Abstract

BackgroundResidents living in sheltered housing depend on help from healthcare personnel (HCP) with medication management, regarding regular long-term and pro re nata (PRN) medication. The HCP assess the need for PRN medication prior to administration to the residents. The purpose of this study was to describe HCP’s perceptions of factors affecting PRN medication management in sheltered housing for older adults.MethodThis was a qualitative study with five focus-group interviews with 22 HCP working in sheltered housing for older adults. The HCP were heterogenous regarding scholarly education and experiences, working in four different municipalities in mid-Norway, representing urban, sub-urban and rural districts. The analysis was inductive, based on qualitative, manifest, content analysis. The main outcome was HCP perceptions of the factors affecting PRN medication management in sheltered housing.ResultsFour main factors affecting the PRN medication management were identified in the data and were related to either: 1) the medication; 2) the resident; 3) the HCP; or 4) the organisation. These categories included 14 subcategories. Overall, the HCP described the management of PRN medication as a complex process, where the above factors all have impact on the residents’ health and safety.ConclusionHCP working in sheltered housing describe that PRN medication management is affected by numerous human factors, that consequently may affect patient outcomes and safety. HCP involved in PRN medication management should be aware of factors that affect their decision-making, and safe management requires a professional practice built on medicines competence, practical skills and experience.

Highlights

  • Residents living in sheltered housing depend on help from healthcare personnel (HCP) with medication management, regarding regular long-term and pro re nata (PRN) medication

  • Four main factors affecting the PRN medication management were identified in the data and were related to either: 1) the medication; 2) the resident; 3) the HCP; or 4) the organisation

  • This study describes four main areas that affect PRN medication management, according to HCP working in sheltered housing for older adults

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Summary

Introduction

Residents living in sheltered housing depend on help from healthcare personnel (HCP) with medication management, regarding regular long-term and pro re nata (PRN) medication. The HCP assess the need for PRN medication prior to administration to the residents. The purpose of this study was to describe HCP’s perceptions of factors affecting PRN medication management in sheltered housing for older adults. In German nursing homes, it was reported that 74.9% of the patients were treated with one or more PRN medications, for which analgesics and psycholeptics were the most often used [6]. An Australian study from nursing homes suggested that administrating PRN was too ‘easy’; for example giving tranquilisers to patients, with the aim of producing a calm shift or to avoid disturbing other residents, and that PRN medication is more frequently administered on night shifts [10]. A Norwegian study reports on a general overuse of PRN medication in nursing homes, but occasionally PRN underuse or misuse [7]

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