An exploration of the prescribing and administration of medicines in a sample of UK care homes

Cheng, Vicky 2021. An exploration of the prescribing and administration of medicines in a sample of UK care homes. PhD Thesis, Cardiff University. Item availability restricted.

	PDF - Accepted Post-Print Version Download (44MB)
	PDF (Cardiff University Electronic Publication Form) - Supplemental Material Restricted to Repository staff only Download (105kB)

Abstract

Residents of care homes are some of the most vulnerable members of society and are particularly susceptible to medicines harm. The safe and effective management of medicines helps to maintain or improve the quality of life of residents. However, there have been concerns surrounding poor prescribing and medicines administration practices within the setting. The aim of this thesis was to explore current prescribing and medicines administration practices in a sample of UK care homes, and to understand whether senior carers could administer medicines safely and effectively. Medicines administration data was extracted from a digital medication management system (PCS™) to explore prescribing patterns, and medicines administration by staff in nursing homes. Semi-structured interviews and surveys were used to explore staff perceptions of senior carers administering medicines under the delegation of nurses. Analysis showed that a significant number of residents were prescribed medicines commonly associated with adverse outcomes in older adults. These included anticholinergic drugs (50%), hypnotics and/or anxiolytics (30%), analgesics (49%), and antimicrobials (24%). Although senior carers were at least as competent as nurses in administering medicines (no statistically significant differences in error rates; pvalue> 0.05), 92% of residents were exposed to medication administration errors during the three-month study period. Interviews and surveys explored staff perceptions of medication administration errors in care homes and a number of themes were identified notably the need for medicines training by senior carers. The findings from this thesis have highlighted that the quality of prescribing and medicines administration remains suboptimal in care homes, and the issues identified may ultimately cause resident harm. New models of care, such as senior carers administering medicines in nursing homes may fail if systemic issues which give rise to such issues are not addressed. Therefore, exploring strategies to efficiently safeguard the quality of medicines management in this setting should be prioritised.

Item Type:	Thesis (PhD)
Date Type:	Completion
Status:	Unpublished
Schools:	Pharmacy
Subjects:	Q Science > Q Science (General)
Date of First Compliant Deposit:	15 July 2021
Last Modified:	02 Aug 2022 01:12
URI:	https://orca.cardiff.ac.uk/id/eprint/142540

Actions (repository staff only)

Edit Item