A review of factors that contribute to sub‐optimal medication management for older adult with dementia in residential care settings: Nurses’ perspectives

Abstract

AbstractBackgroundMedication use can play an important role in the health and well‐being of people with dementia in the long‐term care facilities. However, nurses often find the process of managing medicines for this population to be complex and challenging. As a result, various strategies are being employed to facilitate the medication management process including altering or modifying medications, hiding medication in food or drink of residents, and deviation from the ‘rights’ of medication administration (Barnes et al., 2006; Mc Gillicuddy et al., 2017; Mercovich et al., 2014; Qian et al. 2018; Serrano Santos et al., 2016; Thomson et al., 2009; Verrue et al., 2011; Wright, 2002). These practices are associated with increased risk of medication errors (Kartunen et al., 2019). Despite this, factors contributing to these practices are not well understood.MethodA comprehensive search of CINAHL, Medline, SOCIndex, PubMed, and PsychINFO databases was conducted between November and December 2019. ProQuest Dissertations and Theses and Google Scholar were used to search for gray literature. No date limitation was applied. A modified form of standardized critical appraisal tool known as mixed method appraisal tool (MMAT) was used to assess the quality of the papers (Hong, Gonzalez‐Reyes, & Pluye, 2018). Nvivo was used to extract findings. Data synthesis was done using convergent synthesis approach, more specifically, thematic analysis (Hong et al. 2017).ResultThe search resulted in 806 unique titles for screening. A total of 96 abstracts were screened, after which a full‐text review conducted for 59 articles. After the full‐text review, 12 articles were eligible to be included in the final report. The findings highlighted 2 major factors: individual and system factorsConclusionThere is need for both individual and system interventions to facilitate safe medication management for residents with dementia.