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    Quality and continuity of medication management when people with dementia transition between the care home and hospital setting

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    PhD Thesis (3.318Mb)
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    Publication date
    2020
    Author
    Hill, Suzanne E.
    Supervisor
    Blenkinsopp, Alison
    Alldred, David P.
    Quinn, Catherine
    Keyword
    Care homes
    Hospitals
    Dementia
    Medicines management
    Transitions of care
    Medications management
    Rights
    Creative Commons License
    The University of Bradford theses are licenced under a Creative Commons Licence.
    Institution
    University of Bradford
    Department
    Faculty of Health Studies
    Awarded
    2020
    
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    Abstract
    Improving medication management at transitions of care is a national and international priority. People with dementia, who transition between hospitals and care homes, can be at an increased risk of adverse events, harm and costly re-hospitalisation. There is limited research which examines factors which may influence the quality and continuity of medication management in this context, particularly in the UK. This research uses a systems approach to explore the factors which may influence the quality and continuity of medication management when people, with dementia, move between the care home and hospital setting. This multi method, multi-phase study included interviews with hospital staff, care home staff, residents with dementia and relatives and examination of policies and documents used to support medication management at transition. Overall, policy recommendations and implementation strategies to support medication management at transition were limited. Residents, staff and relatives emphasised the importance of administration routines and preferences, but there were no strategies to support the communication of this information. Procedures, tools and training to support care homes based medication reconciliation was also limited. Residents and relatives were rarely involved in medication management due to limited resources and decision making. This sustained, rather than challenged, the power imbalance between residents and staff. Better defined roles and integrated processes which take account of the needs of this transition may help residents, relatives and care home staff to feel valued and empowered to provide information which supports person-centred medication management and boost resilience by helping to identify medication errors or adverse events.
    URI
    http://hdl.handle.net/10454/19062
    Type
    Thesis
    Qualification name
    PhD
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