Polypharmacy Among the Elderly

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

Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.

Nurses are responsible for multiple patients on any given day making medication errors a potential problem in the nursing field. Medication administration not only encompasses passing medication to the patients yet begins with the physician prescribing the medication, pharmacy filling the correct prescription and ending with the nurse administering and monitoring the patient for any adverse effect from the medication. According to the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), ‘A medication error refers to any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional,

One of the critical core components of Skilled Nursing Facility is medication administration. As cited by Tenhunen, Tanner, and Dahlen (2014), they stated that 88% of the residents living in the nursing homes are aged 65 years old and older. They discussed that every five of administered medications in nursing home has one probability of error. This means that about half of the residents have the possibility of two or more medication errors daily. This applies to the Pasadena Care Center (PCC) because its residents are mostly older adults who require medications on a daily basis. Moreover, residents are prescribed with multiple medications, which make them vulnerable to medication errors. The staff at PCC is trying their best to ensure safe medication administration, however, it still in need of a major change. The goal of the proposed change is to decrease the medication errors in this organization to ensure patient safety.

This article will look at two articles and focus on aspects of safety medication administration in nursing practice by the staff nurses. This is interesting area because the previous report on the medication administration error in the UK shows that approximately 5.6% of doses administered to adult hospital patients and it has been estimated that 0.6-1.2% of medication administration errors may lead to severe harm even death (Mcleod et al, 2013). Leape et al (1995) indicated that nurses were responsible for 86% of all medication error interception, regardless of the original errors. The nurses play the important role in identifying the causes of medication errors and preventing medication administration errors in nursing practice in order to provide safe care toward the service users (Henneman et al, 2010). The Medicines and Healthcare Products Regulatory Agency (MHRA 2004) documented that the health professionals need to effectively and safely use medicines to ensure patients get the maximum benefit from the medicine; meanwhile minimizing the potential harm. This article will be critiqued on the different types of evidence which explored safety medication administration in the nursing practice toward service user. Using evidence is important in nursing practice because it can help nurses in addressing questions related to best possible care and improve patients’ outcome. It is embedded within the code the nurses are expected to use best possible evidence in the nursing

Inappropriate prescribing commonly occurs in adults aged 65 or older, who have a higher prevalence of chronic disease, disability, and dependency (Page II, Linnebur, Bryant, & Ruscin, 2010). Exposure to inappropriate medications is associated with increased morbidity, mortality, and health care utilization (Page II, Linnebur, Bryant, & Ruscin, 2010). Below is a list of measures that concentrate on the prescribing of correct medications in the hospital

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

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

This journal talks about it takes failure to resolve medications across changes in care is an important cause of harm to patients. There is not a lot to known about medication discrepancies before patients are admitted to a skilled nursing facilities. To describe the prevalence of, type of medications involved in, and sources of medication discrepancies upon admission to the SNF setting. Cross-sectional study. Patients admitted to SNF for subacute care. Number of medication discrepancies upon admission to the SNF setting. Cross-sectional study. Patients admitted to SNF for subacute care. Number of medication discrepancies, defined as unexplained differences among documented medication regimens, including the hospital discharge summary, patient

The US is an aging society like many societies around the world and as a result, there is an increase in the number of patients admitted to nursing homes. The elderly population is a fragile population that undergoes mental and physical decline in health. This increases the number of medications used, which increase the risk of adverse drug reactions due to drug-drug and drug-disease interactions. Pharmacists have become increasingly active in nursing homes by providing medication therapy management services, but the benefit in reducing prevalence of these adverse drug reactions is not fully understood. Medication therapy management is a growing field that has been incorporated by pharmacists in different states to optimize therapeutic outcomes in individual patients. Understanding the relationship between medication management and drug- drug

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.

“According to the Institute of Medicine’s Preventing Medication Errors report, the average hospitalized patient is subject to at least one medication error per day” (Barnsteiner, 2008, p. 2-459). A patient’s home medication regimen is frequently continued during hospitalization. It is often found that during the process of interviewing a patient to collect all relevant data associated with their medication history, over 60% of inpatients had at least one error on their prior to admission medication list (Salanitro et al., 2012). The many challenges and current inability to accurately identify medications taken at home can lead to potential adverse events. “An adverse drug event (ADE) is defined as harm experienced by a patient as a result

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).

Elderly patients that take several medications compound the risk of developing an adverse drug reaction. Not only does the aging process have an effect on how elderly bodies process medication, but elderly people take more medications than their younger counterparts. According to Conry (2005), the elderly patient takes an average of 5 prescription medications and two non-prescription medications (Conry, 2005). While medications are frequently necessary to enhance the quality of life of the elderly, non-pharmacologic methods should be used whenever possible. Healthcare providers need to understand how aging impacts the body’s response to medications, which drugs pose more risk to

Medication error is one of the biggest problems in the healthcare field. Patients are dying due to wrong drug or dosage. Medication error is any preventable incident that leads to inappropriate medication use or harms the patient while the medication is in the control of the health care professional,or patient (U.S. Food and Drug Administration, 2015). It is estimated about 44,000 inpatients die each year in the United States due to medication errors which were indeed preventable (Mahmood, Chaudhury, Gaumont & Rust, 2012). There are many factors that contribute to medication error. However, the most common that factors are human factors, right patient information, miscommunication of abbreviations, wrong dosage. Healthcare providers do not intend to make medication errors, but they happen anyways. Therefore, nursing should play a tremendous role to reduce medication error