...accurately set up and maintain a medication administration record – Understand that records are confidential – Know how to conduct a quantitative review of a record – Know how to conduct a qualitative review of a record – Be able to track consumer issues through a record revised 8.08 The challenge for all service providers is to understand the “whys” of documentation while also understanding the “hows”. If we are able to understand the “whys”, the mundane tasks of everyday documentation and record keeping become something that is part of the whole instead of the dreaded work we face every day. revised 8.08 Let’s Begin With A Little Chat about Program Quality You may notice that this training seems to be mostly about paper, not people. That doesn’t mean we don’t like people In fact some of our best friends are…. well, people. revised 8.08 And it’s not that we think “Good Paper Equates to Good Program” In fact, we’ve seen some very lousy programs that have really “good paper”. We call that, “doing the wrong thing, very, very well”. revised 8.08 But the thing is……….. In looking back, it’s been extremely rare that we have found really good services with really poor documentation. revised 8.08 Let’s face it……….. If we are going to keep up with all that we do to provide quality service … We’re going to have to write it down revised 8.08 So, here’s how you write it down!………… revised 8.08 Why such a big deal about...
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...include alcohol, marijuana, and prescription drugs as well as common over-the-counter medications such as cough syrups containing pseudoephedrine and inhalants. This paper focuses on the drug abuse of prescription medications among teenagers from age 13 to 18 that has emerged as a public health concern and one that has evolved into epidemic levels. This seeks to elevate the visibility of the elapsed challenges, and problems associated with this epidemic. Prescription Medication Abuse: A Public Health Threat There is a compelling rationale that prescription medications are intentionally to be taken under the direction of a physician because if improperly consume these can be hazardous. Subsequently, teens are crafting decision to abuse prescription medications based on lack of information. In fact, numerous teens assumed that prescription medication abuse is safer than abusing illicit medications. Unfortunately, drug abuse pertaining to medication prescription is on the rise. This is the primary reason why this is relevant to me, more over because I have two teenagers. In 2004, approximately 15 million Americans between the ages of 12 and up took prescription medication illicitly. Painkillers, anti-anxiety medications, stimulants, and steroids are some powerful prescription medications that teens abused. How are these prescription medications abused? These medications are...
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...investigation on children in foster care that had been prescribed powerful psychiatric medications. These medications were given four times the rate of other children. Concerns have been on the rise for children that are given “psychotropic medications”. Primarily the concern is high for those children in foster care, and who receive Medicaid, because they are in a system that has lost structure of the importance of the health and welfare of children and adolescence. Also because foster children are more likely to have more emotional and social issues, and need treatment to include psychiatric medication. Psychotropic medications are those that affect the nervous system and produce many changes in behavior or awareness. These medications can be given in the form of a tranquilizer, sedative or antidepressant. Changes should be made to prevent how children receive medications, to deter overdosing and complications from misdiagnosing the child’s illness. The effect that psychiatric drugs have on children can be sometimes upsetting. Psychiatric or psychotropic medications are used to help children with behavioral impairment. Changes should be made that will benefit children in situations as mentioned. Not only in foster care but any child that is prescribed psychiatric (psychotropic) medications. Implementing change that will assure children are prescribe the right mediations, and are given the medication according to their treatment plan, to ensure the safety of those affected by misdiagnosis...
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...errors occur. Until recently the Centers for Medicare & Medicaid Services (CMS) mandated that all patient medications be administered 30 minutes before or after a scheduled time (Department of Health & Human Services [DHHS] & Centers for Medicare & Medicaid Services [CMS], 2011, December 22). Given the expanding role of nurses, the CMS mandate is now unrealistic and counter-productive. The Institute for Safe Medication Practices (ISMP) addressed this issue by creating an Acute Care Guideline for the timely administration of schedule medications. Institute for Safe Medical Practice The ISMP is dedicated to preventing medical errors by promoting safe medication administration procedures (ISMP, 2013a). The ISMP reviews all facets of safe medication administration. Medication errors frequently result in debilitating injuries or death. The ISMP posits that the most frequent medical error is medication administration. Medication error affects over 1.5 million people annually (ISMP, 2007b, p. 1). The ISMP has committed staff and resources to reduce medication errors. It has developed training and educational programs for health care staff and consumers. “30-minute rule” Challenged In 2010, ISMP conducted a survey to assess nurses concerns and the efficacy of the CMS Interpretive Guidelines. The survey revealed that nurses felt pressured when forced to give medications on an unrealistic schedule. Adhering to an unrealistic schedule often times interfered with a nurse’s ability...
