Critical Review On Improving The Quality Of Prescribing

There are three different types of Nursing Homes. A Skilled Nursing Facility (SNF) is a facility that is required to provide continuous (24-hour) nursing supervision by registered or licensed vocational nurses. Commonly referred to as "nursing homes" or "convalescent hospitals," these facilities normally care for the incapacitated person in need of long or short-term care and assistance with many aspects of daily living (walking, bathing, dressing, and eating). At a minimum, SNF's provide medical, nursing, dietary, pharmacy, and activity services.

Nursing home facility is for patients who need extended care because they are very sick or unable to function without continued nursing and supportive services in a formal health care facility. These patients are sick and/or are in need of assistance but they are not ill enough that they require the intense treatment and care offered at a hospital. About forty-seven percent of all nursing home facility care is paid for by Medicaid and residents and their families pay approximately one-third of the cost for the facility services. In recent years the length of time one stays at a nursing home has greatly decreased. Even with the decrease in stay there is still a fifty percent chance of an individual in his/her lifetime having to spend some time in a nursing facility. Both of these previous mentioned trends is reflective of the nursing facilities moving toward becoming more technologically sophisticated as well as being able to function as more of a

Nearly half of seniors do not take their medications when or how they were prescribed. There are mistakes on dosages, methods of delivery, time of delivery, what they should be taken with, and even if they should still be taken. Compounding the issue, most seniors over the age of 65 are taking between 8 and 13 different medications. Put these numbers together and it is no wonder that problems with medication management are one of the leading reasons seniors end up in the emergency room, and is the number one reason seniors end up back in the hospital after being recently discharged. According to a study published in "Pharmacotherapy", nearly 70 percent of hospitalized seniors suffered from at least one

A 40-bed capacity aged care facility that offers hospital level of care with registered nurses on duty in each shift (Anne Maree Rest Home, 2014,b). Weekly visits from the doctor helps keep the care going in the right track. A physiotherapist visits weekly and is also on call whenever needed. There is a low ratio of residents to health care givers to ensure quality care at all times (Anne Maree Rest Home, 2014, b). Staff is highly trained, ensuring safe and efficient care to the elderly. The organization train employees to be of excellence because this ensures success of the body (Wentland, 2007). Residents engage in activities developed by the

In the United States today, the elderly make up approximately 13% of the population but use 30% of all prescriptions written. This article focuses on the importance of understanding patients’ prescriptions and their adverse drug events (ADE), as well as the best ways to care for patients with many prescriptions. The article also discusses the best ways to avoid ADEs.

Older adults are at high risk for adverse effects of medication error more than their counteract younger adults. This is because they depend on more than one medication in order to treat or prevent disease, syndromes and sickness (Lindenberg, 2010). It is inevitable that the elderly face adverse effects of drugs while on medication especially when they still live independently. However, chances of errors in hospitals and care homes are more frequent when the medication process connects several departments (Belen et. al., 2009). Therefore, tactical measures are required in the provision of drug therapy in order to optimize safe medication in older adults. This paper discusses the issue by analyzing the existing structure of administering medication, reviewing the occurrence of medication errors; evaluating systems developed to advance safe medication administration. Finally, addressing the implication for professional nursing practice.

De-prescribing is, therefore, a complex process that is required for the safe and effective cessation of inappropriate medications to improve the quality of life (Hasler, Senn, Rosemann, & Neuner-Jehle, 2015). Page et al. (2016) suggested a five-step approach for safe and successful de-prescribing: (1) consider all medications currently taken and the indication for each medication, (2) evaluate the overall risk of medication-induced harm in an individual, (3) assess each medication for its potential to be de-prescribed, (4) sort medications by the order of priority to de-prescribe, (5) implement and monitor de-prescribing regimen. While de-prescribing appears feasible and relatively safe to reduce the impact of polypharmacy in older adults,

Polypharmacy is an emerging problem that has drastically increased in the past 20 years (Alpert, 2015). This is a huge problem in the elderly population greater than 65 years old because this group is more likely to have been diagnosed with multiple conditions that require many different medications. Other reasons include the increasing availability of newer medications that treat more than one condition, the elderly who are known to be on multiple pills a day, and providers prescribing more than one drug to aggressively treat chronic conditions (Alpert, 2015). About 44% of men and 57% of women greater than 65 years of age take five or more medications in a week, about 10% of both men and women take more than ten pills each week (Woodruff, 2010).

