...Polypharmacy and the Importance of Senior Helpers Polypharmacy and medicine management go hand-in-hand. Polypharmacy is the technical term for simultaneously taking multiple medications in order to treat different conditions and symptoms. Among seniors, polypharmacy can be a very serious issue. Senior helpers significantly reduce the instances of missed medication, overdosing, negative drug interactions and serious or fatal complications from medication side effects. According to "American Nurse Today" (October 2010, Vol. 5 No. 10), “Forty-four percent of men and 57 percent of women older than age 65 take five or more medications per week; about 12 percent of both men and women take 10 or more medications per week.” Not only are the chances...
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...Is common in older population in primary care service to see a huge amount of inappropriate prescribing drugs. Persons over 65 yrs. old have a high prevalence of two or more chronic medical conditions, which require multiple medications (polypharmacy) to manage symptoms and prevent future complications. Polypharmacy may describe prescribing of many drugs (appropriately) or too many drugs (inappropriately). Management of complex patients led to difficulty at the prescriber level, mostly via division of care and the participation of multiple prescribers. Multiple practitioners in patient care, each adding to the patient’s medication list is one of the factors to polypharmacy. The risk of heart failure is exacerbated due to myocardial toxicity and, drug interactions. Improving the management of patients with multimorbidity through multifaceted interventions targeted at risk factors or specific functional difficulties may potentially improve prescribing. The involvement of pharmacists in pharmaceutical care and strategies focusing on deprescribing. Improving communication between multiple providers. Improving medication reconciliation after discharge...
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...ROLE DESCRIPTIONS BPO Service Delivery- Techno function & SDM COGNIZANT TECHNOLOGY SOLUTIONS © Cognizant Technology Solutions 1 Process Executive Track: BPO Service Delivery Management Career Stage: Learning/Contributing Location: Offshore Role Title: Process Executive Typical Grade: PE (L1) Reporting to: TL / TM / AOM Position Summary Individuals in this role are responsible for meeting TAT and maintaining accuracy in day-to-day transaction processing in client/Internal applications, process flows. They are expected to transcribe information from a variety of sources into a standardized database system using various applications based on certain pre-defined rules. Key Result Areas Meet /Exceed all defined SLA’s of the process (quality, TAT etc.) as agreed with the client 100% Compliance to process adherence as defined in the SOP Meet internal process metrics as defined Complete all mandatory assessment/ certifications as applicable Adherence to audit compliance Typical Responsibilities Business / Customer Provide updates and submit reports related to own area of work Project/Process Meet process SLAs / metrics – productivity and quality targets within the established timelines Ensure process guidelines are followed and met as documented Process pre-defined number of transactions as assigned Respond to data requests Raise process related issues / concerns on time with process and team leads Record data relating...
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...Polypharmacy in the Elderly Courtney Lopez Western Governors University Polypharmacy in the Elderly I. Introduction a. Audience hook: John, an 85 year old man is admitted into the emergency room with a heart rate of 40, and complaints of dizziness and weakness for several days. Nancy RN is the nurse taking care of John when he is brought in. Upon reviewing Johns’ medications, Nancy is aware that there are two prescriptions for the same beta blocker each with a different dose and frequency, among six other prescriptions. When questioned about his medications, John states "he takes two different medications for his heart with some other pills, but doesn’t know the name of the medication or the dose." John is diagnosed with a beta blocker overdose. After four days in the ICU, John is feeling much better now, with normal vital signs and a better knowledge of his medications, and will be transferred to a telemetry floor for continued care. b. Thesis statement: Polypharmacy in the elderly population can be reduced by early discharge education in the inpatient setting, along with the use of drug combinations or extended release medications to lower the frequency, amounts, and financial burden incurred by this population. c. Main points: 1. Multiple dosing changes and frequency of medications can cause confusion, adverse reactions, and noncompliance. 2. Education during hospitalization can decrease recurrence of repeat hospitalization. II. Polypharmacy...
