Medication econciliation
Evidence-Based Practice and the Procedural Education of Nurses
Medication reconciliation is a critical issue in healthcare reform. Today, improvement in this area of treatment could have a transformative effect on the current practices of nursing and medicine administration. The discussion, literature review and research tests that are conducted hereafter will outline the implications of medication reconciliation; justify the call for improvement in this treatment area; and offer support for the resultant recommendations using the Quality and Safety Education for Nurses (QSEN) template as a guide. The discussion will provide a background discussion on the three primary procedural steps by which medication reconciliation is defined: Verifying Medications by Collecting an Accurate Medication History; Clarifying Information by Ensuring Medications and Doses Are Appropriate, and; econciling and Documenting Change. Additionally, the discussion will offer a literature review as a means of providing some comprehensive knowledge of current practices in the field. Subsequently, a…...
mlaReferences
Agency for Healthcare Research and Quality (AHRQ). Medication Reconciliation. U.S.
Department of Health and Human Services.
Alabama Universal Medication Form, Retrieved April 28, 2012 from: http://alaha.org/uploadedFiles/Resources/UniversalMedicationForm.pdf
American Association of Colleges of Nursing (AACN). (2008). The Essentials of Baccalaureate Education for Professional Nursing Practice. Quality and Safety
It is interesting to note that Tambour and Quertemont studied the effects of the same two drugs plus Disulfiram, an alcohol-deterrent drug. Their findings, in reviewing other studies, indicated slightly different results from Richardson. Since different drugs target different neuro-inhibitors, the drugs were used both separately and together. Quertemont discovered, in reviewing the results of previous and current studies, that none of the drugs worked particularly well, and that the combination of two of the drugs didn't seem to help. Her review of these studies contradicted the Richardson trial in which acamprosate was found to be ineffective.
Quertemont and Tambour ultimately concluded that the future of curing alcoholism lie in both discovery of new drugs and the refinement of the use of current drugs either singly or in combination.
In Willenbring and Gitlow's debate over the value of drugs to treat alcohol dependence, Dr. Gitlow concludes that until it is proven that…...
mlaBibliography
Gitlow, S., & Willenbring, M. (2008). Are medications that reduce risk of drinking, or heavy drinking, or that promote abstinence, of value in the treatment of alcohol dependence? American Journal on Addictions (peer-reviewed), 17(1), 1-5, doi:10.1080/10550490701756047.
Kranzler, H. (2006). Medications to treat heavy drinking. Are we there yet? Addiction (peer-reviewed), 101(2), 153-154, doi:10.1111/j.1360-0443.2006.01324.x.
Richardson, K., Reid, S., Baillie, A., Morley, K., Teesson, M., Sannibale, C., et al. (2008). Do acamprosate or naltrexone have an effect on daily drinking by reducing craving for alcohol? Addiction, (peer-reviewed), 103(6), 953-959, doi:10.1111/j.1360-0443.2008.02215.x.
Tambour, S., & Quertemont, E. (2007). Preclinical and clinical pharmacology of alcohol dependence. Fundamental & Clinical Pharmacology (peer reviewed), 21(1), 9-28, doi:10.1111/j.1472-8206.2006.00459.x.
Medication Compliance in Psychotic isorders
Janssen, Birgit., Gaebel, Wolfgang., Haerter, Martin, Komaharadi, F., Lindel, Birgit., & Weinmann, Stefan. (2006 April). "Evaluation of factors influencing medication compliance in inpatient treatment of psychotic disorders. Psychopharmacology 187:229-236.
The authors and researchers examine short- and long-term compliance to prescribed antipsychotic drugs. Their objective is to evaluate patient-related and treatment-related factors associated with medication compliance in inpatients with the following diagnoses: schizophrenia, schizoaffective disorder, and other psychotic disorders. The study is a "naturalistic study," based in seven hospitals with patients assessed weekly. The following characteristics were studied: social function, side-effects of medication, mental status, and compliance to medication requests. The researchers in this study attempted to determine whether medication is the basis for compliance or whether multiple factors including innate factors such as social influence and individual characteristics, environmental characteristics, genetic and personality characteristics were more likely to influence medication compliance in psychotic patients because medication compliance…...
mlaDolder, Christian R., Pharm.D., Jonathan P. Lacro, Pharm.D., Laura B. Dunn, M.D., and Dilip
V. Jeste., M.D (2002 Jan). Antipsychotic medication adherence: Is there a difference between typical and atypical agents? Am J. Psychiatry, 159:103-108.
