The perspectives of health care professionals on self-administration of medication - a field study in a general surgical ward

Abstract

Aim : To investigate the perspectives of healthcare professionals on self-administration of medication for patients admitted to a general surgical ward. Background: Self-administration of medication focuses on patient involvement in care and increases patients’ insight into prescribed medication. However, concerns and resistance from health professionals regarding self-administration may be an obstacle. Methods: A field study with participant observation and qualitative interviews included 7 healthcare professionals: 3 pharmaconomists and 4 nurses. Data analysis took a phenomenological-hermeneutic approach. Results: The study revealed 3 themes: firstly, “getting through the eye of the needle” was about the processes by which patients were evaluated as being suitable for self-administration; secondly, “being in control and losing control” reflected the importance of having control over medication processes and the fear that relinquishing control would result in medical errors; thirdly, “insight and independence” reflected health professionals’ recognition that patients performing self-administration gained greater insight into their medication and a greater sense of independence. Conclusion: Implementation of self-administration of medication illustrated the dilemma health professionals are facing with a healthcare system changing from a paternalistic ideology, where nurses are expected to be in control of the medication, to a patient empowerment participation ideology where the professionals have to relinquish control of the administration of medication and support patient autonomy and this was difficult for the nurses. Lack of knowledge about how to provide care in an empowerment participation ideology resulted in insufficient communication with patients about administration of medication and could result in medication errors.