Åsa Gransjön Craftman1, Charlotte Grape2, Katarina Ringnell2, Margareta Westerbotn2,3. 1. Sophiahemmet University, Stockholm, Sweden. asa.craftman@shh.se. 2. Sophiahemmet University, Stockholm, Sweden. 3. Department of Clinical Science and Education, Söodersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Abstract
AIMS AND 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. DESIGN: 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. RELEVANCE TO CLINICAL PRACTICE: 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.
AIMS AND 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. DESIGN: 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. RELEVANCE TO CLINICAL PRACTICE: 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.