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Title: Developing a medicines management intervention in older patients with dysphagia
Author: Serrano Santos, Jose Manuel
ISNI:       0000 0004 6497 7603
Awarding Body: University of East Anglia
Current Institution: University of East Anglia
Date of Award: 2015
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Background: Administering medication to patients with dysphagia (PWD) is a challenging process for patients and healthcare professionals (HCPs). This study aimed to improve those administrations by focusing on the development of the elements of a pharmacy service providing individualised guidance on the administration of medication to older PWD in care homes. The objectives were to:- assess the feasibility of a pharmacy service promoting guidance on the administration of medication to PWD, - identify and develop theory on the elements that affect the administration of medication to PWD in care homes, - identify outcomes for the modelling process previous to a large scale intervention. Methods A questionnaire was designed to evaluate the acceptability by HCPs of a pharmacy service for PWD in hospital wards. Qualitative interviewing was used in care homes to explore the perceptions of nurses on the administration of medication to PWD and nurse’s acceptability of a pharmacy service providing individualised medication administration guides (I-MAGs). Observational drug rounds were carried out in care homes to describe the quality, type and frequency of errors in the administration of medication to PWD. Results I-MAGs were well received on the hospital wards and nurses felt more confident and time efficient in their practice when the I-MAGs were present on the ward. Interviews identified the isolating environment of the care home, the importance of formulation choice, the lack of awareness of dysphagia and gaps in nurse’s pharmaceutical knowledge as barriers in the medicines management of PWD. Observational drug rounds revealed that medicine administration errors (MAEs) in care homes (excluding time errors) are three times more frequent in PWD than in those without. Conclusion: Medicines management for PWD requires a multidisciplinary approach from several HCPs and consequently PWD could benefit from interventions that overcome the practice barriers between those HCPs.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available