ArticlesNurses' observations and experiences of problems and adverse effects of medication management in home care
Section snippets
Literature review
Evidence from previous research suggests that polypharmacy2, 3, 4, 5, 6, 7 (generally defined as taking five or more drugs2), lack of knowledge or understanding,2 cognitive status,2, 6, 8 older age,3 living alone,2 and cost of medications9, 10 all contribute to medication mismanagement in the elderly population. These risk factors have been found to be prevalent in older people receiving home care services.7, 11
Medication mismanagement has been associated with many adverse outcomes, such as
Method
This was a nonexperimental, descriptive study of home health care nurses' observations and experiences of medication management in the home setting. Data were collected by self-report from home health care nurses at participating agencies.
Results
One-hundred-and-one nurses completed the survey questionnaire, resulting in a 30% response rate. These nurses reported on a total of 1467 patients. The majority of nurses completing the survey had many years experience in home care, were staff nurses, worked full time, were in general home care practice, and provided direct patient care. Thirty-nine percent had baccalaureate degrees. On average, nurses visited 15 (SD 7.2) patients per week (Table 1).
Research Question 1: Identify and describe
Discussion
Nurses observed many different kinds of medication problems typically defined as errors, such as patients taking medications in ways that deviate from the prescribed medication regimen, including taking the wrong medication, taking the right medication in the wrong dose, taking the right medication at the wrong time, skipping a dose, or simply not taking a prescribed medication. Results also suggest that patients are experiencing many adverse effects from medication errors.
The reasons for
Recommendations
Results of this study support recommendations for technology application, regulatory and policy changes, further research, and nursing practice. Technology provides many opportunities to improve communication and access to accurate information. Regulations that support the introduction and financing of technology and those with specific requirements for accurate documentation at the time of discharge, a review of medications during each patient encounter, pharmacy checks for drug compatibility,
Acknowledgements
This study was funded by internal funds from the University of Massachusetts at Boston.
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Med Wise: A theory-based program to improve older adults' communication with pharmacists about their medicines
2016, Research in Social and Administrative PharmacyCitation Excerpt :They require considerable support in developing the skills and motivation to ask questions, explore options, and share care decisions with their providers, including their pharmacist. Taking an active role to engage pharmacists is especially important for older adults, whose medication regimens are more likely to be complicated and most at risk of medication problems.5–7 The Institute of Medicine (IOM) has documented serious threats to patients' medication safety and called for system-wide change to help protect against preventable harm.8
Unnecessary complexity of home medication regimens among seniors
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- 1
CAROL HALL ELLENBECKER, RN, PhD, is an associate professor at the College of Nursing and Health Sciences at the University of Massachusetts in Boston.
- 2
SUSAN C. FRAZIER, RN, BSN, is a graduate student at College of Nursing and Health Sciences at the University of Massachusetts in Boston.
- 3
SHARON VERNEY, RN, C, is a graduate student at College of Nursing and Health Sciences at the University of Massachusetts in Boston.