Should Health Care Aides Assist With Medications in Long-Term Care?

Overview

Journal Gerontol Geriatr Med

Specialty Geriatrics

Date 2017 Feb 1

PMID 28138498

Citations 2

Authors

Mubashir Arain

Siegrid Deutschlander

Mahnoush Rostami

Esther Suter

Affiliations

Soon will be listed here.

Abstract

The objective of the study was to determine whether health care aides (HCAs) could safely assist in medication administration in long-term care (LTC). We obtained medication error reports from LTC facilities that involve HCAs in oral medication assistance and we analyzed Resident Assessment Instrument (RAI) data from these facilities. Standard ratings of error severity were "no apparent harm," "minimum harm," and "moderate harm." We retrieved error reports from two LTC facilities with 220 errors reported by all health care providers including HCAs. HCAs were involved in 137 (63%) errors, licensed practical nurses (LPNs)/registered nurses (RNs) in 77 (35%), and pharmacy in four (2%). The analysis of error severity showed that HCAs were significantly less likely to cause errors of moderate severity than other nursing staff (2% vs. 7%, chi-square = 5.1, value = .04). HCAs' assistance in oral medications in LTC facilities appears to be safe when provided under the medication assistance guidelines.

Citing Articles

Systematic review of types of safety incidents and the processes and systems used for safety incident reporting in care homes.

Scott J, Sykes K, Waring J, Spencer M, Young-Murphy L, Mason C J Adv Nurs. 2024; 81(1):69-115.

PMID: 38895931 PMC: 11638520. DOI: 10.1111/jan.16264.

Are healthcare aides underused in long-term care? A cross-sectional study on continuing care facilities in Canada.

Arain M, Deutschlander S, Charland P BMJ Open. 2017; 7(5):e015521.

PMID: 28515199 PMC: 5736087. DOI: 10.1136/bmjopen-2016-015521.

References

Fries B, SIMON S, Morris J, Flodstrom C, Bookstein F . Pain in U.S. nursing homes: validating a pain scale for the minimum data set. Gerontologist. 2001; 41(2):173-9. DOI: 10.1093/geront/41.2.173. View

Reinhard S, Young H, Kane R, Quinn W . Nurse delegation of medication administration for older adults in assisted living. Nurs Outlook. 2006; 54(2):74-80. DOI: 10.1016/j.outlook.2005.05.008. View

Hirdes J, Frijters D, Teare G . The MDS-CHESS scale: a new measure to predict mortality in institutionalized older people. J Am Geriatr Soc. 2003; 51(1):96-100. DOI: 10.1034/j.1601-5215.2002.51017.x. View

Field T, Gurwitz J, Avorn J, McCormick D, Jain S, Eckler M . Risk factors for adverse drug events among nursing home residents. Arch Intern Med. 2001; 161(13):1629-34. DOI: 10.1001/archinte.161.13.1629. View

Hewko S, Cooper S, Huynh H, Spiwek T, Carleton H, Reid S . Invisible no more: a scoping review of the health care aide workforce literature. BMC Nurs. 2015; 14:38. PMC: 4511030. DOI: 10.1186/s12912-015-0090-x. View

Baril C, Gascon V, St-Pierre L, Lagace D . Technology and medication errors: impact in nursing homes. Int J Health Care Qual Assur. 2015; 27(3):244-58. DOI: 10.1108/IJHCQA-03-2013-0029. View

Young H, Gray S, McCormick W, Sikma S, Reinhard S, Johnson Trippett L . Types, prevalence, and potential clinical significance of medication administration errors in assisted living. J Am Geriatr Soc. 2008; 56(7):1199-205. PMC: 2633588. DOI: 10.1111/j.1532-5415.2008.01754.x. View

Hussein S, Manthorpe J . An international review of the long-term care workforce: policies and shortages. J Aging Soc Policy. 2005; 17(4):75-94. DOI: 10.1300/J031v17n04_05. View

Zimmerman S, Love K, Sloane P, Cohen L, Reed D, Carder P . Medication administration errors in assisted living: scope, characteristics, and the importance of staff training. J Am Geriatr Soc. 2011; 59(6):1060-8. DOI: 10.1111/j.1532-5415.2011.03430.x. View

10.

Stone R, Harahan M . Improving the long-term care workforce serving older adults. Health Aff (Millwood). 2010; 29(1):109-15. DOI: 10.1377/hlthaff.2009.0554. View

11.

Charboneau A, Shelton P, Brickley J, Rich W . Medication errors and penalties in assisted living facilities. Consult Pharm. 2011; 26(8):554-65. DOI: 10.4140/TCP.n.2011.554. View

12.

Mallidou A, Cummings G, Schalm C, Estabrooks C . Health care aides use of time in a residential long-term care unit: a time and motion study. Int J Nurs Stud. 2013; 50(9):1229-39. DOI: 10.1016/j.ijnurstu.2012.12.009. View

13.

Woods D, Guo G, Kim H, Phillips L . We've got trouble: medications in assisted living. J Gerontol Nurs. 2010; 36(4):30-9. DOI: 10.3928/00989134-20100302-02. View

14.

Szczepura A, Wild D, Nelson S . Medication administration errors for older people in long-term residential care. BMC Geriatr. 2011; 11:82. PMC: 3254134. DOI: 10.1186/1471-2318-11-82. View

15.

Mor V, Branco K, Fleishman J, Hawes C, Phillips C, Morris J . The structure of social engagement among nursing home residents. J Gerontol B Psychol Sci Soc Sci. 1995; 50(1):P1-P8. DOI: 10.1093/geronb/50b.1.p1. View

16.

Barber N, Alldred D, Raynor D, Dickinson R, Garfield S, Jesson B . Care homes' use of medicines study: prevalence, causes and potential harm of medication errors in care homes for older people. Qual Saf Health Care. 2009; 18(5):341-6. PMC: 2762085. DOI: 10.1136/qshc.2009.034231. View