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 NURS FPX 4020 Improvement Plan Tool Kit 4 CM

Improvement Plan Tool Kit

NURS FPX 4020 Improvement Plan Tool Kit 4 CM

This improvement plan tool kit aims to enable patients to sustain medication safety improvement measures in their home care settings after hospital discharge. This tool kit has been organized into four categories with three annotated sources each. The categories are as follows: general safety through education and quality best practices, environmental safety and quality risks, patient/caregiver led preventative strategies, best practices for improving continued education on medication related safety issues. 

Annotated Bibliography

General Organizational Safety and Quality Best Practices

Popescu, A.,  Currey, J., & Botti, M. (2019). Multifactorial influences on and deviations from 

Medication administration safety and quality in the acute medical/surgical context.

Worlds views on Evidence-Based Nursing, 8(1), 15-24. https://doi.org/10.1111/j. 1741-

6787.2010.00212.x

This article illustrates the background of medication administration and the relationships 

between caregivers and patients. It provides readers with references on the importance of having a nurse/patient therapeutic relationship to help reduce the risk of medication errors. When nurses deviated form best-practice guidelines, medication errors rise. These approaches include, double checks, education, interaction, engagement and follow up after discharge. Concrete examples in the resource demonstrated the therapeutic relationship enabled the nurse to provide education regarding medication administration and decrease the chances of medication errors after discharge. The therapeutic relationships that were built enabled the patient to feel more comfortable asking questions which prepares the patient to safely administer medications at home.   

NURS FPX 4020 Improvement Plan Tool Kit 4 CM

Sista, S., M.D., Thanadar, R., M.D., & Ali, A., M.D. (2016). THE IMPORTANCE OF 

PATIENT EDUCATION WITH RARE MEDICATION SIDE EFFECTS: CLASSIC EXAMPLE OF AGRANULOCYTOSIS WITH METHIMAZOLE. Endocrine Practice, 22, 247-248. Retrieved from http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fimportance-patient-education-with-rare-medication%2Fdocview%2F1794012629%2Fse-2%3Faccountid%3D27965

This article explains the importance of detailed education to the patients on all aspects of safe medication administration including side effects to ensure that the patient will follow physician orders and adhere to medication guidelines and prevent potential life threating complications. Adequate education can help the patient at home recognize complications and seek medical attention early to prevent severe side effects. This source is valuable in understanding the importance of building that relationship to promote in depth medication education to help prevent adverse effects.

Paparella, S. F. (2018). Alignment with the ISMP 2018-2019 Targeted Medication Safety Best 

Practices for Hospitals: JEN. Journal of Emergency Nursing, 44(2), 191-194.    http://dx.doi.org.library.capella.edu/10.1016/j.jen.2017.11.014

This article discusses the benefits of consensus-based best practice on certain medication safety issues that are harmful and even fatal errors for patients. The journal article focuses on the importance of how personal education can improve medication safety. It states that technology and new devices have been helpful but nothing compares to individual education and instruction. The Institute for Safe Medication Practices (ISMP) has revealed that certain preventable mediation-related harm and even death continues even with new technologies. The goal of best practice is to prevent adverse effects by education. 

Environmental Safety and Quality Risk

Lette, Stoop, H. J., Nijpels, G., & Baan, C. A. (2020). Safety risks among frail older people

 living at home in the Netherlands: A cross‐sectional study in a routine primary care

 sample. Health & Social Care in the Community.

This source mentions a range of safety issues patients can face at home. Environmental risk can increase when patients live alone, have other health related issues. This article implies that an integrated approach to educate about medication administration as well as side effects and benefits is a necessity and can promote a safe environment. Most risk were increased by mental status and can be greatly reduced with proper education given to patients and care givers. 

Montiel-Luque, A., Antonio Jesús Núñez-Montenegro, Martín-Aurioles, E., Canca-Sánchez, J. 

C,. Toro-Toro, M., González-Correa, J. A., & on behalf of the Polipresact,Research Group. (2017). Medication-related factors associated with health-related quality of life in patients older than 65 years with polypharmacy. PLoS One, 12(2) doi:http://dx.doi.org/10.1371/journal.pone.0171320

This journal article is primarily a study to determine the safety and quality risk of medication issues patients have at home and what patients are more at risk. These studies prove that the older population is at a higher risk for medication errors at home. People with multiple comorbidities and polypharmacy (multi drug use) are also at t higher risk to have medication errors once they are discharged from the hospital. Without adequate education and information on administration, benefits and risk, along with follow up after being discharged the risk are even higher. This source helps health care workers realize the importance of developing that therapeutic relationship and providing clear and appropriate education.

