The Effectivenss of Nurse Navigation on Medication Compliance

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In a rapidly changing healthcare environment wrought with financial pressures, government mandated performance incentives along with rising healthcare cost, hospitals have been challenged to meet the bottom line. Many hospitals have closed their doors while others have elected to cut staffing resources, programs and re-think their strategies (Barkell, Killinger, & Schultz, 2002). Under the Affordable Care Act, Medicaid recipients are now limited to six emergency room (ER) visits per year and nine primary care visits per year before they are forced to pay out of pocket or unable to pay. Many healthcare leaders now worry that emergency room reimbursement will be restricted and due to the growing number of uninsured, combined with a shortage of primary care doctors many patients will not be able to get into their doctors offices creating an overwhelming burden on already congested emergency rooms. Many patients return to the emergency room or seek primary care treatment in an ER due to factors related to medication noncompliance, whether it is lack of funds, transportation to their physician’s office or poor health literacy. This study will examine the effectiveness of utilizing a nurse navigator to improve medication compliance. The nurse navigator strategies will focus on education, primary intervention and collaboration with key stakeholders to reducing barriers to compliance. Navigators help patients make informed medical decisions and assist with setting up multiple doctors' appointments and tests. Navigators also provide tips on dealing with new diagnosis, complex medical problems and terminal conditions. They make sure patients stay on track with their treatment plan and offer emotional support. Depending on the hospital, navigators might be nurses, social workers or other staffers certified through programs that include training in care coordination, motivational interviewing skills, and cultural sensitivity. They have access to patient medical records and treating physicians. They can also run interference on insurance issues, help with translation for non-English speakers and even make sure patients have a ride to the doctor's office. Background This writer’s organization is a 100 bed acute care hospital located in a rural underserved area. This organization provides care to a large number of uninsured and underinsured patients. According to the Center for Disease Control (2011), 38% of the population lives below the federal poverty index level and 46% of the population live in housing units. The health and economic disparities pose a significant risk to the morbidity and mortality of the client population.

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