Medication administration process in a residential aged care home: An observational study

Area of Science:

• Gerontology
• Nursing Practice
• Patient Safety

Background:

• Understanding nurses' medication administration processes is vital for improving safety systems.
• Actual nursing workflows must be understood to enhance medication safety in aged care.

Purpose of the Study:

• To elucidate the medication administration process in residential aged care facilities.
• To identify deviations within this process that could impact patient safety.

Main Methods:

• Direct observation of seven nurses during 12 morning medication rounds in an Australian residential aged care home.
• Utilized an activity theoretical framework to guide observational data collection.

Main Results:

• A common medication administration workflow was identified, from preparation to documentation and verification.
• Fifteen process deviations were noted, posing risks to safe medication administration.
• Electronic medication administration records showed potential to mitigate documentation-related deviations.

Conclusions:

• The study details the medication administration process and identifies specific deviations in aged care.
• A safety checklist is proposed to evaluate nursing practices and enhance medication administration.
• Nursing managers should understand workflows, deviations, and their contexts to build robust medication safety systems.