To crush or open capsules to administer medications instead

To conclude, it
is prominent swallowing difficulties are of high prevalence in individuals 65
years and older; having a vast effect on the way patients are administered
their routine medicines. Nurses knowledge on covert administration has developed
and is occurring less frequently in accordance with guidelines from NICE
(2015). However, it is clear nurses lack understanding of manufacturers suffixes
and the potential interactions modifying certain tablets could cause to
patients. There is a shortage of swallowing screening tools about which are not
routinely used when patients are admitted, however, nurses predominantly ask
patients what their swallowing ability is like compared to other health
professionals such as physicians and pharmacists. Communication of methods to
modify and the availability of alternatives is an issue in primary care; a
large proportion of healthcare professionals seek advice from other colleagues
which may converse un-evidence based information instead of obtaining information
from a pharmacist. Additionally, nurses tend to crush or open capsules to
administer medications instead of considering other alternatives such as
intravenous access, liquids, rectally, sublingual and buccal routes, nasally
and via transdermal patches.

Although,
the research included is limited, all researchers used prospective cohort
studies and no papers included randomised controlled studies which are seen to
produce more reliable results. The use of cohort studies allowed multiple
outcomes to be measured from only using one exposure and the incidence of
medication errors and prevalence of deglutition disorders to be discovered. Cofounding
variables such as: age, the number of tablets each participant took, the tablet
sizes and the environment the patient were in were included in most studies but
not all consistently. Nevertheless, only one out of eight studies included a
follow up and only one included confidence intervals and a relative risk rate,
this makes the findings prone to bias (LoBiondo-Wood and Haber, 2017). Therefore,
these outcomes should be used as a guidance and direction for future research.

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