Polypharmacy Analysis

It should be made mandatory for the nurses to read back the documented prescription to the doctor. It should be signed by the doctor for confirmation after been reviewed by the druggist.

Polypharmacy, described as an individual taking more than four medications, can be concerning with the aging population. Polypharmacy concerns include adverse drug reactions, drug interactions, higher cost, decreased mobility, decreased quality of life and cognition impairment. Those at greater risk of negative polypharmacy consequences include elderly, psychiatric patients, recently hospitalized, individuals with multiple doctors or pharmacies and people with impaired vision or dexterity. There are times that polypharmacy is at times needed to help a person with their diagnosis, an example of this is using multiple medications to treat congestive heart failure which can include digoxin, diuretics, and angiotensin-converting enzyme inhibitors

For nurses extending their role to include prescribing there is much to consider. Revelay (1999) states that, accountability involves an individual giving an account of their actions with the rationale and explanation given for these actions. The decisions regarding boundaries of practice are firmly placed in the hands of the individual practitioner (Carlisle 1992). Accountability means being able to justify any actions and accepting responsibility for them, and is an integral part of nursing practice (Rowe 2000) The NMC Code of Professional Conduct (2004) states that a nurse is personally accountable for her practice, has a duty of care to patients and must work within the laws of the country.

It is imperative that all members of the care team are able to quickly and accurately communicate the patients’ condition and needs to other members of the care team. Proper communication allows for better monitoring of the patients’ condition and allows the providers and pharmacists to more accurately assess the patients’ treatment needs. The implementation of electronic medical records (EMR), as Nightingale Hospital is currently researching, has been shown to greatly improve care team communication and patient outcomes by allowing easy, verifiable access to all the patients’ records. Implementation of an EMR system will provide a necessary foundation for a great improvement in staff and provider communication, resulting in improved outcomes for all patients, including those undergoing anticoagulation therapy. Specifically regarding anticoagulation therapy, EMR will allow other care team members, including other nurses, providers and pharmacists’ one place to look for patient histories, allergies, lab and other results and monitor, potential drug interactions and adjust medication levels with regard to patient specific needs. EMR will also allow for more accurate medication administration through

The problem in this scenario is the challenges faced with trying to implement a new clinical pathway. This particular clinical pathway trying to be implemented is concerning ventilator-dependent patients who are discharged to home with home health care needs. These patients tend to have multiple health care needs beyond the ventilator and the new clinical pathway will establish a smooth transition from hospital to home, allowing for all the patient’s needs to be met. The challenges arise when trying to get all areas of the health care team to get involved. This especially includes the physicians that seem reluctant to follow a nurse’s guidelines. Not only are the physicians reluctant, the home health care representative will not be available to attend team meetings for a while. The new clinical pathway is due to be started in one month, so there is little time to get all parties on board.

Three ethical issues relating to marketing and advertising are Truth in Adverting and Marketing, Advertising and Marketing Harmful Products and Advertising and Marketing Tactics. The FDA (Food and Drug Administration) has requirements for truth in advertising and the FTC

When patients are brought back for rooming, the nurse or medical office assistant will review the printed list with the patient prior to documenting in the EMR. During the office visit, we will review polypharmacy and are adding a document to our resources section of the EMR regarding polypharmacy and accurate medication list that will be given to all patients. I have always been aware of the importance of accurate medication list, but was not reviewing this often enough in our patients EMR.

Administration of medication to a patient is an interdisciplinary concern. When dealing with medication, nurses are held with as much accountability as other members within the medical team. To uphold this standard, it is important for nurses to stay informed with new research to help provide better care to their patients. The nursing community also adheres to the “nursing process,” a guide that nurses utilize to achieve well-rounded care. Nurses can relate the nursing process not only to their plan of care, but also to different subjects to systematically analyze information. Applying the nursing process to this research created a connection that allows awareness of the

Two days after implementation, nurses proposed to the manager a revised staffing matrix to accommodate time constraints. The manager was willing to support Discounted MEDS; therefore, by the next high-volume discharge day, the matrix included an additional registered nurse (RN). Nurses also agreed to place copies of specific medication resources to accommodate other potentially busy discharge days. This discipline started recording

            As electronic health records, have been a former nursing present transition, medication list equally compare in a transition as medication reconciliation is addressing preexisting medications that are no longer being taken by the patient, removed from the patient's medication list. The development of medication reconciliation is becoming the up and coming push to obtaining patient medication list accurately, precisely, and safely beginning in outpatient settings.  Similarly, nursing presences theory supports direct nursing practice to improve direct patient care, safety among medication treatment, as well as engagement to providers with patients (Presence in nursing practice: a concept analysis,

What is your opinion about how well prepared APNs should be for the responsibility of prescribing medications? “I believe that Advanced Practice Nurses should take the time to research and familiarize

Nurses play a huge role when it comes to healthcare and keeping individuals alive and healthy. Nurses aid in the well-being of their patients by promoting, protecting, and optimizing their health by relieving suffering through various steps of nursing diagnosis, treatment, and by being advocates for their client’s. Registered nurses (RN’s) are a type of nurse that is registered with the College of Nurses of Ontario and they have a major role and responsibility in the direct care for their patients. According to the College of Nurses of Ontario, “Nursing is a profession that is focused on collaborative relationships that promote the best possible outcomes for clients.” (CNO, 2014, pg 3, para 2) To provide best possible outcomes for clients, the roles of nurses are constantly changing due to the fact there are many possible different ways to improve and treat health because each individual is unique. An area that needs to be expanded within the registered nurse’s range of practice is the ability to prescribe drugs since it is a topic that registered nurses currently are not competent to do so. The healthcare system in Canada and Ontario would be faster and more efficient if registered nurses are allowed to prescribe medications.

The use of psychotropic medication can be an effective part of the therapeutic process when treating clients with major depression and other mood disorders. Segal, Kennedy, Cohen & Group CDW (2010), as cited by Sheperis (2015), affirm that a combination of medications and therapy are more effective than counseling alone when treating depression. While the clinical mental health counselor (CMHC) is not qualified to prescribe medications, they may refer the client to a medical professional when a diagnosis indicates it is warranted. (Sheperis, 2015). Once prescribed, the CMHC takes on the important role of educating and monitoring the client regarding their medications.

Mrs A is a 71 year old widow with CCF and osteoarthritis who has recently been exhibiting quite unusual behaviour. Her daughter is concerned about her mother's ability to remain independent and wishes to pursue nursing home admission arrangements. She fears the development of a dementing illness. Over the last two to three months Mrs A has become confused, easily fatigued and very irritable. She has developed disturbing obsessive/compulsive behaviour constantly complaining that her lace curtains were dirty and required frequent washing. Detailed questioning revealed that she thought they were yellow-green and possibly mouldy. Her prescribed medications are:

Every day, when working as a nurse, I see many patient that lack knowledge about medications that they are taking. They take pills without even knowing why they need them, what side effects they should look for, or what contraindications that need to know. Very often it leads to patients taking wring dosage at the wrong time. I also can lead to medical errors at the hospital due to misleading information patients provide on admission. In my paper I introduce the problem and a possible solution to it. Computer program that will allow nurse to provide patients with information about their every new medication. This paper will provide information about implementation and evaluation of this solution. In addition, it will also include my reflection