The researchers and authors of this study had a primary objective of comparing medication adherence in outpatient veterans using typical vs. atypical antipsychotic agents. To accomplish this goal the researchers used pharmacy refill records; the patient selection criteria including patients using medications haloperidol, perphenazine, risperidone, olanzapine and quetiapine. Patients used medications for a 3-month period before using an atypical agent, and refill records were reviewed for a period of 12 months. The results of this study suggested that adherence rates were higher in patients receiving atypical agents, suggesting that medication compliance is more likely in patients receiving these agents compared to typical antipsychotic agents. Patient personality traits were not examined in this study, as in previous studies, so it is uncertain whether characteristics including aggression, addiction or other factors may have influenced compliance, as was the case in some previous studies. Patients were likely to miss medications seven times per month on typical antipsychotics vs. four times per month on atypical antipsychotics in this particular study. At the end of the study refill rates showed a four percent difference between typical and atypical agents, with approximately 54% of patients on atypical agents likely to refill their medications vs. roughly 50% of patients likely to comply with necessary refills on traditional or typical antipsychotics.
Medication Communication
Cliff, Barbara (2012). "Excellence in Patient Satisfaction within a Patient-Centered Culture." Academic journal article from Journal of Healthcare Management, Vol. 57, No. 3.
his article can be used to explain how the scores of HCAHPS has become an important consideration among the healthcare leaders. Furthermore, this resource is also important because it explains the Value-Based Purchasing program that would be implemented nationwide in the fiscal year 2013 for better reimbursement. his article also explains the breakdown of the payment in this particular system; 70% would be the cost of the clinical care and medication of the patient, meanwhile 30% would be based on patient's satisfaction. In this paper, it has also been explained how HCAHPS surveys forms the basis for the patient's domain.
Bernhofer, E., (October 25, 2011) "Ethics and Pain Management in Hospitalized Patients" OJIN: he Online Journal of Issues in Nursing Vol. 17 No. 1.
his particular resource is…...
mlaThis article provides with all the statistics that are required for the findings of HCAHPS scores nationwide. It explains the approach that was adopted to collect all the required information. Basically, this resource can be used to obtain all the required data and statistics on the surveys of HCAHPS. The limitations of this research are also explained in this article and therefore, they can be kept in mind when doing any further research on the topic.
15. D' Amore, John' Murray, John; Powers, Helen; Johnson, Craig (2011). "Does Telephone Follow-up Predict Patient Satisfaction and Readmission?" Population Health Management.
This article explains the importance of communication with respect to the increase in quality of the healthcare services and their delivery at the hospitals. The introduction of HCAHPS has highlighted the fact that it has increased the engagement of the employees of the healthcare systems. When patients are followed up through telephone, email or other ways of communication, it also adds to their satisfaction. In this study a comparison has been made between the satisfaction levels of the patients who were followed up through telephone and those who were not.
medication errors by nurses. There are six references for this paper.
Health care professionals are responsible for the welfare and safety of their patients. One of the most dangerous and preventable mistakes a nurse can make is a medication error. It is important to understand how errors occur, their repercussions and ways to prevent a medication error.
In order to prevent a medication error, a nurse must first understand how it is defined. A medication error is "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use (http://www.fda.gov/cder/present/DIA62002/gross/sld014.htm)."
Causes
There are a number of factors which can contribute to medication errors. These…...
mlaReferences
Cohen, Hedy. (01 July, 2004). "Pediatric medical errors part 3: safety strategies: medication use system to analyze errors." Pediatric Nursing, pg 33.
Meadows, Ginny. (01 July, 2002). "Safeguarding patients against medication errors." Nursing
Economics."
(Medication errors defined. (accessed 04 September, 2005).
Population and Global Health: Medication Adherence in Seniors
Assess the preventive and protective healthcare needs of a community of individuals, including emergency preparedness. Develop a plan for using behavioral change techniques to promote optimum health of a community, include culturally and spiritually sensitive care.
Describe the population/community you have chosen
The elderly are an incredibly high needs population when it comes to the field of professional medicine: they are consistently under-served and struggle very often to get even their most basic health needs met. One of the particular issues that prevents this population from staying healthy is the issue of medication adherence. A lack of proper medication adherence can cause a range of complicated issues and all of these issues are highly preventable: the individual just needs to stay on their medication. Medication adherence in seniors greater than 60 years of age is a primary factor for preventing serious complications from chronic conditions…...
mlaReferences
Coughlin, T.A. (2006). The health care experiences of rural Medicaid beneficiaries. Journal of Health
Care for the Poor and Underserved, 17(3), 575-91.
