Browsing by Author "Niemelä, Aliisa"

Annually thousands of Finnish children are placed in foster care as a measure of child welfare. Institutional foster care is provided by child welfare institutions. Social and health care professionals, such as bachelors in social services, youth workers, practical nurses, and registered nurses working in these institutions are responsible for carrying out the children’s medication treatment. Depending on completed basic and additional training and work experience, the personnel have varying competencies in medication treatment. The aim of this study was to provide research-based information on the challenges and development needs related to the safe and rational medication treatment of children in foster care living in child welfare institutions. This was studied from the point of view of institution personnel and social workers responsible for placement decisions. Furthermore, the study investigated the medication use process of children in institutional foster care and, how the child’s health and medication treatment related needs are considered in the placement process and in selecting the foster care place. The study was conducted as a qualitative study using focus group discussions (FGDs) carried out to child welfare social workers (n=1) and child welfare institution personnel (n=10) during November and December 2022. Semi-structured focus group discussions (n=3) were conducted over the video conferencing software Microsoft Teams®. The participants (n=11) were recruited through child welfare services of Central Uusimaa Wellbeing County. Qualitative content analysis was used to analyze the data. According to the focus groups, medication treatment is common among children living in child welfare institutions. In the daily life of child welfare institutions, there were challenges and development needs related to medication treatment and medication use process. The main challenges and development needs were the lack of up-to-date information regarding the children’s health status and medication, challenges in organizing acute medication treatment, the personnel’s up-to-date drug administration permissions and varying competencies in medication treatment. In addition, fragmented overall responsibility of the medication treatments and poor access to healthcare presented challenges for organizing and carrying out medication treatment for the children. Medication use process during foster care appeared to be fragmented and it was seen to be susceptible to errors. According to this study, the possibilities for taking children’s health status and medical needs into account at the point of placement were scarce. These needs often did not guide placement decisions. Considering the medication use process and medication safety, it is essential that child welfare institutions have access to up-to-date health and medication information of the children. To achieve the best interests of the children, organizing acute medical treatment should be facilitated and the overall responsibility health care and medication therapy clarified. In addition, seamless access to the necessary healthcare must be ensured for children in foster care. Considering medication safety, it is important to ensure that the personnel of child welfare institutions have up-to-date competencies in medication treatment that meet the needs of the children.