Wong, K. L. (2010). Medicine and the Marketplace : The Moral Dimensions of Managed Care. University

 of Notre Dame Press.

This article offers a comprehensive discussion on managed care. As our population ages there is an increase in patients going home post hospitalization verses to a healthcare setting. As older Americans are wishing to ‘age in place’ or stay home longer it is the job of health care workers to provide education and follow up care to ensure our patients are safe at home. It is also our responsibility to provide education so these patients are able to safely take their medications without causing self-harm or mortality. This article offers an integrative framework to balance patients and their home safety. 

Patient/Caregiver Led Preventative Strategies

Cooper, A., Edwards, A., Williams, H., Evans, H. P., Avery, A., Hibbert, P., Makhem, M., 

Sheika, A., Donaldson, L. J., & Carson-Stevens, A. (2019). Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports. Age & Ageing46(5), 833–839. https://doi.org/10.1093/ageing/afx044

This source describes the factors associated with potential or actual harm caused by medication errors at home and highlights a few interventions patients have found beneficial to reduce these risk. Patients felt that better, clear and complete communication across care boundaries would lessen that risk of in home mediation errors. They also found that patients would be more confident administering their medication at home with more interaction from the pharmacy as well as individual ‘bubble’ pack medication that is easy to read with specific times and doses available. This source provides information that patients feel help them feel safer at home after discharge.

Knudsen, P., Herborg, H., Mortensen, A. R., Knudsen, M., & Hellebek, A. (2020). Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. Quality & Safety in Health Care, 16(4), 291.

            http://dx.doi.org/10.1136/qshc.2006.018770

This article shows a pharmacy that has done some studies on patient self-medication errors. This article describes types of errors and how to prevent them. This study proved that one of the best ways to prevent further medication errors is to accurately report medication errors and find the root cause to help prevent future errors. They found that electronically generated prescriptions has played a big role is medication error reduction. 

NURS FPX 4020 Improvement Plan Tool Kit 4 CM

Grimes, T. C., Garfield, S., Kelly, D., Cahill, J., Cromie, S., Wheeler, C., & Franklin, B. D.

(2020).

 Household medication safety practices during the COVID-19 pandemic: a descriptive

qualitative study protocol. BMJ Open, 10(11) http://dx.doi.org.library.capella.edu/10.1136/bmjopen-2020-044441

This source explores home medication safety practices in hopes to develop best practice guidelines. Evidence suggest that as our population is aging and staying at home longer as well as medication being one of the main health interventions in America, patients and caregivers or ‘lay persons’ involvement, it is especially important to optimize medication outcomes and safety. This source is relevant in that it specifies that caregivers greatly benefit in knowledge, more information is better. Good, clear communication and education will help decrease the risk of home medication errors and adverse effects.

Best Practices for Improving Continued Education on Medication Related Safety Issues

Taibanguay, N., Chaiamnuay, S., Asavatanabodee, P., & Narongroeknawin, P. (2019). Effect of 

patient education on medication adherence of patients with rheumatoid arthritis: a randomized controlled trial. Patient Preference and Adherence, 13, 119-129. http://dx.doi.org.library.capella.edu/10.2147/PPA.S192008

This article was aimed to assess the influence of different approaches to patient education. This study showed that a multi-component to medication education improved medication adherence. Providing verbal and written education in a language that most anyone can understand (at most 5th grade level) proved to have the greatest impact at medication adherence. Educating on the benefits and risk as well as dosage, time and reason for taking the medication improved these numbers greatly.

Chang, J., Wang, Q., & Yu, F. (2018). Socioeconomic differences in self-medication among

middle-aged and older people: data from the China health and retirement longitudinal

study. BMJ Open, 7(12) http://dx.doi.org.library.capella.edu/10.1136/bmjopen-2017-

017306

This article points out that patient education on medication administration makes a dramatic difference on safety and adherence. Weather it is over the counter medication or prescription medication adequate education regarding: administration, adverse effects, comorbidities and even disease processes can greatly impact adherence and safety. Adequate over the counter and prescription medication education has also been correlated with decreasing hospitalizations, emergency room visits as well as other adverse outcomes. 

