104 resultados para Medication reconciliation
Resumo:
Rationale Psychiatric illnesses such as schizophrenia and their treatments have consequences in terms of lifestyle, diet and weight.
Aims and objectives ‘Mind and Body’ is a 10-week programme of weekly sessions aimed to improve the health status of people treated with second generation antipsychotic medications.
Methods The programme focuses on a range of lifestyle strategies including diet and exercise and was conducted at a Community Health Centre by professionally qualified staff. Between 2002 and 2006, 50 participants enrolled in, and 30 completed the programme. Measures of body weight, health status (Short Form-36) and blood markets (plasma glucose, haemoglobin A1c and lipid profile) were collected at commencement and completion of the programme.
Results A modest improvement was demonstrated in mean values for the majority of measures collected.
Conclusions A lifestyle program for people treated with antipsychotic medications is achievable and may be worthwhile although gains may be modest.
Resumo:
Aim: This article is a report of a study examining the practices of acute care nurses when administering medication via enteral tubes. Background. Administering medication via enteral tubes is predominantly a nursing responsibility across countries. It is important to establish what nurses actually do when giving enteral medication to inform policy and continuing education development.
Method: In 2007, a survey was conducted using a random sample of acute care nurses at two large metropolitan hospitals in Melbourne, Australia. There were 181 Registered Nurses who participated in the study; 92 (50Æ8%) practised in intensive care units, 52 (28Æ7%) in surgical areas, 30 (16Æ6%) in medical areas and 7 (3Æ9%) were from combined medical–surgical areas. The questionnaire was developed by the researchers and a pilot study was conducted in August 2006 to test reliability, face validity and user-friendliness of the tool.
Results: Nurses reported using a range of methods to verify enteral tube position prior to administering enteral medication; some were unreliable methods. A majority reported administering enteric-coated and slow or extended release forms of medication, and giving solid forms of medication when liquid form was available. Nearly all (96%) reported flushing a tube after giving medication, 28% before, and 12% always flushed between each medication.
Conclusion: Enteral medication administration practices are inconsistent. Some nurses are using unsafe practices and may therefore compromise patient care.
Resumo:
Background and Aims: Although numerous factors influence medication administration, our understanding of the interplay of these factors on medication quality and safety is limited. The aim of this study was to explore the multifactorial influences on medication quality and safety in the context of a single checking policy for medication administration in acute care.
Approach: An exploratory/descriptive study using non-participant observation and follow-up interview was used to identify factors influencing medication quality and safety in medication administration episodes (n = 30). Observations focused on nurses’ interactions with patients during medication administration, and the characteristics of the environment in which these took place. Confirmation of observed data occurred on completion of the observation period during short semi-structured interviews with participant nurses.
Findings: Findings showed nurses developed therapeutic relationships with patients in terms of assessing patients before administering medications and educating patients about drugs during medication administration. Nurses experienced more frequent distractions when medications were stored and prepared in a communal drug room according to ward design. Nurses deviated from best-practice guidelines during medication administration.
Implications: Nurses’ abilities and readiness to develop therapeutic relationships with patients increased medication quality and safety, thereby protecting patients from potential adverse events. Deviations from best-practice medication administration had the potential to decrease medication safety. System factors such as ward design determining medication storage areas can be readily addressed to minimise potential error.
Conclusions: Nurses displayed behaviours that increased medication administration quality and safety; however, violations of practice standards were observed. These findings will inform future intervention studies to improve medication quality and safety.
Resumo:
Objective: This study investigated the relationship between patients' reasoning about medication adherence and neurocognitive and clinical indices for a treatment-compliant sample of Japanese patients with schizophrenia.
Methods: Subjective reasoning about medication adherence was assessed by the Rating of Medication Influences (ROMI) scale. General intelligence, executive function, and verbal memory were assessed by the Wechsler Adult Intelligence Scale-Revised, Wisconsin Card Sorting Test, and Rey Auditory Verbal Learning Test, respectively.
Results: Higher prevention scores were associated with lower executive functioning and older age. Influence of others was associated with years of education, medication dosage, and IQ, and medication affinity was associated with education.
Conclusions: These results suggest that executive functioning, education, and general IQ may all be important factors in individual motivation for medication adherence.
Resumo:
Background Medication side effects are an important cause of morbidity, mortality and costs in older people. The aim of our study was to examine prevalence and risk factors for self-reported medication side effects in an older cohort living independently in the community.
Methods The Melbourne Longitudinal Study on Healthy Ageing (MELSHA), collected information on those aged 65 years or older living independently in the community and commenced in 1994. Data on medication side effects was collected from the baseline cohort (n = 1000) in face-to-face baseline interviews in 1994 and analysed as cross-sectional data. Risk factors examined were: socio-demographics, health status and medical conditions; medication use and health service factors. Analysis included univariate logistic regression to estimate unadjusted risk and multivariate logistic regression analysis to assess confounding and estimate adjusted risk.
Results Self-reported medication side effects were reported by approximately 6.7% (67/1000) of the entire baseline MELSHA cohort, and by 8.5% (65/761) of those on medication. Identified risk factors were increased education level, co-morbidities and health service factors including recency of visiting the pharmacist, attending younger doctors, and their doctor's awareness of their medications. The greatest increase in risk for medication side effects was associated with liver problems and their doctor's awareness of their medications. Aging and gender were not risk factors.
