unknown or not recorded (23%; 7/30). Patients who got drugs covertly more often received antiepileptics, antipsychotics, and anxiolytics compared with patients who were given their drugs openly. CONCLUSIONS: The covert administration of drugs is common in Norwegian nursing homes. Routines for such practice are arbitrary, and the practice is poorly documented in the patients' records.
Entities:
Keywords:
Empirical Approach; Professional Patient Relationship