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J Clin Nurs. 2013 Feb;22(3-4):569-78. doi: 10.1111/j.1365-2702.2012.04262.x. Epub 2012 Sep 17.

District nurses' perceptions of the concept of delegating administration of medication to home care aides working in the municipality: a discrepancy between legal regulations and practice.

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1
Sophiahemmet University College, Aging Research Center (ARC), Karolinska Institutet, Stockholm, Sweden. asa.craftman@shh.se

Abstract

AIMS AND OBJECTIVES:

To describe district nurses' perceptions of the concept of delegating medication management to unlicensed personnel working in municipal social care.

BACKGROUND:

The delegation of medical tasks involves responsibility and is regulated by law to avoid damage and injuries and to protect the patient. The delegation of the administration of medication is a multifaceted task. The delegating district nurse is responsible for the outcome and should also follow up the delegated task.

DESIGN:

A descriptive qualitative study, involving semi-structured interviews and content analysis.

METHODS:

Twenty district nurses were interviewed. The interviews were audio taped. The data were collected from April 2009-August 2010 and analysed using content analysis.

RESULTS:

The findings revealed that the statutes of delegation appear to be incompatible with practice, however, mostly due to lack of time. Communication between district nurses and home care aides, as well as tutoring, was regarded as important. The district nurses found it imperative to be available to the home care aides and made an effort to create a trusting atmosphere.

CONCLUSIONS:

District nurses cannot manage their workload without delegating the administration of medication in the present organisational model of health care and social care. The statutes regarding delegating medicine tasks are also cumbersome and difficult to incorporate for district nurses who are responsible for the delegation.

RELEVANCE TO CLINICAL PRACTICE:

The findings elucidate the current situation as regards district nurses and the need to delegate the administration of medication. Health care and social care for home-dwelling older patients, as well as statutes, needs to be evaluated and updated to meet and be prepared for the increasing demands of care.

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