Home care service employees’ contribution to patient safety in clients with dementia who use dietary supplements: a Norwegian survey

Abstract

Objective To explore home care services (HCS) employees' professional experiences with the use of dietary supplements (DSs) in their clients with dementia. We also investigated their attributed professional responsibility concerning this use and their attitudes toward DSs in general. Differences between nurses and nurse assistants were investigated. Design A cross-sectional survey with self-administered questionnaires. Setting Home care services in six Norwegian municipalities in the period August-December 2016. Subjects A total of 231 (64% response rate) HCS employees; 78 nurses and 153 nurse assistants (auxiliary nurses and employees without formal education). Main outcome measures: Health care employees’ experiences with patient safety in clients with dementia who use DSs. Results Fifty per cent were concerned that clients with dementia might harm their health due to DS use. Thirty-one per cent reported having intervened in order to reduce the risk. Seventy-one per cent preferred to administer DSs to clients with dementia rather than leaving this responsibility to the clients. The respondents placed the responsibility for patient safety in clients with dementia using DSs mainly with the general practitioners, while they ascribed themselves and pharmacies a medium level of responsibility. There were only minor difference between nurses and nurse assistants, and no difference in attitudes towards DSs. Conclusion Employees in HCS were concerned about the DS use in clients with dementia. Moreover, almost one-third had intervened to improve clients' patient safety. The majority indicated that HCS should administer DSs rather than the clients with dementia themselves.KEY POINTS To our knowledge, this is the first study investigating the role of home care services with regard to patient safety in clients with dementia who use dietary supplements (DSs). •Home care service employees worried about patient safety related to DS use in clients with dementia. •Home care service employees attributed to themselves medium responsibility to ensure the safe use of DSs in these clients. •Lack of knowledge was the most important reason why home care service employees did not recommend DSs to clients.

Keywords

• home care services
• dietary supplements
• dementia
• patient safety
• risk management
• professional practice behavior
• attributed responsibility
• cross-sectional survey