Griffiths, R., Johnson, M., Piper, M., & Langdon, R. (2004). A nursing intervention for the quality use of medicines by the elderly clients. International Journal of Nursing Practice,
Griffiths, R., Johnson, M., Piper, M., & Langdon, R. (2004). A nursing intervention for the quality use of medicines by the elderly clients. International Journal of Nursing Practice,
There is a common saying that nobody is perfect. No human being is immune to errors and mistakes from time to time. Not even trained professionals in the course of discharging their duties and roles. In a medical setting, the cost of even the simplest of errors could be immense. For this reason, it would be prudent to assess/examine the legal and ethical implications of disclosure and non-disclosure of a personal error and the course of action that would be most appropriate when medication errors are detected. Further, it would also be prudent to evaluate strategies and approaches to minimize education errors. One of the most important considerations, from an ethical perspective, that health practitioners ought to make with reference to the disclosure of medication errors is whether or not they (or their loved ones) would like to be notified if they were to find themselves in a similar scenario. For…...
Medication changes with technology: A description and detailed review of five clinical electronic systems that correlate with the process of medication administration technology.
Computerized physician / prescribed order entry (CPOE)
In 2000, following the huge spate of accidental death (approximately 2 million) that occurred nationwide, the Department of Health Services (DHS) surveyed hospitals in California regarding the nexus of patient safety and technology and which technological system they had it in mind to procure by 2005.
46% of the hospitals surveyed rated the computerized physician / prescribed order entry (CPOE) as their preferred technological system since it helps the prescribing clinician enter the medication order directly into the system (Spurlock, et al., 2003). The CPOE, moreover, can instantly detect any error in the prescription as well as employing various levels of decisions support to detect errors to situations that could have led to an error in the prescription (such as duplicate or incorrect…...
mlaReferences
Spurlock, B. et al. (2003) Legislating Medication Safety: The California Experience. Convergence Health Consulting.
Health Information Technology (2009) Electronic medication administration records improved communication and decision-making in nursing homes http://www.ahrq.gov/research/jul09/0709RA29.htm
Institute of Medicine (2001). Crossing the Quality Chasm: A New Health System for the 21st Century. The National Academies Press. http://www.nap.edu/books/0309072808/html .
Medication Practice Improvement Episode
Medication Intercept
An intravenous antibiotic Benzylpenicillin (Benpen) course was prescribed for a child to treat acute osteomyelitis. The 30mg/kg dose calculation was duly followed. The child weighed 28kg and so 840mg Benpen dose was to be given every six hours and this was charted accordingly. The chart showed these times: 06:00, 12:00, 18:00 and 24:00. Dose number two was to be taken at 14:00 and two Ns -registered nurses - that administered the dose signed on the column of 12:00 and indicated 14:00 above the signatures. At the time of the handover, no communication was made to the fresh team that the antibiotics had been administered late. When it reached 18:00, me and my colleague went to ready the patient for the next Benpen dose; since it is a requirement that two nurses check an intravenous medication. I discovered that the last dose had been administered at 14:00…...
mlaReferences
Evans, J. (2009). The prevalence, risk factors, consequences and strategies for reducing medication errors in Australian hospitals: A literature review. Contemporary Nurse: A Journal for the Australian Nursing Profession, 31(2), 176-189.
Teunissen, R., Bos, J., Pot, H., Pluim, M., & Kramers, C. (2013). Clinical relevance of and risk factors associated with medication administration time errors. American Journal of Health-System Pharmacy, 70(12), 1052-1056. Doi:10.2146/ajhp120247
Jones, S.W. (2009). Reducing medication administration errors in nursing practice. Nursing Standard, 23(50), 40-46.
Volpe, C.R.G., Pinho, D.L.M., Stival, M.M., & de Oliveira Karnikowski, M.G. (2014). Medication errors in a public hospital in Brazil. British Journal of Nursing, 23(11), 552-559.
Medication adherence is delineated as the magnitude to which patients take medications as recommended by their health-care providers. Correct and accurate adherence to a treatment plan, particularly taking medication on a regular basis and as recommended in the prescriptions is a shared clinical challenge not only for clinicians but patients as well. The population growth of older adults continues to magnify and increase with the baby boomer age group almost coming to their age of retiring. The inference of this is that there is an increasing necessity for enhancing healthcare results amongst patients suffering from heart failure. Self-care discrepancies have been established to be considerably linked with deleterious healthcare results amongst heart failure patients. It has been conveyed that patients with heart failure who show diminished self-care capabilities in undertakings like medication compliance have recurrent hospitalizations and dwindled quality of life (Britz and Dunn, 2010).
