Safe medication administration in long-term elderly care assessed by nursing staff

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Leena Palotie auditorium 101A, Aapistie 5 A, Oulu

Topic of the dissertation

Safe medication administration in long-term elderly care assessed by nursing staff

Doctoral candidate

Master of Nursing Science Markus Karttunen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Medical Research Center Oulu

Subject of study

Nursing Science


Docent Päivi Kankkunen, University of Eastern Finland


Docent Satu Elo, University of Oulu

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Shortcomings in the medication safety in elderly care

A recent doctoral dissertation indicates that deviations from the instructions and recommendations of medication administration are common in long-term elderly care.

In his doctoral dissertation, Master of Nursing Science Markus Karttunen examined through a survey, the nursing staff's self-assessment of how they adhere to guidelines on safe medication administration during the medication process in long-term elderly care. The objective was to identify the challenges of safe implementation of medication administration in nursing.

Although most of the nurses who participated in the study estimated that they implement medication in a safe manner, almost half of the respondents stated that they deviate from the guidelines and recommendations for medication administration and the monitoring and evaluation of the effects of medication.

One third of nurses estimated that they do not always comply with the guidelines and recommendations when preparing medication. Nurses caused risks to patient safety by crushing medicines and opening capsules. In addition, shortcomings were observed in medication documentation.

Routine checks were not always performed at different stages of the medication administration process. On the basis of the nurses’ estimates, patient involvement in the medication administration process was not always completed.

However, according to the results, careful asepsis was implemented throughout the medication process.

The results showed that a nurse’s opinion of their own competence affected medication administration process. The better the nurse considered their skills in pharmacology, infection control and medication calculations, the better they seemed to implement medication. In addition, older nurses adhered to the instructions and recommendations of medication administration more thoroughly than young nurses.

The study was participated in by nearly 500 nursing professionals who implemented medication administration in their work and worked in municipal long-term elderly care units at the time of the survey.

“Drug therapy is an important but, at the same time, a challenging part of elderly care,” says Karttunen. “For example, estimating the effects of medication and identifying adverse effects become difficult as the body ages and the number of diseases increases.”

The majority of medicines used by the elderly are administered orally, but according to previous studies, as many as one third of long-term elderly care patients have difficulties in swallowing medication. Therefore, special attention should be paid to the pharmaceutical form as many medicines should not be halved or crushed.

To ensure that medication administration is always safe and effective, guidelines and recommendations should always be followed. Furthermore, the effects of medicines should be monitored continuously together with the patient or their relatives.

Health care operating units can use the information produced by the dissertation in developing medication processes, increasing the competence of health care personnel and influencing attitudes. The information is also useful for educational institutions and higher education institutions in the planning of basic and continuing education in medication administration.
Last updated: 1.3.2023