Safe to crush? A pilot study into solid dosage form modification in aged care.

Area of Science:

• Geriatric Pharmacy
• Medication Management
• Aged Care Quality

Background:

• Medication administration in aged care facilities (ACFs) presents unique challenges.
• Solid dosage form modification, such as crushing tablets, is common but carries risks.
• Assessing current practices and staff knowledge is vital for resident safety.

Purpose of the Study:

• To observe medication solid dosage form modification practices in ACFs.
• To evaluate nursing staff's self-perceived knowledge regarding medication modification.
• To identify the resources available to staff for medication modification.

Main Methods:

• Direct observation of medication rounds in Australian Capital Territory ACFs.
• Assessment of nursing staff's knowledge of medication dosage form modification.
• Evaluation of available resources for medication modification.

Main Results:

• 75 medications were modified across 160 observations, with 32% deemed inappropriate.
• Crushing techniques led to drug mixing, spillage, and incomplete dosing.
• Staff reported adequate resources but lacked knowledge on their effective use.

Conclusions:

• A high incidence of inappropriate medication crushing was observed.
• Inadequate knowledge of resource utilization contributes to unsafe practices.
• Targeted staff training is essential to improve medication modification safety in ACFs.