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...of ADHD in Youth Brent Townes COM/172 November 10, 2014 Crystal Hicks Diagnosis of ADHD in Youth There have been a lot of studies done on attention-deficit hyperactivity disorder in the school aged children of today. The Center for Dieses Control and Prevention has completed a mass survey that states 1 and 5 school aged boys has been diagnosed with ADHD, and 11 percent of school aged children overall (ages 4-17 years old). Approximately 6.4 million have been diagnosed as of 2011. This number has increased from 7.8% in 2003 to 11% in 2011. Boys are 13.2% more likely than girls at 5.6% to ever be diagnosed with ADHD. The diagnosis of ADHD is a real disorder that needs to be addressed, but does not always need medication to treat it. Diagnosis of ADHD For a child to be diagnosed with ADHD there is certain criteria that is supposed to be met. There are several steps to the process in being diagnosed with ADHD, however, there is not one test alone that can diagnosis it. There are many other issues such as anxiety, depression, and other learning disabilities that have similar symptoms as ADHD. There was recently a new manual printed for medical professionals called DSM-5 to diagnosis ADHD. There was a few changes to the DSM-5 such as: symptoms can occur by age 12 rather than by age 6; and adults and children 17 and older are only required to have 5 symptoms rather than the 6 symptoms for children 16 and younger. Here are a few examples of the symptoms...
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...pressure abnormalities. As such, she was on a number of heart regulating medications which included some beta blockers. As part of time management, we went through the patient's care plan and medication charts to determine what needed to be done and at what time regarding this patient. This guided how we were to execute care during the shift and in a timely manner. Her care plan had indicated that the patient's observations were to be done TDS (three times a day) It was during this process that we decided that it was not necessary, at this point, to take the patient's vital signs as these had been done just a few hours before we had started. When the time for the medication round came, we went to the patient's bed side drawer to collect and give her her medications following the seven rights to medication administration. As a result of our earlier time plan, we did not take her observations. Somehow, the patient asked us curiously why we were not taking her reading as, previously and always before, other nurses seemed to take her readings first? The answer to the patient by the buddy was that we would do that later and I went along with this! I had the same query but did not want to sound stupid or oppose the buddy nurse as I thought she had more experience therefore she knew better. This query in my head was because a few days before, we had had a quick lecture from our facilitator about common medications used in the ward...
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...The Hispanic population is no stranger to hard times and struggles in life, just like any other culture here in the melting pot of America. Many are first and second generation immigrants who traveled to America in search of a better life for themselves and their families. They come with their own traditions, values, and belief systems that make them who they are as a culture. At times these values and beliefs can be challenged when they don’t fall in line with American beliefs, especially regarding healthcare. When this happens it’s imperative that respect and sensitivity to cultural needs are shown when providing medical care. Healthcare providers must educate themselves about different cultures, assess their patients and their families, in a language they understand and include their family members when appropriate. Hispanic Views on Mental Health In regards to mental health, the Hispanic culture views mental illness as shameful, this carries the stigma of being “loco” which brings humiliation to the entire family. Many Hispanics/Latinos rely on their extended family, community, traditional healers, or churches for help during a health crisis. It is not uncommon for this culture to believe their mental illness is a punishment or a test from God and, as result, thousands of Hispanics/Latinos with mental illnesses often go without professional mental health treatment (CMHSC, 2007). Those who do seek help tend to discontinue therapy due to a resignation toward suffering...