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...Polypharmacy is an increasing concern in health care, particularly among older adults with multiple co-morbidities. It is defined as the use of multiple drugs (five or greater ) or more than are medically necessary (citation). The elderly represents 14% of the United States (US) population and it is expected to increase to 23% in 2043 with the aging of the baby boomers (citation). They consume about 33% of prescribed medications in the US. It is estimated that 24-39% of the elderly take on average more than five medications on a daily basis (citation). Common medications in this population are cardiovascular, antihypertensive, antiglycemic, anticoagulant, analgesics, sedatives, and gastrointestinal preps. It is believed that medication therapy...
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...Case Study Ms. J. O. is an 82 year old female with a variety of comorbidities including Alzheimer’s type dementia. She is a resident of a dementia unit of a local assisted living facility. She was brought in to the hospital for a fall from which she stated she had hit her head but never lost consciousness. On arrival to hospital she was noticed to be very confused with complaint of back pain, chest pain but alert. After a short period of time her GCS abruptly dropped to 3 requiring intubation. CT scan of her head showed no bleeds, strokes or abnormality. All lab values were within normal limits and her blood pressure was mildly hypotensive 93/55. Past medical history 1. Ms. J.O. has had numerous falls recently requiring multiple emergency room visits. Each visit also showed evaluation of altered mental status over her normal state of being. On one fall she suffered a pelvic fracture, sacral fracture and L2-3 fracture. Another fall she suffered a nasal bone fracture. She was treated for pain control for each visit and then returned to assisted living facility. Per family she has been at her facility for about a week before this fall. 2. 3. Type 2 diabetes 4. Ulcerative colitis 5. Anxiety/Depression 6. Hypothyroidism 7. Osteoarthritis 8. GERD 9. Alzheimer’s type dementia 10. Stroke 11. Peripheral neuropathy 12. Chronic back pain from falls 13. Hypertension 14. Knee surgery 15. Cataract surgery 16....
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...In this essay, I will do a journal article comparison. The articles selected have something in common – treatment of drug. The first article is “Do drug treatment variables predict cognitive performance in multidrug-treated opioid-dependent patients? A regression analysis study” by Pekka Rapeli, Carola Fabritius, Hely Kalska and Hannu Alho. This article was taken from an open access article under Substance Abuse Treatment, Prevention, and Policy 2012, at http://www.substanceabusepolicy.com/content/7/1/45. The second article entitled “Treating Drug Abuse and Addiction in the Criminal Justice System: Improving Public Health and Safety” by Redonna K. Chandler, Bennett W. Fletcher and Nora D. Volkow. It was taken from a public access journal under National Institute of Health: JAMA. 2009 January 14; 301(2): 183–190. doi:10.1001/jama.2008.976. The purpose of the first article was to examine the predictive power of drug treatment variables on specific cognitive performance measures in multidrug-treated opioid dependent patients. Also, the researchers interested in finding out which of the possible significant associations turn out as hypothesized. On the other hand, the purpose of the second article was to summarize relevant neuroscientific findings and evidence-based principles of addiction treatment that, if implemented in the criminal justice system, could help improve public health and reduce criminal behaviour. For methodologies, the first research involved 104 Opioid-Dependent...
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...Early Nursing Intervention in Parkinson's Disease CE Parkinson's disease (PD), is a multisystem neurodegenerative process that results in both motor and nonmotor symptoms. Quality of life (QOL) is significantly impaired for both the patient and the family. Therapy should focus on early detection and alleviation of motor/nonmotor symptoms and improvement of QOL for the patient and his or her entire support system. Patients, families, and healthcare providers often do not recognize the nonmotor symptoms as being related to PD.[1-6] Although there is no consensus about when to start therapy, early treatment is thought to maintain QOL more effectively than delayed treatment. Considerations for early treatment include the effect of PD symptoms on lifestyle and employment, the patient's role within the family system, attitudes about medication, and patients' perceptions of QOL.[1,6-9] Clear Communication About Motor Symptoms Treatment starts with a comprehensive and accurate assessment. The motor assessment is the most obvious. Asking about tremor, rigidity or stiffness, balance, and slowness of movement is imperative; however, using language the patient and family will understand is paramount to effective ongoing communication. For example, patients may better relate to terms such as "shake" instead of "tremor," and "falling backward" or "feeling lightheaded or dizzy" when they stand up or stand too long rather than "losing your balance." The practitioner might also ask whether...
