Troubles de la déglutition chez les patients gériatriques : de l'évaluation des pratiques à la conception d'outils de formation.

Swallowing disorders often lead caregivers to crush tablets and open capsules, which may be a risky practice. The aim of our work was to assess caregiver's knowledge and practices about crushing drugs, and to develop teaching tools to improve medication safety in our hospital. This study was conducted within two geriatric units and was divided into 3 phases: knowledge and practices assessment, corrective measures implementation and evaluation. Based on these findings, we developed corrective measures: a training video was developed and a checkbox about the patient's swallowing capacities was configured in the computerized patient record (DxCare®, Medasys). Caregivers' satisfaction was measured and a checkbox spontaneous filing ratio was measured on one given day. A total of 7 nurses and 7 physicians were interviewed during the audit. Only one of them declared he recorded dysphagia in patients' records. Among nurses, 3/7 claimed to inquire about crushing possibility before administration. Regarding the correctives measures, 5 out of the 25 caregivers who have seen the video didn't know any of the risks mentioned, and knowledge of these risks was variable between different caregivers' profiles. A given day, 69.4% of patients' admission records contained a completed checkbox, allowing pharmacist to suggest alternatives. Through this work, we identified and prevented non-optimal practices, mostly caused by a lack of knowledge of the risks related to drug crushing. Training tools have been developed in our center to improve medication use. [ABSTRACT FROM AUTHOR]