Survey of the needs of patients in a private nursing home: a pharmacist's view

Validated data collection instruments were used to assess the health status and existing drug therapy of 79 patients (16 male, 63 female; mean age 84 [±9] years) in two private nursing homes in Norfolk. The homes had already been found to be above average standard in terms of medicines supply, storage and administration. The most common symptoms of long term chronic disease were associated with neurological, cardiovascular, arthritic, psychiatric or diabetic diagnoses. Fifty nine patients had some memory impairment; 77 suffered from additional health problems which could arise from inappropriate therapy or dosing. All patients received most of their medicines from nursing staff. The mean (±SD) number of items received per day was 7.1 (±3.4). Of drugs prescribed for regular use, 79 per cent were given in accordance with the wishes of the prescriber. In contrast, only 21 per cent of medicines prescribed for use when necessary ( prn ) were given as intended. Thirty three per cent of prn medicines, some prescription only, had been given in the absence of any GP knowledge or instruction. Although there were written procedures for drug administration, there was only 58 per cent compliance with these guidelines. Drug administration charts proved to be an incomplete record of pre‐existing drug allergy, topical application, self‐medication and drugs used in routine nursing procedures, eg, bladder washouts.