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Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province
Thesis (MNur)--Stellenbosch University, 2021.
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Stellenbosch : Stellenbosch University
2021
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| _version_ | 1867613887671566336 |
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| access_status_str | Open Access |
| author | Nicholson, Emerentia Cynthia |
| author2 | Damons, Anneleen |
| author_browse | Damons, Anneleen Nicholson, Emerentia Cynthia |
| author_facet | Damons, Anneleen Nicholson, Emerentia Cynthia |
| author_sort | Nicholson, Emerentia Cynthia |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description | Thesis (MNur)--Stellenbosch University, 2021. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/109866 |
| institution | Stellenbosch University (South Africa) |
| language | en_ZA |
| last_indexed | 2026-06-10T12:43:16.997Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2021 |
| publishDateRange | 2021 |
| publishDateSort | 2021 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/109866 Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province Nicholson, Emerentia Cynthia Damons, Anneleen Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Nursing & Midwifery. Drugs -- Administration -- Cape Town (South Africa) Old age homes -- Cape Town (South Africa) Older people -- Health and hygiene-- Cape Town (South Africa) Nurses -- Cape Town (South Africa) UCTD Thesis (MNur)--Stellenbosch University, 2021. ENGLISH SUMMARY : Background: With the current population growth, the population is also ageing which leads to more chronic diseases and the elderly receiving multiple medications. In South Africa, the Western Cape Province has the third-largest proportion of elderly persons (Statistics South Africa, 2019). However, limited published research exists on factors associated with safe medication administration in residential facilities for older persons, which attest to the fact that the safety of vulnerable older persons receives little attention. To address this gap in knowledge, the research aimed to determine the factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province. Methods: After obtaining ethics approval from The Health Research Ethics Committee of Stellenbosch University (S19/10/252) as well as permission from the residential facilities for older persons, a non-experimental cross-sectional descriptive design was applied, with a quantitative approach. Pre-testing of a self-administered validated questionnaire during a pilot test allowed for modifications to enhance reliability, validity, and appropriateness for the South African context. With the application of a stratified sampling method, 10 funded and 18 private residential facilities for older persons within the Metro-North, Western Cape Provence, were included. Study participants comprised of all three nurse categories, namely Professional nurses (registered nurses) (RNs) n=60 (48.8%), Enrolled nurses (ENs) n=35 (28.5%), and Nursing auxiliary (assistants) (ENAs) n=28 (22.8%). The response rate was n=123 (60.6%) of the total study population of N=203. Descriptive and inferential analyses were performed using the Statistical Package for the Social Sciences Version 27 (SPSS27), with the support of a biostatistician. Results are presented in bar graphs, tables, and figures. Results: The description of the results is according to the components in Donabedian’s Structure-Process-Outcome standards of the Quality of Care Model (2005:691-729). Study results showed that the workforce was mature, with n=34 (27.6%) having more than nine years of work experience. A total of n=43 (35.0%) did not receive medication training in the last five years. Increased workloads n=93 (75.6%) was perceived by participants as the highest source of job pressure. Organisational resources and infrastructures showed constraints in terms of medication storage difficulties, n=56 (45.5%), and blisters in an incorrect order, n=68 (55.3%). Procedures followed by the nurses during medication administration indicated various weaknesses, such as the negation of the performing of thorough checks in favour of administering medications based on