Running Head: Enhancing Medication Compliance in Elderly Individuals
Research Utilization Paper
An Intervention Study to Enhance Medication Compliance in Community-Dwelling Elderly Individuals
Chris Elmer
HSCI 401
Fall 2001
My research study was to determine whether daily videotelephone or regular telephone reminders would increase the quantity of prescribed cardiac medication taken in a sample of elderly individuals who have congestive heart failure (CHF) (Peteva, 2001).
Within this research I would disseminate the new scientific knowledge with the help of the pharmaceutical company that makes the congestive heart failure medication. With the help and support of the pharmaceutical maker, I would provide a full in-service to the nursing staff of hospitals and doctor’s offices alike. In doing this, this would provide a friendly and educational atmosphere in a nursing practice setting to get complete understanding of the research findings and how they as nurses can make a difference in the consumption of prescribed medication.
Secondly, I would write a journal article and have it published in the pharmaceutical’s bulletin to include a well-known nursing journal. These journal articles would contain the findings of the research and suggestions on how the nursing staff can help the patients improve the compliance of taking prescribed medication.
Once the information is disseminated into the medical public, the nurses will apply the learned knowledge to their practice for the elderly patients who are taking congestive heart failure medication. First, the nurse will collect all the patients that are currently taking congestive heart failure medication and explain to them on a one-on-one basis the benefits of having reminders to comply with taking prescribed medications. Then nurse would also explain the pros and cons of the reminders and that the videotelephone reminders would be provided at no cost to the patient. If the patient agrees to utilize the videotelephone reminder, the patient would sign a patient confidentiality agreement and liability agreement for legal reasons. What the agreements would stand for is a “need to know basis,” meaning that the patients information is strictly confidential and those who are on a need to know basis would have access to the patients information. The liability agreement is so that the patient could not sue the pharmaceutical company or the medical facility where they are being treated if a complaint involved only the videotelephone reminder program.
Once the videotelephone reminder program is implemented the pharmaceutical company and myself would provide quarterly visits to the medical site to collect data on the progress of the program.
Heart disease is the leading cause of death in the United States and the estimated cost of treatment is $32 billion yearly. Approximately 5 million people living in the United States suffer from congestive heart failure (CHF) and half of those diagnosed will die within 5 years. An individual may present to the hospital with weakness, short of breath (SOB), swelling of the extremities, ascites, and breathing difficulties while lying down. The quality and length of life for someone suffering from heart failure can be improved with early diagnosis, medication, physical activity, and diet modification (CDC, 2013).
The systematic review indicated (1) ‘Case management interventions were associated with reduction in all-cause mortality at 12 months follow up, but not at six months’. (Takenda, et al, 2012) The systematic review also went on to state that while case management interventions were not associated with reduced mortality, case management interventions were indicated to reduce the occurrence of patients presenting to hospital with exasperations of chronic heart failure. The benefits of case management based interventions were apparent after 12 months had lapsed. Six of the twenty five studies assessed (2) heart failure clinics, and the evidence for this intervention was less convincing with the review stating ‘there was no real difference in all-cause mortality, readmissions for HF or between patients who attended a clinic and those who received usual care’. (Takenda, et al., 2012)
4). Examples of how nurses can integrate this competency include; using current practice guidelines and researching into hospital’s policies (Jurado, 2015). According to Sherwood & Zomorodi (2014) nurses should use current evidence based standards when providing care to patients. Nurse B violated one of the rights of medication administration. South Florida State Hospital does not use ID wristbands; instead they use a picture of the patient in the medication cup. Nurse B did not ask the patient to confirm his name in order to verify this information with the picture in the computer. By omitting this step in the process of medication administration, nurse B put the patient at risk of a medication error, which could have caused a negative patient
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
Heart failure is a major clinical, social and economic problem in the United Kingdom according to the Department of Health [DH] (2013).The National Institute for Health and Clinical Excellence [NICE] (2010) reported that about 900,000 people suffer from heart failure in the United Kingdom. The National Institute for Cardiovascular Outcomes Research [NICOR] (2011) conducted a national audit which found that one in every 20 people over the age of 65 is diagnosed with heart failure which demonstrates that it mainly affects the elderly. As a leading cause of mortality, heart failure contributes to more than 6,000 deaths each year (NICOR, 2011). Newly diagnosed cases of heart failure have a 40% risk of dying within a year (NICOR, 2011). Despite advances in therapy, mortality is still high and only half of patients are alive five years after being diagnosed with heart failure (NICE, 2010).