Medication adherence is a multi-faceted aspect…...
MEDICATION SAFETY EDUCATION POGAM 1Practice Question: Medication Safety Education Program to educe the isk of Harm Caused by Medication ErrorsThe PICO project seeks to implement a medication safety education program to help reduce instances of medication errors in my practice setting. The project was selected in response to the high incidence of medication errors at the facility that has resulted in avoidable disability, death, and reputational issues. This project defines a medication error as any preventable event that may lead to or cause inappropriate use of medication and harm to the patient (Tariq et al., 2022). The facility already implements an alarm system that notifies nurses whenever they are required to administer drugs to patients. However, incidents of medication errors remain high, pointing to a need to consider additional strategies. The primary aim of the project is to determine whether a safety education program would yield greater efficacy than the…...
mlaReferences Abukhader, I., & Abukhader, K. (2020). Effect of Medication Safety Education Program on Intensive Care Nurses’ Knowledge Regarding Medication Errors. Journal of Biosciences and Medicines, 8(6), Doi: 10.4236/jbm.2020.86013 Alhadhey, H., Mahmoud, M. A., Hassali, M.,…& Bates, D. W. (2014). Challenges to and the Future of Medication Safety in Saudi Arabia: A Qualitative Study. Saudi Pharmaceutical Journal, 22(4), 326-32. Benjamin, D. M. (2003). Reducing Medication Errors and Increasing Patient Safety: Case Studies in Clinical Pharmacology. Journal of Clinical Pharmacology, 43(7), 768-83. Tariq, R. A., Vashisht, R., Sinha, A., & Scherbak, Y. (2022). Medication Dispensing Errors and Prevention. Treasure Island, FL: StatPearls Publishing.
GAPS IN PACTICEDiscussion: Discuss Gaps in PracticeOne of the most significant practice concerns in clinical settings happens to be medication errors. From the onset, it would be prudent to note that medication errors are described by the U.S. Food and Drug Administration FDA (2019) as any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional, patient, or consumer. The focus of this discussion front will be errors attributable to healthcare professionals. The negative impact of medication errors in as far as patient outcomes and wellbeing are concerned is well documented. For instance, as the FDA (2019) further indicates, medication errors could result in disability, life threatening situations, and even death. Towards this end, the relevance of deploying strategies to rein in this particular concern cannot be overstated.In the past, there have been a…...
mlaReferencesAbukhader, A., & Abukhader, K. (2020). Effect of Medication Safety Education Programon Intensive Care Nurses’ Knowledge Regarding Medication Errors. Journal of Biosciences and Medicines, 8, 135-147. Cohen, M.R. (2007). Medication Errors. American Pharmacist Association. Gorgich, E.A., Barfoshan, S., Ghoreishi, G. & Yaghoobi, M. (2016). Investigating the Causes of Medication Errors and Strategies to Prevention of Them from Nurses and Nursing Student Viewpoint. Glob J Health Sci., 8(8), 220-227. John Hopkins Medicine (2016). Study Suggests Medical Errors Now Third Leading Cause of Death in the U.S. Food and Drug Administration – FDA (2019). Working to Reduce Medication Errors. https://www.fda.gov/drugs/information-consumers-and-patients-drugs/working-reduce-medication-errorshttps://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us U.S.
POJECT MANAGEMENT PLAN Project Management PlanThe PICO project seeks to reduce the incidence of medication errors in the practice setting by introducing mandatory medication safety education for all clinical staff. The project serves as a means to respond to the high incidence of medication errors at the facility that has resulted in preventable injuries, death, and reputational issues. The projects primary aim is to compare the effectiveness of medication safety education and the current alarm notification system at the facility in reducing the risk of medication errors. This assignment develops a project management plan for the proposed project. The plan details how the project will be carried out, including the scope, objectives, deliverables, timelines, and budget (Sipes, 2020). According to Sipes (2020), a project plan helps to keep a project on track, minimize wastage of resources, and keep stakeholders engaged because they understand the expected deliverables at each stage of…...
mlaReferences Abukhader, I., & Abukhader, K. (2020). Effect of medication safety education program on intensive care nurses’ knowledge regarding medication errors. Journal of Biosciences and Medicines, 8(6), Doi: 10.4236/jbm.2020.86013Alhadhey, H., Mahmoud, M. A., Hassali, M.,…& Bates, D. W. (2014). Challenges to and the future of medication safety in Saudi Arabia: A qualitative study. Saudi Pharmaceutical Journal, 22(4), 326-32.Hickey, J. V., & Giardino, E. R. (Eds.). (2021). Evaluation of quality in health care for DNPs (3rd ed.). Springer Publishing.Milosevic, D. Z. (2003). Project management toolbox: tools and techniques for the practising project manager. John Wiley & Sons.Sipes, C. (2020). Project management for the advanced practice nurse (2nd ed.). SpringerPublishing Company.
