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Medication administration in Australian residential aged care: a time-and-motion study

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dc.contributor.authorChen, E.Y.H.
dc.contributor.authorBell, J.S.
dc.contributor.authorIlomaki, J.
dc.contributor.authorCorlis, M.
dc.contributor.authorHogan, M.E.
dc.contributor.authorCaporale, T.
dc.contributor.authorVan Emden, J.
dc.contributor.authorWestbrook, J.I.
dc.contributor.authorHilmer, S.N.
dc.contributor.authorSluggett, J.K.
dc.date.issued2021
dc.descriptionData source: Supporting information, https://doi.org/10.1111/jep.13393
dc.description.abstractRationale/aim: Medication administration is a complex and time-consuming task in residential aged care facilities (RACFs). Understanding the time associated with each administration step may help identify opportunities to optimize medication management in RACFs. This study aimed to investigate the time taken to administer medications to residents, including those with complex care needs such as cognitive impairment and swallowing difficulties. Method: A time-and-motion study was conducted in three South Australian RACFs. A representative sample of 57 scheduled medication administration rounds in 14 units were observed by a single investigator. The rounds were sampled to include different times of day, memory support units for residents living with dementia and standard units, and medication administration by registered and enrolled nurses. Medications were administered from pre-prepared medication strip packaging. The validated Work Observation Method By Activity Timing (WOMBAT) software was used to record observations. Results: Thirty nurses were observed. The average time spent on scheduled medication administration rounds was 5.2 h/unit of average 22 residents/day. The breakfast medication round had the longest duration (1.92 h/unit). Resident preparation, medication preparation and provision, documentation, transit, communication, and cleaning took an average of 5 minutes per resident per round. Medication preparation and provision comprised 60% of overall medication round time and took significantly longer in memory support than in standard units (66 vs 49 seconds per resident per round for preparation, 79 vs 58 for provision; P <.001 for both). Almost half (42%) of tablets/capsules were crushed in memory support units. The time taken for medication administration was not significantly different among registered and enrolled nurses. Conclusions: Nurses took an average of 5 minutes to administer medications per resident per medication round. Medication administration in memory support units took an additional minute per resident per round, with almost half of tablets and capsules needing to be crushed.
dc.identifier.citationJournal of Evaluation in Clinical Practice, 2021; 27(1):103-110
dc.identifier.doi10.1111/jep.13393
dc.identifier.issn1356-1294
dc.identifier.issn1365-2753
dc.identifier.urihttps://hdl.handle.net/11541.2/142417
dc.language.isoen
dc.publisherWiley
dc.relation.fundingNHMRC 9100000 Cognitive Decline Partnership Centre
dc.relation.fundingNHMRC Dementia Research Leadership Fellowship
dc.relation.fundingNHMRC Early Career Fellowships
dc.relation.fundingHelping Hand Aged Care
dc.relation.fundingHammondCare
dc.relation.fundingBrightwater
dc.relation.fundingDementia Australia
dc.relation.fundingMonash University
dc.rightsCopyright 2020 John Wiley & Sons
dc.source.urihttps://doi.org/10.1111/jep.13393
dc.subjectaged
dc.subjectlong-term care facilities
dc.subjectmedication administration
dc.subjectmedication safety
dc.subjecttime and motion study
dc.titleMedication administration in Australian residential aged care: a time-and-motion study
dc.typeJournal article
pubs.publication-statusPublished
ror.mmsid9916395309101831

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