Simon Sinek, in the YouTube video “The Millennials in the Workplace Interview”, states that Millennials need to learn balance with their social media and physical life. According to Sinek, a millennial is a person born approximately between 1984-2000. Throughout the Interview, Simon is very zealous, empathetic, apologetic, and humorous. He uses metaphors, They Say I Say, diction, and parallel structure.
Life for Millennials is not as easy as it has been said to be. According to Taylor Tepper, an editor of Money Magazine, when the Great Recession peaked in 2010, the large mass of Millennials graduating college were more vulnerable being that the unemployment rate among young adults peaked at 14% (Tepper). A Pew Research Center survey came to the conclusion that “Millennials are the first in the modern era to have higher levels of debt, poverty and unemployment, and lower levels of wealth and personal income than their two immediate predecessor generations had at the same time” (Tepper). In addition, David Bass, a Millennial himself and author of “The Millennial Generation Lacks a Strong Work Ethic,” states that the current employment rate for young adults is 55.3%, “the lowest rate since the end of World War Two” (Bass). These numbers do not tell it all, rather “a generation’s greatness is not determined by data; it’s determined by how they react to the challenges that befall them,” challenges that this generation does not fall short of
This spoiled generation has hit a wall called life and is currently trying to find a way to get over it. The workplace has been a brutal environment for generations now. The millennials, also known as Generation Y, are not the first generation to want change in the workplace, but they are the first ones to be brave enough to step up and place their demands over their own job. The millennials shouldn’t be criticized, they should be admired by every other worker in the workplace. Matchar supports the addition of millennials, but added negative connotation in her article about them.
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.
You do not need a vast knowledge in jazz music for the name Herbie Hancock to sound familiar to you. Having had an amazing career over the course of more than half a century, Hancock has become known as a remarkable jazz pianist, an innovative composer and an explorer of original musical forms. Hancock has had an enormous influence on both electric and acoustic jazz and more recently on hip-hop and R&B. His career is not only acclaimed by numerous jazz music enthusiasts, but also by the music industry, as Hancock has won fourteen Grammy awards along the way.
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.
Drug administration forms a major part of the clinical nurse’s role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (O'Shea 1999). So as a student nurse this has become my duty and something that I need to practice and become competent in carrying it out. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I was not competent enough to dispensing a certain drug it would be my responsibility in speaking up and let the registered nurses know, so that I could shadow them and have the opportunity to learn help me in future practice and administration.
The key priority for nursing care with this patient is her learning disabilities and the potential communication barriers that may occur. The patient’s hypertension is well controlled with medication; for these reasons I will focus this assignment around communication barriers with people with learning disabilities, and the importance of good communication between the multi-disciplinary team within the unit. I will also explore any issues with consenting to the procedure, as it is imperative that the patient is fully aware of the procedure and understands the possible risks and complications. I introduced myself to the patient stating that I was a student nurse and gained verbal consent to carry on with the assessment, as a student nurse you must respect patients wishes at all times, if they do not wish for a student to carry out the assessment this must be respected, the patient wishes out way the need for the student to gain experience (NMC 2005).... ...
In Simon Sinek’s speech, Millennials In the Workplace (2017), he goes into great detail about the main consequences that Millennials face in the working world and why those consequences exist in the first place. He begins by talking about his first point, “Failed parenting strategies, where they were told that they were special - all the time, they were told they can have anything they want in life, just because they want it.” (2017, 1:55) This point I believe is one of the most important because
There is a generation that is 80 million strong who is the start of a new millennium. The people of this generation are called the Millennials. Many think of them as closeminded, faulty and not fit to run the major cooperation’s of the world someday, yet the true identities of this group are just starting to be revealed. Millennials can easily and thoroughly understand the new advances in technologies. They are also the most diverse and open minded generation yet. They show a lot of potential and could someday change the world for the better. A writer for Time magazine, Joel Stein, does a wonderful job describing the millennials for who they truly are in his article “The New Greatest Generation.” While Stein agrees with Twenge in that millennials show faults, he maintains that their faults have potential to make them the next greatest generation. Despite the negative connotations millennials receive, they often have the ability to be resourceful with the technology, open-minded to the diversities the world displays and have a lot of potential.