According to the BWH study, in some cases an increase of potential adverse drug events was possible, especially when every dose of medications was not scanned. For barcode scanning technology to work as designed, every medication dose would have to be scanned before it reached the patient (BWH, 2002). Given the current shortage of nurses available to perform routine tasks in hospital care settings, it is likely that multiple errors might occur from a nurse not having time to or forgetting to scan every dose a patient would take before medicating the patient.
Some reports acknowledge that technological systems as barcode scanning are "cumbersome" and may "cause an unreasonable increase in time needed to administer medications" with some hospitals reporting an 8-second delay in medication recognition when nurses used a database instead of manual methods (Cipriano, 2002).
Conclusion
The use of barcode scanning for medication processing and administration is not the cure-all for…...
mlaReferences
Bayley, C. & Berlinger, N. Who is responsible? The Hastings Center Report, 36(3): 11.
BWH. (2005). BWH study finds using bar code technology in a hospital pharmacy dramatically reduces dispensing errors and potential adverse drug events." Brigham and Women's Hospital. February, 2005. Accessed 7, May 2007: http://www.hms.harvard.edu/news/pressreleases/bwh/1006barcodes.html
Cipriano, P.F. "Statement of the American Academy of Nursing and the American
Organization of Nurse Executives regarding barcode labeling." July 26, 2002. Accessed 7, May, 2007:
esearch questions related to psychotropic medications might include ow can a clinician determine whether a psychotherapeutic treatment is enough or when a psychotropic medication should be prescribed? In what ways can different types of psychotropic medications be abused? In what cases should a clinician avoid giving a medication due to a theory of substance abuse? How often should a clinician run an assessment for substance abuse when he or she has a patient with a psychotropic prescription? Among the most interesting findings in regards to psychotropic medications and dependence are the findings or Lazaratou et al. (2007)., who found that most parents were afraid to give their children psychotropic medications and feared a long time drug use based on the use of the medication, although this is unsubstantiated by research.
eferences
Lazaratou, Helen et al. (2007). Parental attitudes and opinions on the medication in mental disorders of children. Ann…...
mlaReferences
Lazaratou, Helen et al. (2007). Parental attitudes and opinions on the medication in mental disorders of children. Ann Gen Psychiatry. 6(32)
Cor Pulmonale is pulmonary heart disease, which causes failure of the right ventricle. This comes as a result of high blood pressure within the lungs. Pulmonary edema is fluid accumulation in the lungs, often as a result of congestive heart failure. Both diseases would be unfortunate and difficult to deal with, but pulmonary edema would be preferable. There are medications and treatments that can be used in order to reduce the fluid in the lungs and keep the congestive heart failure at bay. The Cor Pulmonale, though, will damage the heart\'s right ventricle, and there is nothing that can be....
While stress is a commonly used term, it is a poorly defined term that can refer to a wide scope of things, depending on the context. Generally speaking, stress refers to the person’s response to some sort of aversive stimuli or stressor, though stress can also be used to refer to the stimuli that causes the stress. The perception of stress appears to be related to whether a person finds a particular stimulus to be overwhelming. Therefore, a stress concept analysis can have different meanings and is personalized for each person experiencing a particular stressor. Generally, we....
It is difficult to address the issue of lack of mental health funding for first responders without first acknowledging the general lack of appropriate thoughts about mental health. While physical illness is treated as a legitimate illness and self-care to help avoid that illness is supported, mental illness is oftentimes still treated like a character defect. People who seek assistance for mental health not only have to face a lack of funding, but often have to worry about whether the stigma that attaches to seeking such help will work against them in their future professional lives. For....
Electronic medical records, which refer to medical records that are not only stored in electronic systems (which includes almost all medical records in the modern world, with the exception of some medical records maintained in non-industrialized nations), but that are accessible to multiple healthcare providers across different platforms. The question is whether these records are able to improve quality of care by allowing healthcare providers to get a full picture of a patient’s medical history, as well as any presenting concerns or issues, as soon as the patient presents for medical treatment. It would seem like the....
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