Automated Medication Dispensers In The Home May Improve Medication Adherence Automated medication dispensers may be the key for improved quality of care and safety for individuals who live in a community-based setting. Errors and adverse incidents related to medication use are becoming more common whether it is because of cognitive changes related to aging, substance abuse or simply just not taking medications as prescribed. A working definition of medication misuse for the purposes of this paper is the use of medications, illicit, prescribed, or over-the-counter, in a manner other than as recommended or directed (Centers for Disease Control and Prevention, 2013). It has been reported that in the United States alone, 105 people die each day from drug overdose and more than 6,748 people are treated by an emergency department in this country each day for medication misuse and abuse (CDC, 2013). Many companies are marketing devices and systems to help reduce the incidents of medication misuse and abuse with automated medication dispensing systems. PICO The PICO framework can help to determine the appropriate question to ask (Craig & Smyth, 2012). Patient Patients living in a community-based setting who have medication misuse, non-adherence, and/or drug diversion may lead to adverse events resulting in poor outcomes for these individuals. Intervention The implementation of a secured automated medication dispense in the home setting may improve medication adherence, decrease risk for drug diversion and non-adherence among high-risk patients in the community setting. Comparison The current standard of practice for individuals who are at risk for non adherence to medications is to limit medication supplies, utilization of a w... ... middle of paper ... ...evremont, C., Zhomitsky, S., & Tranulis, C. (2013). A randomized controlled trial with a canadian electronic pill dispenser used to measure and improve medication adherence in patients with schizophrenia. Frontiers in Pharmacology, 4, 1-6. doi: 10.3389/fphar.2013.00100. Wakefield, B., Orris, L., Holman, J., & Russell, C. (2008). User perceptions of in-home medication dispensing devices. Journal of Gerontological Nursing, 34(7), 15-25. Retrieved from http://www.search.proquest.com/docview/204168632?accountid=45760. Winland-Brown, J., & Vallante, J. (2000). Effectiveness of different medication management approaches on elders' medication adherence. Outcomes Management for Nursing Practice, 4(4), 172-176. Retrieved from http://www-ncbi-nlm-nih-gov.db15.linccweb.org/pubmed/?term=effectivness of different medication management approaches on elders medication adherence.
Prescription and pharmaceutical drug abuse is beginning to expand as a social issue within the United States because of the variety of drugs, their growing availability, and the social acceptance and peer pressure to uses them. Many in the workforce are suffering and failing at getting better due to the desperation driving their addiction.
Wilder, C., Elbogen, E., Moser, L., Swanson, J., & Swartz, M. (2010). Medication preferences and adherence among individuals with severe mental illness and psychiatric advance directives. Psychiatric Services, 61, 380-385. doi:10.1176/appi.ps.61.4.380
Some method such as audits, chart reviews, computer monitoring, incident report, bar codes and direct patient observation can improve and decrease medication errors. Regular audits can help patient’s care and reeducate nurses in the work field to new practices. Also reporting of medication errors can help with data comparison and is a learning experience for everyone. Other avenues that has been implemented are computerized physician order entry systems or electronic prescribing (a process of electronic entry of a doctor’s instructions for the treatment of patients under his/her care which communicates these orders over a computer network to other staff or departments) responsible for fulfilling the order, and ward pharmacists can be more diligence on the prescription stage of the medication pathway. A random survey was done in hospital pharmacies on medication error documentation and actions taken against pharmacists involved. A total of 500 hospital were selected in the United States. Data collected on the number of medication error reported, what types of errors were documented and the hospital demographics. The response rate was a total of 28%. Practically, all of the hospitals had policies and procedures in place for reporting medication errors.
According to Gamble and Brennan (2000), the effectiveness of medication for schizophrenia to relieve patients from psychotic symptoms is limited. Although patients have adequate medication, some received little or no benefit from it and almost half of them still experience psychotic symptoms. They are also more likely to suffer relapse (Gamble and Brennan, 2000). Furthermore, Valmaggia, et al. (2005) found that 50% of patients who fully adhere to anti-psychotic medication regimes still have ongoing positi...