During a interview with County Pharmacists Associations newly elected president, Lillian Shisehaunt, pharmacist, said there were a few concerns that needed to be made aware of. She began to speak the concerns about how older people are taking way too many medications at the same time. In this meeting, other pharmacist agreed to the statement stated as well.

According to the Health Care Finance Administration (HCFA), on July 1, 1999, established a quality indicator that residents taking nine or more medications will be used to identify long-term facilities where medications potentially are overused and residents may be at increased risk for adverse drug reactions (ADR). However, this approach can be controversial because the medication is essential for older people health safety. There are many factors on the overuse of medication which can include age, health and the number health care visits. Especially on home care and long-term facilities, most of the elderly in this facilities are forced to take these medications due to facility policies (Hanlon, 2001). Another

The concept of “deprescribing medications” as mentioned in your paper is an interesting topic. This is a relativity new concept that the use of multiple medications that can increase the risk of adverse drug reactions to the patient. When polypharmacy is apparent, the risk of drug interaction falls hospitalization and death can occur. The APN has a role in the medical profession to start a trend of watching over and deprescribe medication for the polypharmacy patients. While compiling the prescribed medication and the medication the patient consumes the chance that they can overlap each other and cause harm is increased. With the elderly population deprescribing by tapering, stopping, and or discontinuing medication

“polypharmacy as the use of five or more prescription medications—is common among seniors and can lead to reduced compliance with medication regimens and problems with drug–drug interactions” (2012, p.428). Elderly patients are mostly at risk to polypharmacy issues due to aging effects on how the body tolerates medications, and also, as a result of taking more medications than younger patients. Reason et al., continues to demonstrate that the use of prescription increase with age and in association with multiple morbidities in the elderly patients. Medications such as over the counter drugs, herbal preps, and home remedies are widely used by older adults. These medications have a higher risk of causing adverse drug reaction especially with

Are any of you are aware of the terminology of any medication taken or do you all simply take the medication because it was prescribed by a doctor? it is undeniable that drugs do save lives, but few prescription medications are completely free of risks or side effects. Naturally, the more drugs that are taken at the same time, the greater the risk of adverse interactions and potentially devastating side effects. This problem of “overmedication” is increasing to almost epidemic proportions among the elderly. For example, a recent Washington Post article that described an 83-year-old grandmother who wished to remain anonymous. The woman had been hospitalized for an asthma attack. In the hospital, she was prescribed

Polypharmacy by definition is the concurrent use of multiple medications. More often than not, it is supplementary with the prescription and use of too many or unnecessary medicines at dosages or frequencies higher than therapeutically essential (National Prescribing Service Newsletter, 2000). It is becoming a prevalent concern in the nation given that there is an increase in the older adults who are being treated for multiple chronic diseases. Research indicates, “44% of men and 57% of women older than age 65 take five or more medications per week; about 12% of both men and women take 10 or more medications per week” (Woodruff, 2010, para. 1). In that same research, it pointed out that most of the commonly used over the counter drugs are

Despite these negative notions, the extension of pharmacist prescribing has nowadays been perceived as generally positive with attitude shifts of health care professionals on pharmacist independent prescribing, supporting by approximately 35% shift of service delivery from doctors to pharmacists in Acute / Foundation Trust (Latter et al., 2010) and the possibly more importantly, acceptance by patients with 87% of patients are satisfied with the consultation with their PIPs (Latter et al.,