Conclusion Prevalence of self-reported medication side effects was comparable with that reported in adults attending General Practices in a primary care setting in Australia. The prevalence and identified risk factors provide further insight and opportunity to develop strategies to address the problem of medication side effects in older people living independently in the community setting.
Resumo:
Aims and objectives
To explore the effects of introducing an electronic medication management system on reported medication errors.
Background
Computerised medication management systems have been found to improve medication safety; however, introducing medication management system into healthcare environments can create unanticipated or new problems and opportunities for medication error.
Design
Descriptive analysis of medication error reports.
Methods
This was a retrospective analysis of 359 incident reports drawn from the period of 1 May 2005–30 April 2006 across two hospital sites of a single not-for-profit private health service located in metropolitan Melbourne. Site A used a conventional pen and paper system for medication management, and Site B had introduced a computerised medication management system.
Results
Most medication errors occurred at the nurse administration (71·5%) and prescribing (16·4%) stages of delivery. The most common medication error type reported at Site A was omission (33%), and at Site B was wrong documentation (24·2%). A higher proportion of errors at the prescribing phase, and less nurse administration errors, were detected at Site B where the medication management system was in use. The incidence of other, less frequent errors was similar across the two hospital sites.
Conclusions
This examination of medication error reports suggests there are differences in the types of medication errors that are reported in association with the introduction of electronic medication management system compared to pen and paper system systems. The findings provide a new insight into the effects of introducing an electronic medication management system on the types of medication errors reported.
Relevance to clinical practice
The findings provide a new insight into the types of medication errors that are reported during implementation of an electronic medication management system. Extra support for physicians prescribing practices should be considered.
Resumo:
Background
Studies have shown a correlation between bipolar disorder and diabetes mellitus. It is unclear if this correlation is a part of common pathophysiological pathways, or if medication for bipolar disorder has negative effects on blood sugar regulation.
Methods
The Norwegian prescription database was analyzed. Prescriptions for lithium, lamotrigine, carbamazepine and valproate were used as proxies for bipolar disorder. Prescriptions for insulin and oral anti-diabetic agents were used as proxies for diabetes mellitus. We explored the association between medication for bipolar disorder and diabetes medication by logistic regression
Results
We found a strong association between concomitant use of medication to treat diabetes mellitus and mood stabilizers for the treatment of bipolar disorder. Females had a 30% higher risk compared to men of being treated for both disorders. Persons using oral anti-diabetic agents had higher odds of receiving valproate than either lithium or lamotrigine. Use of insulin as monotherapy seemed to have lower odds than oral anti-diabetic agents of co-prescription of mood stabilizers, compared to the general population.
Conclusions
This study showed a strong association between the use of mood stabilizers and anti-diabetic agents. The association was stronger among women than men.
Resumo:
Background Phosphate binder medication adherence is required to maintain optimal phosphate levels and minimise bone disease in people with end stage kidney disease.
Objectives To examine the impact of a nurse-led education intervention on bone disorder markers, adherence to phosphate binder medication and medication knowledge.
Design Descriptive study with a paired pre–post intervention survey.
Participants Adults receiving haemodialysis.
Methods Twelve-week intervention where patients self-administered their phosphate binder medication at each dialysis treatment. Nurses provided individualised education. Patients completed a pre- and post-intervention survey designed to explore their knowledge of phosphate binders.
Results There were no statistically significant changes in clinical markers but a significant improvement in the proportion of patients who took their phosphate binder correctly, increasing from 44 to 72% (p = 0.016). There were moderate to large effect size changes for improved knowledge.
Conclusions A nurse-led intervention education programme can increase patients' phosphate binder adherence. However, this does not necessarily manifest into improved serum phosphate levels.
Resumo:
This article explores the changing ways in which Australians and Vietnamese remember and memorialize their involvement in the Vietnam War and how these processes intersect with notions of reconciliation and historical justice in postwar contexts. It uses the Battle of Long Tan of August 1966 as an entrée into these considerations and questions how heritage-making and memorialization processes can facilitate the achievement of reconciliation between parties formerly in conflict. Not surprisingly, the Australian and Vietnamese veterans of the battle and the two states, the Commonwealth of Australia and the Socialist Republic of Vietnam, have different motivations for wanting to remember Long Tan. On the Australian side, a sense that reconciliation and atonement are needed is often reflected in official government and veterans’ statements about the war and Australia-Vietnam relations, in the memorialization process at Long Tan and in the involvement of Australian veterans groups engaged in local economic development and community building in Vietnam. On the Vietnamese side, where the Vietnam War played out as a civil as well as an international war, efforts by those who actively supported the former Republic of Vietnam based in Saigon in the south and among the overseas Vietnamese (Viet kieu) to memorialize their engagement in the conflict have been frustrated. The usefulness of the notion of seeking historical justice is therefore questioned in post–civil war situations where people are locked into fixed histories and are unprepared or unable to revisit and retell personal and collective memories and histories.