assumptions that it would be correct, as n=95 (77.2%) will not check the content of blisters or containers, assuming it was correct. This was despite n=102 (82.9%) of the study participants who did come across incorrect content when administering medications. Furthermore, a witness signature was not required when making amendments to the MARs, n=47 (38.2%). A total of n=5 (4.1%) conceded that they signed the MAR charts before administering the medications. The use of technology was limited, as almost half of the participants did not use computers in the workplace, n=58 (47.2%). Missing of medication altogether was the most predominant medication error encountered in the facilities, n=79 (64.8%). Statistical tests showed a significant correlation between medications administered at the wrong times and interruptions during medication rounds p = <.001. Also, the most common error of medication accountability was not signing for medication administered, n=70 (56.9%). Conclusion: From these study results, it was clear that determining the factors associated with safe medication administration in the residential facilities for older persons could assist with avoiding medication errors among older persons to prevent harm and death. Recommendations regarding the implementation of the prescribed staffing model and increased medication training should be emphasised. A multifaceted approach is advised to address constraints such as bulky medication storage systems and inadequate workflow processes. Facilities should develop and implement risk management strategies to encourage medication error reporting. Also, further research is needed to identify the prevalence of medication errors in residential facilities for older persons. Therefore, the constant review of evidence-based practices can ensure effective ways to provide for the needs of the vulnerable elderly. AFRIKAANSE OPSOMMING : Agtergrond: Met die huidige bevolkingsgroei verouder die bevolking ook en dit lei tot meer kroniese siektes en bejaardes wat verskeie medikasies ontvang. In Suid-Afrika het die Wes-Kaap Provinsie die derde grootste persentasie bejaardes (Statistieke Suid-Afrika, 2019). Meer nog, beperkte gepubliseerde navorsing bestaan oor faktore geassosieer met veilige medikasietoediening in residensiële fasiliteite vir ouer mense, en dit is ’n bewys dat die veiligheid van kwesbare ouer mense min aandag ontvang. Om hierdie gaping in kennis aan te spreek, was die doel van die navorsing om die faktore geassosieer met veilige medikasietoediening in spesifieke residensiële fasiliteite vir ouer mense in die Metro-Noord, Wes-Kaap Provinsie te bepaal. Metode: Na die verkryging van etiese goedkeuring by die Gesondheidsnavorsingsetiekkomitee aan die Universiteit Stellenbosch (S19/10/252) asook toestemming van die residensiële fasiliteite vir ouer mense is ’n nie-eksperimentele, beskrywende, deursnee navorsingsontwerp met ’n kwantitatiewe benadering gevolg. Vooraf toetsing van 'n self-geadministreerde gevalideerde vraelys is tydens ’n loodstoetsing geïmplementeer en het veranderinge toegelaat om betroubaarheid, geldigheid en toepaslikheid vir die Suid-Afrikaanse konteks te verbeter. Met die toepassing van ’n gestratifiseerde steekproefmetode is 10 befondsde en 18 privaat residensiële fasiliteite vir ouer mense in die Metro-Noord, Wes-Kaap Provinsie, ingesluit. Studiedeelnemers het bestaan uit al drie verpleegkundige kategorieë, naamlik Professionele (geregistreerde) verpleegkundiges (GV’s) n=60 (48.8%), Ingeskrewe verpleegkundiges (IV's) n=35 (28.5%), en Ingeskrewe verpleeghulpe (IVH’s) n=28 (22.8%). Die reaksiekoers was N=123 (60.6%) van die totale studiebevolking van N=203. Beskrywende en afgeleide ontledings is uitgevoer met behulp van die Statistiese Pakket vir Sosiale Wetenskappe, weergawe 27 (SPSS27), met die steun van 'n biostatistikus. Resultate word in staafgrafieke, tabelle en figure aangebied. Resultate: Die beskrywing van die resultate is volgens die komponente in Donabedian se Kwaliteit van Sorg Model naamlik: Struktuur, Proses, en Uitkomste ( Donabedian, 2005:691–729). Studieresultate het getoon dat die arbeidsmag volwasse was, met n=34 (27.6%) met meer as nege jaar se werkservaring in bejaardesorg. 