Home care service employees' contribution to patient safety in clients with dementia who use dietary supplements: a Norwegian survey

Scand J Prim Health Care. 2021 Dec;39(4):403-412. doi: 10.1080/02813432.2021.1970944. Epub 2021 Sep 15.


Objective: To explore home care services (HCS) employees' professional experiences with the use of dietary supplements (DSs) in their clients with dementia. We also investigated their attributed professional responsibility concerning this use and their attitudes toward DSs in general. Differences between nurses and nurse assistants were investigated.

Design: A cross-sectional survey with self-administered questionnaires.

Setting: Home care services in six Norwegian municipalities in the period August-December 2016.

Subjects: A total of 231 (64% response rate) HCS employees; 78 nurses and 153 nurse assistants (auxiliary nurses and employees without formal education).Main outcome measures: Health care employees' experiences with patient safety in clients with dementia who use DSs.

Results: Fifty per cent were concerned that clients with dementia might harm their health due to DS use. Thirty-one per cent reported having intervened in order to reduce the risk. Seventy-one per cent preferred to administer DSs to clients with dementia rather than leaving this responsibility to the clients. The respondents placed the responsibility for patient safety in clients with dementia using DSs mainly with the general practitioners, while they ascribed themselves and pharmacies a medium level of responsibility. There were only minor difference between nurses and nurse assistants, and no difference in attitudes towards DSs.

Conclusion: Employees in HCS were concerned about the DS use in clients with dementia. Moreover, almost one-third had intervened to improve clients' patient safety. The majority indicated that HCS should administer DSs rather than the clients with dementia themselves.KEY POINTSTo our knowledge, this is the first study investigating the role of home care services with regard to patient safety in clients with dementia who use dietary supplements (DSs).•Home care service employees worried about patient safety related to DS use in clients with dementia.•Home care service employees attributed to themselves medium responsibility to ensure the safe use of DSs in these clients.•Lack of knowledge was the most important reason why home care service employees did not recommend DSs to clients.

Keywords: Home care services; attributed responsibility; cross-sectional survey; dementia; dietary supplements; patient safety; professional practice behavior; risk management.

MeSH terms

  • Cross-Sectional Studies
  • Dementia*
  • Dietary Supplements
  • Home Care Services*
  • Humans
  • Patient Safety
  • Surveys and Questionnaires

Grant support

This work was supported by the Northern Norway Regional Health Authority (Helse Nord RHF) [grant number HST1310-15]. The funding body played no role in the design of the study, the collection, analysis or interpretation of data, or the writing of the manuscript. The publication charges for this article have been funded by a grant from the publication fund of UiT, The Arctic University of Norway.