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ABSTRACT

Much attention has been paid to how the use of medicines by older people can be improved. In the UK, the National Service Framework for Older People set out how health and social care providers can ensure older people gain maximum benefit from prescribed medication and prevent unnecessary illness caused by its inappropriate use.
Social care workers are increasingly involved in medication related activities for older people living at home. Medication management for older people is a complex and potentially hazardous process. Clinical governance encourages NHS providers to tackle adverse events and yet neither policy nor research has paid attention to the risks associated with the involvement of social care workers in medication management.
This poster describes an empirical study undertaken to understand the circumstances in which social care worker involvement in medication related activities for older people living at home might jeopardise patient safety and to identify ways of diminishing the risk of adverse events.
The study adopted a systems approach to understanding human error. This approach has generated a number of conceptual models and practical tools to help specify the range of factors that predispose to adverse events in hospital settings. However none of these models have been used in domiciliary settings. The study sought to develop a framework specifying the range of factors that predispose to adverse events when medication related activities were transferred from district nurses (home nurses) to social care workers. Data were collected from open-ended interviews with 64 district nursing and home care personnel in two highly contrasting study sites.
The poster will define the conditions of safe and unsafe practice in relation to medication management for older people living at home. It will also consider what hazards distinguish domiciliary and hospital settings and the implications for risk management and current policy.