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...elderly, sports, poor posture, osteoporosis, arthritis, disk disease, obesity and poor physical strength. 2. Describe differences between acute pain management and chronic pain management. The differences between acute pain management and chronic pain management are: acute pain can be treated right away and the patient’s pain might be relieved. The patient with chronic pain will have to be treated long term. 3. Identify common concerns related to long-term use of opiod medications. The common concerns with opioid medications are: the risk of drug tolerance, drug abuse, respiratory depression, and accidents related to the use of opioids. 4. What are the top three nursing diagnosis priorities for a patient with an acute exacerbation of chronic pain? The top three nursing diagnosis priorities for a patient with an acute exacerbation of chronic pain are: 1. Acute or chronic lower back pain. 2. Risk for injury due to lower back pain. 3. Risk for social isolation. 5. Identify and explain at least two adjuncts, other than medications, that are used for chronic pain management. Two other treatments that can be used to treat chronic pain are the rotation of hot and cold packs to reduce inflammation, and sooth the pain. The second adjunct treatment is relaxation by giving the muscles a break. 6. Describe the possible impact of chronic pain on the psychosocial, spiritual, cultural, and developmental levels of a patient. The person with chronic pain may withdraw...
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...Week 9 Final Project Ethics Program Report Patton Fuller Community Hospital Ethics Program Report Within Patton Fuller Community Hospital (PFCH) it has been brought to my attention there are moral and ethical issues we are facing. These issues are; * Unauthorized disclosure of patient information * Data security breach * Medication doses error Since the hospital main focus is the patients as it is states in their mission statement, that they cares about the patients and not the bill, so any medical error can have a great effect on the hospital reputation. These medical errors that been brought to my attention can bring medical law suits to the hospital and their staff. I was hired as the ethics advisor to design a new ethics program for the company that will best exemplify and maintain our business ethics. Within this plan we will go over the hospital policies and procedures, the code of ethics and training on ethics. We will discuss expectations for the employees and the consequences for non-compliance. The purpose and goal for this plan is detect and prevent any violations and or regulation of the law, either non criminal or criminal of this organization of the hospital. This program will apply to the following: * Physicians * Professional staff * Administrative staff * Students * Volunteers * Exempt staff * Non exempt staff Patton Fuller community hospital will ensure all employees will have total access to the protocol that...
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...Communication at Pleasant View Lodge There are many different ways communication is handled in companies. The nature of my employment is that I am a qualified medication aide-short for a Q.M.A. A qualified medication aide (Q.M.A.) administers non-injectable medications, assist in care of residents, crush medication to be administered, apply topical treatments, and deliver medication in a timely manner. All patients are under the supervision of a registered nurse. A qualified medication aide is required to remain educated on medications, the drug class of medications, and to know the dangers of combining certain medications. They should remain CPR certified and know what to do upon an overdose. Every employer has a chain of command that they follow for instructions on what to do next. The chain of command in an assisted living workplace is very simple. I will start from top to bottom on the command chart. The administrator is the head over everyone employed at the facility. Next, the administrator is director of social services, dietary director, director of nursing, activity director, maintenance director, housekeeping/laundry, business office, and admissions. The director dietary is over the kitchen employees which are the cooks and dietary aides. They refer all their questions and concerns to the director of dietary. The activity director is the person who does activities with all the alert and oriented residents. The activity aide usually leads most of...
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...stands on the precipice of a new health epidemic; prescription drugs are the new face of concern for the average American citizen.; cost, shortages, and abuse can often be found on any given day in print, online, or more commonly, social networking sites. As technology continues to advance, so too does the ability to procure medications for 90% of what the body needs to maintain optimal health. In addition to this, agenda pushing doctors, contractual obligations to pharmaceutical manufacturers, and drug reps have created a health care atmosphere where it is almost impossible to walk into a physician’s office for an annual health screening without leaving with a handful of questionable ‘needed’ prescriptions. Doctors are prescribing more medications than ever before seen. This is in fact creating more prescription related abuse. With this new availability comes the responsibility of ensuring those receiving are adequately informed of consequences, and potential addiction issues. All too often, a consumer seeks advice from a healthcare provider and does not self-educate on the medication received. Yes, medical staff, especially the prescribing individual has a personal and professional responsibility to the consumer to inform of potential risks associated with the medication. However, in the end, personal responsibility takes precedence to any other person’s social responsibility. Medication comes with a price, and it is unfortunate that the price is at times not a monetary...
