Medication Safety Project
Medication Safety Project
Medication Safety Project
Please carefully answer the following questions based on this information:
A new admittance has been assigned to you.
The following are the clients diagnoses:
1) Alzheimers disease
Parkinsons disease is number two.
3) CVA with residual weakness on the L side
4) Osteoporosis is a bone disease that affects women.
5) Urinary incontinence is a symptom of urinary incontinence.
6) Recurrent urinary tract infections
7) Hypertension (high blood pressure)
8) Coronary artery disease; stent 2 years ago
9) Swiss Francs (EF 30 percent )
Atrial fibrillation (Atrial Fibrillation) is a condition in which the
Osteoarthritis, particularly in the hips and knees, is number 12 on the list.
13) Macular degeneration is a condition that affects the eyes.
14) DM Type 2
Peripheral neuropathy (neuropathy of the peripheral nerves) is a condition that affects
16) Renal insufficiency (chronic)
Anemia (number 17)
Hypothyroidism is a condition in which the thyroid gland is underactive.
COPD on Oxygen (19)
Diverticulosis is a disease that affects the intestines.
The following medications are on the clients medication list:
1) Aricept (donepezil) 5 mg PO daily
2) 10/100 Sinemet PO TID
3) 325 mg aspirin PO once a day
4) Coumadin (warfarin): 5 mg PO qHS
5) Detrol (tolterodine) 2 mg PO BID
6) Lipitor (atorvastatin) 40 mg PO qHS
insulin (number 7) (long-acting and sliding scale)
8) Neurontin (gabapentin) 300 mg PO TID
9) 325 mg iron sulfate PO TID
10) 50 mg trazodone PO qHS
11) daily levothyroxine 50 mcg
12) lasix (furosemide) 60 mg PO BID
13) 20 mEq potassium chloride PO daily
14) 100 mg metoprolol PO BID
15) lisinopril 20 mg orally once a day
16) amlodipine 10 mg orally once a day
17) 1,000 mg acetaminophen PO TID
18) 100 mg docusate sodium PO BID
19) 17 g PO daily polyethylene glycol powder (Miralax)
20) 18 mcg tiotropium (Spiriva) breathed daily
21) 10 mg PO montelukast (Singulair)
22) fluticasone/salmeterol inhalation (Advair) 100/50 BID
23) For wheezing, albuterol/Atrovent nebulizers on a daily basis
24) one daily multivitamin
25) 400 IU vitamin E every day by mouth
26) 500 mg calcium carbonate PO TID
27) 800 units of vitamin D per day by mouth
28) 100 mg kava root PO QID
29) Macrobid (nitrofurantoin) 100 mg PO qHS
Based on your examination of the three references listed under readings in the library guide and the information in the case study:
1) Explain why you might be concerned about administering which of these medications to an elderly client.
2) Talk about what alternatives you would suggest to the client or the provider (as appropriate).
3) Describe the education and/or information you would provide to ensure that the client knows the drug regimen before to release.
Drug underuse, overuse, and abuse are persistent problems in the US healthcare system, resulting in medication errors, adverse events, and less-than-optimal patient outcomes.
For example, high-risk medications, such as opioids, are frequently chosen and dosed incorrectly; confusion over medication names may result in patients receiving the wrong drugs; and patient information about medications is generally poorly designed and confusing, leading to unsafe use by consumers.
To address these concerns, AHRQ financed a patient safety Centers for Education and Research on Therapeutics (CERTs) project at Northwestern University called Tools for Optimizing Pharmaceutical Safety, which focuses on developing tools for safer medication usage (TOP-MEDS).
The CERTs demonstration program is a nationwide project aimed at doing research and providing education to improve the optimal use of treatments, such as pharmaceuticals, medical devices, and biological products.
The TOP-MEDs CERT was given money to work on a variety of projects in four areas: statistical methodologies for drug safety and effectiveness studies, opioid prescribing for acute pain, preventing and detecting medication name confusions, and patient-centered drug information.
The projects specific objectives were to:
For large-scale adverse drug event (ADE) screening, develop and use a multivariate person-time logistic regression model.
Develop and validate a web-based simulator to instruct prescribers on the right selection and dose of opioids to improve the safety and effectiveness of inpatient acute pain management.
Develop and evaluate strategies for preventing and detecting drug name confusion mistakes in clinical databases, as well as refine a standard battery of tests for pre-market safety screening of medication names.
In an urban primary care context, thoroughly analyze an EHR-based, low literacy strategy for encouraging safe, effective prescription drug use among English- and Spanish-speaking patients.
Statistical analysis of claims data sets, retrospective evaluation of EHRs, simulation studies, prospective and retrospective observational research, randomized trials, and psychological experiments were all used in the projects.
The team claimed success in the first project area, where they were attempting to develop a model for ADE screening that could be adopted and disseminated more widely.
The opioid simulator had been constructed and evaluated by the conclusion of the project period.
It was shown to be successful as a teaching aid in the initial analysis.
Furthermore, preliminary results from the health literacy experiment revealed that the patient would gain just slightly or not at all.
The studys findings have been widely disseminated through papers and talks.
Additional information on the progress of TOP-MEDs can be obtained at the National Patient Safety Foundation, in addition to the projects final report and other publications.