Gransjön Craftman Åsa, Grape Charlotte, Ringnell Katarina, Westerbotn Margareta
Sophiahemmet University, Stockholm, Sweden.
Department of Clinical Science and Education, Söodersjukhuset, Karolinska Institutet, Stockholm, Sweden.
J Clin Nurs. 2016 Nov;25(21-22):3189-3198. doi: 10.1111/jocn.13335. Epub 2016 Jul 27.
The aim was to describe registered nurses' experience in the context of delegating the administration of medication to unlicensed personnel in residential care homes.
The residents in residential care homes have a need for extensive care and nursing, and large amounts of medicines are common practice. Registered nurses' workload and difficulties in fulfilling their duties, such as administration of medicines, have led to frequent delegation of this task between the registered nurses and unlicensed assisting personnel. It is, of course, a great responsibility to ensure that the care of the older people remains safe while maintaining quality in the prevailing situation.
A qualitative inductive descriptive study.
Data were collected using audio-recorded semistructured interviews with a purposive sample of 18 registered nurses and interpreted using manifest content analysis. The study was approved by the ethical research committee.
Registered nurses found the organisation unsupportive with regard to nursing interventions. The delegation context was experienced as a grey zone; the rules and regulations were not in line with the unspoken expectation to delegate the administration of medicine to unlicensed personnel, in order to be able to manage their daily work.
The slimmed organisation of residential care homes relies upon registered nurses' use of delegation of medicine administration to unlicensed assistant personnel. It becomes an inevitable assignment entailing a challenging responsibility for patient safety and the quality of care.
The results of this study may contribute to a better understanding of the complexity of caring for older people in residential care homes and to improving the work environment of all healthcare personnel.
描述注册护士在养老院将给药工作委托给无执照人员的背景下的经历。
养老院的居民需要广泛的护理，大量用药是常见的做法。注册护士的工作量以及履行职责（如给药）的困难，导致这项任务在注册护士和无执照辅助人员之间频繁委托。当然，在当前情况下确保老年人护理安全并维持质量是一项重大责任。
一项定性归纳描述性研究。
通过对18名注册护士的有目的抽样进行录音半结构化访谈收集数据，并使用显性内容分析法进行解读。该研究获得了伦理研究委员会的批准。
注册护士发现该组织在护理干预方面不提供支持。委托给药的情况被视为一个灰色地带；规章制度与将给药工作委托给无执照人员的潜在期望不一致，以便能够管理日常工作。
养老院精简的组织架构依赖于注册护士将给药工作委托给无执照辅助人员。这成为一项不可避免的任务，对患者安全和护理质量带来具有挑战性的责任。
本研究结果可能有助于更好地理解养老院中照顾老年人的复杂性，并改善所有医护人员的工作环境。