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...Thesis Statement A patient prescribed a Dysphagia Mechanically Advanced Diet can have certain oral medications crushed and mixed with food at a consistency appropriate for the patient. Pathophysiology On October 6, 2015, in clinical, I cared for an 82 year-old female named Ms. M. She had presented to the hospital Emergency Room with altered mental status and shortness of breath. Ms. M had a past medical history including Parkinsonism resulting in dysphagia. The abnormal lab results that supported the eventual primary diagnosis of a urinary tract infection and possible sepsis include an elevated Absolute Neutrophils Count (ANC) 72%-normal ANC 55%-70% and decreased Absolute Lymphocyte Count (ALC) 16%-normal ALC 22%-44%. (Pagana & Pagana, 2013)...
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...important lesson that I learned was about improving the accuracy of patient identification. It is always important to use at least two patient identifiers when providing care, treatment or services. No matter how silly it may seem, having the correct patient is tantamount. The next patient safety goal is regarding how to improve the effectiveness of communication among caregivers. I found it to be critical to understand the proper way in which to transfer information from one person to the next. Having a standardized system for information sharing is a key part of patient safety. The third principle that I learned was in regard to improved safety of using medications. It is crucial to label medication containers, as well making an annual list of drugs that look alike or sound alike. Making sure that drugs do not get confused or mixed up is definitely going to keep patients more safe. Another concern regarding patient safety is the concept of reducing the risk of health care-associated infections. This can be achieved by maintaining a high level of hand hygiene and by closely monitoring unexpected deaths or major loss of function associated with health acquired infections. The subject of accurately and completely reconciling medications across the continuum of care is pertinent to keeping patients safe. In order to accomplish this, a process needs to be in place that will ensure current medications are compared with the medications that are ordered for that patient...
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...Reason Case was accepted for investigation: On 5/3/17, Hennepin County Child Protection accepted a report of alleged threatened injury of 8 year old Derrick Duerr by his father, Erick Duerr. Per reporter Mr. Duerr is diagnosed with the other specified psychotic disorder and is not taking any medication to address his current state of having delusions. Per reporter Mr. Duerr had been hospitalized a couple of years ago and prescribed medication which he took for a while. Per reporter. Per reporter Mr. Duerr indicated that he doesn’t like the side effect from medications and soon after discharge stopped taking them. Also, per reporter Mr. Duerr believes he has a mission or cause to take care of gang members during drug dealers on his block; either directly or by calling the police. Per reporter the concerns are that Mr. Duerr has little insight into the danger he could put his son regarding his “belief” and “cause” to take care of the drug dealers and gang members. Per reporter Mr. Duerr beliefs if necessary, he will die for this cause and when he is questioned about the risks or danger regarding his son being involved especially with the gang members who live next door per Mr. Duerr. Per reporter stated that Mr. Duerr believes in the cause as he will die for the cause. The outcome of the Assessment: This worker met with...
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...Improving The Safety Of Using Medications In Hospital Settings Background Improving the safety of using medications was the third Joint Commission safety goal for 2014 (Hospital National Patient Safety Goals, n.d.). Every year medication errors are a significant cause of morbidity and mortality in hospitals. Simply put, medication errors come from incorrect dosing by physicians on prescriptions, administration of the wrong dose of the prescribed medication to the patient, failure of the healthcare provider to administer prescribed medication, or failure of the patient to ingest said prescribed medication (Choo, J., Hutchinson, A., & Bucknall, T., 2010). Role of the Nurse According to the Journal of Nursing Management, nurses should practice the five rights of administration that they are taught while in school. Those rights are: right medication, right dose, right route, right time, and right patient (Choo, J., Hutchinson, A., & Bucknall, T., 2010). While checking the five rights is useful in the final stages of the administration process, the rights do not reflect the other complex steps to medication administration, such as preparation, labeling, determining interaction, etc. Normally medication errors are never the result of an isolated human error. They may come from workplace stress, distractions, interruptions, insufficient training, and misinformation (Choo, J., Hutchinson, A., & Bucknall, T., 2010). The individual nurse should make sure that...
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