Gransjön Craftman Asa, Hammar Lena M, von Strauss Eva, Hillerås Pernilla, Westerbotn Margareta
Sophiahemmet University, Stockholm, Sweden.
Aging Research Center (ARC) Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Int J Older People Nurs. 2015 Sep;10(3):201-10. doi: 10.1111/opn.12073. Epub 2014 Dec 16.
Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.
The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.
Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.
According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.
Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.
This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.
在市政社会护理中，为受护理者给药的工作被委托给家庭护理助理，他们同时还负责为老年人提供个人护理服务。家庭护理助理具备实际的给药技能，但缺乏正规的医学知识。
本研究旨在探讨家庭护理助理如何看待在社会护理背景下委托给他们的、为居家老年人给药的工作。
开展了由19名家庭护理助理组成的4个焦点小组。采用定性内容分析法对数据进行分析。
据家庭护理助理称，健康和社会护理依赖于委托安排才能有效运作，但首先它减轻了地区护士的负担。即使委托已经到期，给药工作仍在继续，使监管法规处于从属地位。家庭护理助理对委托法规的内容了解不足。接受给药委托已成为该市社会护理工作的一个隐含前提。
接受给药委托是不可避免且司空见惯的。在实践中，监管法规被置于从属地位，因此患者安全可能受到威胁。健康和社会护理的组织依赖委托安排来满足越来越多居家护理受助者的需求。
这是医疗行业和市政社会护理的管理层都需要解决的一项关键任务，以弥合法规与实践之间的差距，为了受护理者的最大利益创建相互协作的平台，并确保患者安全。
