Proper medication management among older adults can be challenging. Older persons may not fully understand the purpose of the medication and the importance of following the prescription as directed. Over the counter medication, herbs and supplements may not be considered medication; therefore, they do not inform their health care provider that they are taking them. Multiple health care providers can result in duplication of orders or adverse drug reactions. Improper management of medication may lead to adverse drug events ultimately extending a hospitalization or decreasing an older adult’s ability to function safely. Obtaining an accurate record of medications at all points of care promotes safer medication administration and prevents adverse events.
Zwicker D., Fulmer T. (2012) Reducing adverse drug events (ADE) in older adults focuses on drug-drug interactions, drug-disease interactions, iatrogenic ADE’s, poor medication adherence, pharmacodynamics and polypharmacy. According to Zwicker D, Fulmer T. (2012) “Around 31% of all adverse events in hospitals are caused by medication-related problems.” This guideline is developed to promote safety in the hospital and after discharge. It is comprehensive in providing assessment tools to promote medication safety such as Beers Criteria and the Cockcroft Gualt formula to determine renal failure. The guideline assesses functional capacity in both independent activities of daily living and functional activities of daily living as well as cognitive capacity. Zwicker D, Fulmer T. (2012) advised completing a brown bag method of reviewing all medication as part of the assessment in order to include all medication an older adult has at home including over the counter medication herbs,...
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...ternally who reviewed for validation.
Works Cited
Bergman-Evans B. Improving medication management for older adult clients. Iowa City (IA): University of Iowa College of Nursing, John A. Harford Foundation Center of Geriatric Nursing Excellence; 2012 May. 31 p. [117 references]. Retrieved from http://www.guideline.gov/content.aspx?id=37826
Hanlon, J. T., Schmader, K. E., Ruby, C. M., & & Weinberger, M. (2001). Suboptimal prescribing in older inpatients and outpatients. Journal of the American Geriatrics Society, 49 200–209(2), 200-209.
Zwicker D, Fulmer T. Reducing adverse drug events. In: Boltz M, Capezuti E, Fulmer T, Zwicker D, editor(s). Evidence-based geriatric nursing protocols for best practice. 4th ed. New York (NY): Springer Publishing Company; 2012. p. 324-62. Retrieved from http://www.guideline.gov/content.aspx?id=43938
...teract. Many of the medications are very powerful in and of themselves. This article also presents additional approaches to medicating the elderly, including focus on reduction of number of medications prescribed. Both articles present the importance of considering the normal physiological changes within geriatric patients.
Lilley, L. L., Rainforth, S., & Snider, J. (2013). Pharmacology and the Nursing Process (7th Ed.)
When doctors prescribe medication for their patients, a local retail pharmacy is most likely to be utilized to fill the order. However, there is a growing population of older Americans that are no longer able to live independently and must reside in nursing homes or assisted living facilities. In order for this vulnerable population to receive their medications, a different kind of pharmacy is needed, these are known as LTC, long term care pharmacies. Within these specialized pharmacies there are highly trained employees called CPhTs, certified pharmacy technicians who are overseen by state licensed RPHs, otherwise known as pharmacists.
Today?s healthcare environment calls for continued cost containment while providing better, quality care. As a result of the advances of healthcare, life expectancies have increased resulting in a growing, aged population with more chronic conditions. Treatment options, outside the hospital, are the norm for most routine management of patient care, but when someone gets sick, and requires hospitalization, the combination of their age, chronicity of illness and increased comorbidity
Vallerand, April Hazard, Cynthia A. Sanoski, and Judith Hopfer Deglin. 2013. Davis's Drug Guide for Nurses. 13th ed. Philadelphia: F. A. Davis Company.
Every day there is a constant trust adhered to many different people in the profession of Nursing—the decision of what will help patients in terms of medicine, and the confidence to make these decisions. One false act or one slight misdiagnoses of medication to a patient could be the prime factor in whether the patient lives or dies. Nurses in hospitals across the country are spread thin, and thus makes the probability of mistakes higher. If a medicinal dose is off by even one decimal a patient could die, so the only real answer is for nurses to not be afraid to ask for assistance, always follow procedure and voice opinion is they feel something is wrong.
Metcalfe, J. (2005, July). Management of patients with long term conditions. Nursing Standard, 19(45), 53-61.
There are profound effects of ageism that can be harmful to a patient’s overall health. Ageism can cause physicians to consistently treat older patients unequally compared to younger adults. Unequal treatment can be divided into the under-treatment of symptoms and the over-treatment of symptoms. The imbalance in how a physician would treat a geriatric patient is ageist because the older adult is not getting fair treatment in every case. Under-treatment and over-treatment are different; however, they are both equally as harmful to a patients health.
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.
Polypharmacy is the “concurrent use of several differ drugs and becomes an issue in older adults when the high number of drugs in a medication regimen includes overlapping drugs for the same therapeutic effect”(Woo & Wynne, 2011, p. 1426). The patient is currently taking several medications that can potential interact with each other, perform the same therapeutic effect, and creating side effects. The following is a list of her medications and their indications:
PICO Question: Among the elderly patients receiving care at Cary Medical Center on Med/Surg, who are currently taking multiple medications due to comorbidities, would reviewing medications at each provider visit reduce polypharmacy and its associated adverse reactions?
PICO Question: Among the elderly patients receiving care at Cary Medical Center on Med/Surg, who are currently taking multiple medications due to comorbidities, would reviewing medications at each provider visit reduce polypharmacy and its associated adverse reactions?
Geriatric doctors are better equipped to care for older adults, as they are knowledgeable and aware of what treatments/care are/is needed. Doctors’ who do not specialize in geriatrics are making mistakes on choosing the appropriate medication or care needed for individuals to improve their health. Further, these geriatric centers will be better equipped with features that are appropriate for senior citizens, such as handrails, skid-proof floors, etc. (Firger, 2013). The creation of these facilities allows for the fragmented system to become more person-centered and coordinated, since the facilities overall structure is better prepared to handle care for the older adult population.
Participation in continuing education and professional development programs will help clinicians to follow the guidelines and increase the knowledge about minority health issues (Martinez, Maislos, & Rayford, 2012). Support from family or care-givers in assisting older men in taking medications, especially those with co-morbidities will improve medication adherence. Mr. Jose has good family support, excellent health insurance and good financial status. Though he is educated, his knowledge of healthcare and available health resources is inadequate. In addition, he delayed to seek medical help for his urinary symptoms for two years.
Brown. J, (2013). Reducing Medication Errors in Nursing Homes Admissions. Retrieved on March 29, 2014 from http://www.elderbranch.com/blog/reducing-medication-errors-in-nursing-home-admissions/