Sharaydih, R., Abuloha, S., & Wazaify, M. (2020). Promotion of appropriate knowledge and att

attitude towards medicines among schoolchildren in Jordan: the role of teachers. International Journal of

Pharmacy Practice28(1), 84–91. https://doi.org/10.1111/ijpp.12582

This article focused more on educating children about medication use and safety. More people have health related issues at a younger age and the more they are educated early in life the better they will understand what is going on with them and the better they understand how to take their medication safely and appropriately. Thus educating children on the importance of their disease process, their medication and the adverse effects can decrease the risk morbidity and mortality caused by non-adherence or medication errors. 

References

Chang, J., Wang, Q., & Yu, F. (2018). Socioeconomic differences in self-medication among

middle-aged and older people: data from the China health and retirement longitudinal

study. BMJ Open, 7(12) http://dx.doi.org.library.capella.edu/10.1136/bmjopen-2017-

017306

Cooper, A., Edwards, A., William, H., Evens, H. P., Avery, A., Hibbert, P.,  Makhem, M., 

Sheika, A., Donaldson, L. J., & Carson-stevens, A. (2019). Sources of unsafe primary care for older adults: a mixed-methods analysis of patient safety incident reports. Age & Ageing46(5), 833–839. https://doi.org/10.1093/ageing/afx044

Grimes, T. C., Garfield, S., Kelly, D., Cahill, J., Cromie, S., Wheeler, C., & Franklin, B. D. (2020).

 Household medication safety practices during the COVID-19 pandemic: a descriptive

qualitative study protocol. BMJ Open, 10(11)http://dx.doi.org.library.capella.edu/10.1136/bmjopen-2020-044441

NURS FPX 4020 Improvement Plan Tool Kit 4 CM

Knudsen, P., Herborg, H., Mortensen, A. R., Knudsen, M., & Hellebek, A. (2020). Preventing medication errors in community pharmacy: frequency and seriousness of medication errors. Quality & Safety in Health Care, 16(4), 291.

            http://dx.doi.org/10.1136/qshc.2006.018770

Lette, Stoop, H. J., Nijpels, G., & Baan, C. A. (2020). Safety risks among frail older people

 living at home in the Netherlands: A cross‐sectional study in a routine primary care sample. Health & Social Care in the Community.

Montiel-Luque, A., Antonio Jesús Núñez-Montenegro, Martín-Aurioles, E., Canca-Sánchez, J. C., 

 Toro-Toro, M., González-Correa, J. A., & on behalf of the Polipresact,Research Group. (2018).   Medication-related factors associated with health-related quality of life in patients older than 65 years with polypharmacy. PLoS One, 12(2) doi:http://dx.doi.org/10.1371/journal.pone.0171320

Paparella, S. F. (2018). Alignment with the ISMP 2018-019 Targeted Medication Safety Best 

 Practices for Hospitals: JEN. Journal of Emergency Nursing, 44(2), 191-194.         http://dx.doi.org.library.capella.edu/10.1016/j.jen.2017.11.014

Popescu, A., Currey, J., & Botti, M. (2019). Multifactorial influences on and deviations from

          medication administration safety and quality in the acute medical/surgical context. 

          Worldviews on Evidence-Based Nursing, 8(1), 15–24. https://doi.org/10.1111/j.1741- 

          6787.2010.00212.x

NURS FPX 4020 Improvement Plan Tool Kit 4 CM

Sharaydih, R., Abuloha, S., & Wazaify, M. (2020). Promotion of appropriate knowledge and att

attitude towards medicines among schoolchildren in Jordan: the role of teachers. International Journal of

Pharmacy Practice28(1), 84–91. https://doi.org/10.1111/ijpp.12582

Sista, S., M.D., Thanadar, R., M.D., & Ali, A., M.D. (2018). THE IMPORTANCE OF 

PATIENT EDUCATION WITH RARE MEDICATION SIDE EFFECTS: CLASSIC EXAMPLE OF AGRANULOCYTOSIS WITH METHIMAZOLE. Endocrine Practice, 22, 247-248. Retrieved from http://library.capella.edu/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fscholarly-journals%2Fimportance-patient-education-with-rare-medication%2Fdocview%2F1794012629%2Fse-2%3Faccountid%3D27965

Taibanguay, N., Chaiamnuay, S., Asavatanabodee, P., & Narongroeknawin, P. (2019). 

 Effect of patient education on medication adherence of patients with rheumatoid arthritis:     a randomized controlled trial. Patient Preference and Adherence, 13, 119-129. http://dx.doi.org.library.capella.edu/10.2147/PPA.S192008

Wong, K. L. (2020). Medicine and the Marketplace : The Moral Dimensions of Managed Care.

                      University of Notre Dame Press.

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