| Goal of the study: To explore perceptions and concerns of registered nurses regarding safe medication administration in Skilled Nursing Facilities (SNFs) as well as nurse satisfaction with current medication administration systems.;Background: Complexity of care and medication regimens have significantly increased in SNFs. Current SNF residents include patients on ventilators, patients with feeding tubes, patients recovering from complicated postsurgical procedures as well as frail older adults with complex chronic diseases. As a result, the workload for SNF nurses has increased. Although medication management and administration demands have significantly increased, resident-to-nurse ratios have not correspondingly decreased.;Methods: In-depth interviews were conducted to study the perceptions of six registered nurses employed by three different SNFs located in Northern California. Interview questions included nurses' experiences and perceptions about barriers to safe medication administration, current medication administration systems and job training and orientation.;Results: Themes identified were: job training, nurse to resident ratio, complexity of resident care, electronic medication administration records (eMAR) and distractions during medication administration. All interviewees noted that distractions during medication administration were one of their biggest concerns. Other concerns with safe medication management included high resident-to-nurse ratios, increased complexity of residents' conditions, and insufficient training and orientation in the care units. All interviewees, experienced with both eMAR and paper medication administration records (MAR), agreed that eMAR provided safer medication management than MAR and delivered more accurate information regarding specific medications and administration times.;Conclusions: Increased complexity of care for SNF residents provides challenges and raises concerns for SNF nurses. Decreased distractions, increased nurse-to-resident ratio and implementation of eMAR could improve the safety of medication management and the quality of care for SNF residents. Further studies are necessary to explore the safety of medication management. |