Woodruff, K., (2010, October). Preventing polypharmacy in older adults. American Nurse Today, 5(10). Retrieved from http://www.americannursetoday.com/article.aspx?id=7132
Electronic-prescribing, often referred to as e-prescribing, is a fairly new, innovative way for physicians and other medical personnel to prescribe medications and keep track of patients’ medical history. Not only has e-prescribing enabled prescribers to electronically send a prescription to the patients’ pharmacy of choice, in the short amount of time it has been available, it has significantly reduced health care costs, not only for the patient, but for the medical facilities as well. In 2003, e-prescribing was included in the Medicare Modernization Act (MMA) which jumpstarted the role of e-prescribing in healthcare. It has proven to significantly reduce the yearly number medication errors and prescription fraud, and its widespread publicity has helped build awareness of e-prescribing’s role in enhancing patient safety. Although it has not been in practice for very long, e-prescribing has already made a positive impact in the field of health care.
Responsibility and accountability become important when medical staff gives or doses patients with medication. The chance for making a medication error presents itself at all times. Those passing medications must follow established policies and procedures developed and laid forth by t...
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Mc Lellan A (2009) The nurse patient relationship will prove key to effective medication adherence. Nursing Times 105(3).29
Kick, Ella. "Overview: Health Care and the Aging Population: What Are Today's Challenges?" The Online Journal of Issues in Nursing. N.p., n.d. Web.
The first benefit of physician prescribed drugs are how they diagnose, treatment, and how to cope with it. People may not thinks it’s possible but, doctors can actually diagnose and test a patient to see if they are on any drug or if they have abused a prescription drug. Doctors can diagnose a person who been on or is on prescription drugs buy the way they answer to the questions doctor’s are asking or based off they pass history. Blood and urine test may also detect the types of abused drugs. But also in some cases there are certain signs and symptoms that provide clues that someone is on drugs (“Test and Diagnosis”). There is treatment out in communities that can help a person that is abusing the use of prescription drugs. Although, The treatment for a person who abuse prescribed drugs vary. But, counseling and psychotherapy is available in communities. Doctors can also tell if one of their patient have had treatment or in the process of having treatment. Doctors or families are the ones to refer their patient or family member to a center for treatment (“Treatment and Drugs”). There are different types of therapy for a patient that suffering from Prescription Drug Abuse. The treatment is usually a 12-step program but there are other programs included. The types of therapy used is “Group Therapy” where they talk about their recovery with a group of people. Then there is “Cognitive-Behavioral Therapy” where abusers talk about
Although, there are numerous barriers to medication adherence, including: forgetfulness (organic/nonorganic), intentional (felt better/felt worse), lack of information, attitudes/beliefs towards medication taking, complex regimens, etc (Breen & Thornhill, 1998; Razali & Yahya, 1995). There are also many risks involved with being non-adherent which include: increase risk of relapse, hospitalizations, poor long-term course of illness, and higher yearly medical costs (Gilmer et al., 2004; Omranifard, Yazdani, Yaghoubi, Namdari, 2008). It is estimated that the United States spends $2 billion a year on readmission inpatient hospitalizations for patients diagnosed with schizophrenia alone (Weiden & Olfsen, 1995). Hence, it isn’t surprising that individuals diagnosed with schizophrenia have non adherence rates ranging from 40 to 50% (Bulloch & Patten, 2010) and can run as high as 70 to 80% (Breen & Thornhill, 1998). Other mental health illnesses, such as depression, have shown to have non-adherence rates up to 60% (Lin et al., 1995). Since individuals with schizophrenia are notorious for being noncompliance, majority of research is dedicated to this
Specific Purpose: To inform my audience about the dangers of prescription drugs when not taken as prescribed by your physician or pharmacist.
Medication errors are the leading cause of morbidity and preventable death in hospitals (Adams). In fact, approximately 1.5 million Americans are injured each year as a result of medication errors in hospitals (Foote). Not only are medication errors harmful to patients but medication errors are very expensive for hospitals. Medication errors cost America’s health care system 3.5 billion dollars per year (Foote).Errors in medication administration occurs when one of the five rights of medication administration is omitted. The five rights are: a) the right dose, b) the right medication, c) the right patient, d) the right route of administration, and e) the right time of delivery (Adams). Medication administration is an essential part of the nursing profession, taking up to forty percent of a nurse’s time in providing nursing care (Fowler). Consequently, nurses are commonly held accountable for medication errors. To improve the safety of a vital aspect of nursing care, bar code scanning was introduced to reduce errors in medication administration. Although bar code scanning has its advantageous aspects, there are also disadvantageous qualities.