Being the nurse’s eyes and ears: a mixed methods study of assistant nurses’ perceptions of their role regarding drug-related problems in nursing homes

TL;DR

Assistant nurses in nursing homes see themselves as 'eyes and ears' for patient safety regarding medications, but lack specific knowledge about drug-related problems in older people.

Contribution

A mixed methods study exploring assistant nurses' self-perceived role and knowledge in preventing drug-related problems in nursing homes.

Findings

Assistant nurses generally feel confident about medicines but lack specific knowledge on drug-related problems and aging physiology.

They view their role as observing residents and contributing to patient safety by assisting nurses.

Opportunities like attending ward rounds are seen as valuable for gaining knowledge and improving medication safety.

Abstract

Insufficient knowledge among assistant nurses (ANs) in nursing homes (NHs) on medicines and drug-related problems (DRPs) in older people causes difficulties in acknowledging the side effects of medications, which can be harmful to the individual and endangers patient safety. The aim of this study was to explore the ANs’ thoughts on their professional role in preventing DRPs in NH residents, their self-perceived knowledge about medicines, DRPs and physiological conditions in older people, and their wishes concerning further medical education.

This mixed methods study took place in Sweden, in 2022. First, a survey was conducted at nine NHs, with a total of 112 respondents. Data were analysed using descriptive statistics and groups were compared using t-tests. Thereafter, semi-structured interviews were performed at four NHs and included 20 participants. A qualitative content analysis was performed.

In the survey, a generally good self-perceived knowledge of medicines was reported. In the interviews, three main categories were identified: “Professional role of the AN”, “Perspectives on pharmacotherapy in older people” and “Approaches to knowledge”. Their professional role entailed different aspects, including the central assignment of observing the residents whilst having delimited responsibilities and knowledge. Regarding pharmacotherapy, the self-perceived knowledge was generally good, but more specific questions regarding DRPs proved a lack of widespread competence. An approach to obtain more knowledge was found in the possibility for ANs to attend ward rounds. A latent theme emerged in the professional role of the AN in preventing DRPs by being the nurse’s eyes and ears for patient safety.

The AN’s perceived their professional role in preventing DRPs in NHs as being the nurse’s eyes and ears for patient safety. Generally, the ANs’ self-perceived knowledge of medicines was good, although self-perceived knowledge regarding DRPs, and the physiology of older people, was sparser. A positive attitude towards attending ward rounds to contribute firsthand information on the residents, as well as the opportunity to receive knowledge, existed among the respondents. We propose a working model within the framework of doctor’s ward rounds at NHs to increase the knowledge of ANs and utilise their knowledge of patients’ well-being for safe medication follow-up.

The online version contains supplementary material available at 10.1186/s12912-025-03416-y.

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