Medication administration in aged care facilities: A mixed-methods systematic review.

Area of Science:

• Gerontology
• Pharmacology
• Healthcare Management

Background:

• Medication administration in aged care facilities presents complex clinical and interpersonal challenges.
• Existing research lacks synthesis of evidence on perspectives of aged care workers, residents, and families regarding medication administration.
• Understanding these challenges is crucial for improving care quality and resident safety.

Approach:

• A mixed-methods systematic review was conducted, synthesizing data from 128 studies.
• Searches were performed across multiple databases (AMED, CINAHL, MEDLINE, EMBASE, EMCARE, PsycINFO, Scopus, Web of Science) in June 2023.
• Data were analyzed using convergent synthesis, thematic synthesis, and meta-analysis, adhering to PRISMA guidelines.

Key Points:

• Five themes emerged: staffing concerns, resident roles, medication decision-making, electronic records, and medication errors.
• Educational interventions for aged care workers significantly reduced medication administration errors (OR=0.37, p<.001).
• Dose form modification and medication omissions were noted, sometimes to enforce adherence, highlighting complex clinical decision-making.

Conclusions:

• Medication administration requires acknowledgment as both a clinical and interpersonal task.
• Enhanced resident and family engagement in medication administration is vital for improving adherence, satisfaction, and quality of care.
• Future research should focus on decision-making in dose form modification and supporting resident engagement.