Developing a medicines management intervention in older patients with dysphagia

Serrano Santos, Jose Manuel (2015) Developing a medicines management intervention in older patients with dysphagia. Doctoral thesis, University of East Anglia.

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Abstract

Background
Administering medication to patients with dysphagia (PWD) is a challenging process for patients and healthcare professionals (HCPs). This study aimed to improve those administrations by focusing on the development of the elements of a pharmacy service providing individualised guidance on the administration of medication to older PWD in care homes. The objectives were to:- assess the feasibility of a pharmacy service promoting guidance on the administration of medication to PWD, - identify and develop theory on the elements that affect the administration of medication to PWD in care homes,
- identify outcomes for the modelling process previous to a large scale
intervention.
Methods
A questionnaire was designed to evaluate the acceptability by HCPs of a pharmacy service for PWD in hospital wards. Qualitative interviewing was used in care homes to explore the perceptions of nurses on the administration of medication to PWD and nurse’s acceptability of a pharmacy service providing individualised
medication administration guides (I-MAGs). Observational drug rounds were carried out in care homes to describe the quality, type and frequency of errors in the administration of medication to PWD.
Results
I-MAGs were well received on the hospital wards and nurses felt more confident and time efficient in their practice when the I-MAGs were present on the ward. Interviews identified the isolating environment of the care home, the importance of formulation choice, the lack of awareness of dysphagia and gaps in nurse’s pharmaceutical knowledge as barriers in the medicines management of PWD.
Observational drug rounds revealed that medicine administration errors (MAEs) in care homes (excluding time errors) are three times more frequent in PWD than in those without.
Conclusion
Medicines management for PWD requires a multidisciplinary approach from several HCPs and consequently PWD could benefit from interventions that overcome the practice barriers between those HCPs.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Science > School of Pharmacy
Depositing User: Users 2593 not found.
Date Deposited: 29 Nov 2017 12:30
Last Modified: 09 Mar 2021 09:49
URI: https://ueaeprints.uea.ac.uk/id/eprint/65622
DOI:

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