'n Totaal van n=43 (35.0%) het nie medikasie-opleiding in die afgelope vyf jaar ontvang nie. Verhoogde werklading n=93 (75.6%) is deur deelnemers beskou as die grootste bron van werksdruk. Organisatoriese hulpbronne en infrastruktuur het beperkings ten opsigte van medikasiebergingsprobleme getoon, n=56 (45.5%), en “blisterpakke” in verkeerde volgorde, n=68 (55.3%). Die prosedures wat die verpleegsters tydens medikasietoediening gevolg het, het verskeie swakhede aangedui, soos die verwaarlosing van die uitvoering van deeglike kontroles ten gunste van die toediening van medikasie gebaseer op aannames dat dit korrek sou wees, soos aangedui deur n=95 (77.2%) wat nie die inhoud van “blisterpakke” of houers nagaan nie, maar bloot sou aanvaar dat dit korrek was. Dit was ten spyte van n =102 (82.9%) van die studiedeelnemers wat verkeerde inhoude teëgekom gekom het wanneer medikasie toegedien is. Verder was ’n getuiehandtekening nie nodig wanneer wysigings aan die medikasietoedieningsrekords gemaak is nie, n=47 (38.2%). ’n Totaal van n=14 (11.4%) het toegegee dat hulle die medikasietoedieningsrekords onderteken het voordat hulle die medikasie toegedien het. Die gebruik van tegnologie was beperk, aangesien byna die helfte van die deelnemers nie rekenaars in die werkplek gebruik het nie, n=58 (47.2%). Die algehele uitlating van medikasie was die mees oorheersende medikasiefout wat in die fasiliteite teëgekom is, n=79 (64.8%). Statistiese toetse het ’n beduidende korrelasie getoon tussen medikasie wat op die verkeerde tye toegedien is en onderbrekings tydens medikasierondtes p = <.001. Daarbenewens was die mees algemene fout van medikasie-aanspreeklikheid die versuim om te teken vir medikasie wat toegedien was, n=70 (56.9%). Slotsom: Uit hierdie studieresultate was dit duidelik dat die bepaling van die faktore wat met veilige medikasietoediening in die residensiële fasiliteite vir ouer mense geassosieer word, kan help met die vermyding van medikasiefoute onder ouer mense om skade en dood te voorkom. Aanbevelings oor die implementering van die voorgeskrewe personeelmodel en verhoogde medikasieopleiding moet beklemtoon word. ’n Veelsydige benadering word aangeraai om beperkings soos lywige medikasiestoorstelsels en onvoldoende werkvloeiprosesse aan te spreek. Fasiliteite moet risikobestuurstrategieë ontwikkel en implementeer om medikasiefoutverslagdoening aan te moedig. Verdere navorsing is ook nodig om die voorkoms van medikasiefoute in residensiële fasiliteite vir ouer mense te identifiseer. Daarom kan die konstante hersiening van bewysgebaseerde praktyke effektiewe maniere verseker om vir die behoeftes van kwesbare bejaardes voorsiening te maak. Masters 2021-02-24T20:57:36Z 2021-04-21T14:29:28Z 2021-02-24T20:57:36Z 2021-04-21T14:29:28Z 2021-03 Thesis http://hdl.handle.net/10019.1/109866 en_ZA Stellenbosch University xvi, 248 pages ; illustrations, includes annexures application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Drugs -- Administration -- Cape Town (South Africa) Old age homes -- Cape Town (South Africa) Older people -- Health and hygiene-- Cape Town (South Africa) Nurses -- Cape Town (South Africa) UCTD Nicholson, Emerentia Cynthia Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province |
| title | Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province |
| title_full | Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province |
| title_fullStr | Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province |
| title_full_unstemmed | Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province |
| title_short | Factors associated with safe medication administration in specified residential facilities for older persons within the Metro-North, Western Cape Province |
| title_sort | factors associated with safe medication administration in specified residential facilities for older persons within the metro north western cape province |
| topic | Drugs -- Administration -- Cape Town (South Africa) Old age homes -- Cape Town (South Africa) Older people -- Health and hygiene-- Cape Town (South Africa) Nurses -- Cape Town (South Africa) UCTD |
| url | http://hdl.handle.net/10019.1/109866 |
| work_keys_str_mv | AT nicholsonemerentiacynthia factorsassociatedwithsafemedicationadministrationinspecifiedresidentialfacilitiesforolderpersonswithinthemetronorthwesterncapeprovince |