Taking medicines is a frequent problem for patients with dysphagia (PWD). This study aimed to: identify the nature of the problems encountered by patients and healthcare professionals; quantify the problems in an acute care setting; trial individual medicine administration guides (I-MAGs) in order to help nurses correctly administer medicines to PWD. Methods A qualitative methodology was used comprising of interviews with PWD to gain an in-depth insight into taking medicines and a focus group of healthcare professionals to explore the problems of medicine administration. Direct observation of medicine administration rounds was utilized to identify if the medicine administration error (MAE) rate and severity was greater for PWD than those without in four acute hospitals in the UK. In one of the hospitals a controlled trial of I-MAGs was employed together with direct observational medicine rounds and nurse questionnaires to identify if the MAE rate for PWD could be decreased and if the I-MAGs led to an increase in nurses' knowledge. Results The qualitative research identified eight themes the central two being the importance of medicine formulation for PWD and the identification that medicine management falls into the province of five different professional groups putting the PWD at risk of fragmented care. The MAE rate was significantly higher for PWD than for patients without, and was even higher for those with enteral tubes. There was however no difference in error severity. Introduction of I-MAGs did not result in a decrease in MAEs on the intervention wards or an increase in nurses' knowledge. Unexpectedly the MAE rate fell significantly on the control wards. Conclusions Medicine management for PWD crosses discipline boundaries and requires those professionals to work together to reduce MAEs and ensure patients receive their medicines in a formulation which they can take safely.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:577563 |
| Date | January 2012 |
| Creators | Kelly, Jennifer |
| Publisher | University of East Anglia |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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