Unlicensed personnel administering medications to older persons living at home : a challenge for social and care services

BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge. AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care. METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis. RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality. CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients. IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

Research methods in sales ethics: a review of the empirical literature

From a review of the empirical sales ethics literature, this paper reports findings about some of the research methods used to investigate the decision-making of sales practitioners under ethical conditions. The review identifies that several of the methodological deficiencies raised by previous reviewers of the literature have not been adequately addressed by subsequent researchers. The paper primarily reviews quantitative research studies because of their prevalence in the empirical sales ethics literature, and because studies similar to these have contributed much to marketing ethics theory. This discussion also focuses on sampling and data collection methods, the treatment of respondent and non-response bias, the use of instruments and scales, and the application of the scenario technique. Some suggestions are made that would improve the research methods in each of these areas.

Teaching HRD personnel : experiences of computer-mediated communication in differently structured environments

This paper will provide an overview of the CMC structure in two different units of study in the Masters of Professional Education and Training at Deakin University. Each of these structures makes a set of demands on participants, and provides differing collaborative learning opportunities. The paper examines the experiences we have had in each of these structures, focusing on student participation, style of contribution to CMC, and the relationship between socialisation processes and knowledge construction.

Officer wellbeing, satisfaction and commitment : job conditions of Australian law enforcement personnel

Excessive job stress caused by unreasonably high employer demands, low control over one's own work and limited support can have far-reaching effects for the individual, organisation and community. The present study sought to investigate the relationship between officer working conditions and their self-reported levels of wellbeing, satisfaction and commitment using a well-known job strss model, the demand-control-support (DCS) model. Using a large (N= 2085) sample of law enforcement personnel, findings indicated that social support from work sources was the best predictor, whilst job control and workload both had significant influences on levels of employee wellbeing, satisfaction and commitment. Additionally, non-linear relationships were found between workload and wellbeing and satisfaction, indicating that both high and low levels of workload can produce negative outcomes. The results have implications for job design and management training programs, particularly in reference to social support training and workload models.

Is restricting tobacco sales the answer to adolescent smoking?

Background: Enforcement of legislation restricting retail access to tobacco is increasingly relied on to reduce adolescent smoking rates. In 1996, health authorities in the Northern Sydney Health Area began monitoring tobacco retailer compliance (PROOF program) with staged purchase attempts by adolescents below the legal age (18 years).

Methods: Repeat cross-sectional surveys before (1995) and after (2000) the introduction of PROOF monitored changes in adolescent smoking behaviour. Students aged 12 to 17 years from 11 Northern Sydney metropolitan public secondary schools were surveyed for self-reported smoking and tobacco purchasing behavior in 1995 (n = 5,206) and 2000 (n = 4,120).

Results: Between 1996 and 2000, 545 retailer compliance checks found 34% unlawfully sold cigarettes to minors and 28% of these repeated the offence. Nine prosecutions resulted. Modelling revealed a significant association between the intervention and never having smoked (adjusted OR = 1.16, 95% CI = 1.01–1.33) although there was no significant association with being a current smoker. The odds of being a smoker were greater for students from coeducational schools, with this effect being modified by gender.

Conclusions: There was no reduction in adolescent smoking with active enforcement of tobacco access laws despite an apparent increase in students who reported never to have smoked.