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...days multiplied by 1000. Up to 12% of hospitalized patients fall at least once during their hospital stay; falls can lengthen hospital stays and result in poor quality of life, increased costs, admission to a long-term care facility, serious physical injuries, and death. Falls in hospital settings have multiple causes. Ressarch shows that patients who exhibit more of these risk factors are at greater risk of falling than those exhibiting fewer. Risk factors for falling can be classified as intrinsic (e.g., older age, balance disorders, history of falls, decreased vision, altered cognitive status, or history of arthritis, heart attack, stroke, postural blood pressure changes, syncope, dizziness, or chronic lung disease), extrinsic (e.g., polypharmacy and use of certain medications known to increase fall risk [e.g., benzodiazepines, sedatives, neuroleptics, antidepressants, anticonvulsants, class I antiarrhythmics, and diuretics]), and environmental (e.g., inadequate lighting, slippery floors, lack of handrails, and inadequate nurse/patient staffing ratio. Research studies show that fall rates vary by clinical specialty area. One study reported departments such as OB/GYN and Pediatricts having no falls while the highest fall rates are in Med/Surg and skillee nursing...
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...As Dr. Dumphey’s medical assistant Theresa is required to administer medication, keep accurate medication records, and provide patients with information about the medications that are prescribed to them. Theresa answers the phone call from a patient of Dr. Waring, an elderly woman with multiple medical problems. Dr. Waring prescribed her a medication for bronchitis two days ago and she maybe having a reaction to it. Since Dr. Dumphey and Dr. Warning have an arrangement for him to cover for her while she is on vacation Theresa has an obligation to handle this situation because she is Dr. Dumphey medical assistant and Dr. Waring does not have to be notify. The patient’s symptoms include upset stomach, nausea, dizziness, headache, rash on her...
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...Kathleen Rifflard HIM1442C 208328 Chapter 9 Homework Practical Scenario # 1 1. Her grandmother may have thought that since vitamins and herbal substances are considered “good for you” that it doesn’t matter what she takes and how much of it she consumes along with her prescription medication. She is probably unaware of potential adverse effects that taking all of those substances can cause. 2. Potential outcomes of polypharmacy would be potential toxicity, adverse effects in medication and the patient being unaware of exactly what she is taking since some herbal substances contain a variety of active ingredients in widely varying quantities and strengths. Practical Scenario # 2 1. Gingko may interact with anticonvulsants, aspirin and NSAIDs, heparin, warfarin, and TCAs. 2. If the patient purchased red clover instead, it could potentially interact with anticoagulants and antiplatelet agents. Multiple Choice 1. D 2. A 3. B 4. C 5. C 6. B 7. C 8. B 9. C 10. A 11. B 12. C 13. B 14. D 15. A 16. B 17. B 18. A 19. B 20. C Fill in the Blank 1. Solid, liquid 2. Animal muscles, organ cells 3. Weight loss, protein loss, and fatigue 4. Simple sugars, complex carbohydrates 5. Soluble, insoluble 6. Vitamin B, Vitamin C (ascorbic acid) 7. Beriberi 8. Vitamin B3, niacin 9. Megaloblastic 10. Vitamin C (ascorbic acid) 11. Blindness, burning and itching ...
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...Assessment on a geriatric patient is usually different from standard medical evaluation of other patients. For the elderly patients, especially those that are really old. General assessment like the physical and history-taking might not be done at the same time because patient becomes tired easily. The elderly usually have multiple health issues which requires the use of many drugs which is also called polypharmacy. The elderly are best evaluated using a comprehensive geriatric assessment, which includes evaluation of function and quality of life usually by an interdisciplinary team. While assessing a geriatric patient, the nurse should consider that at this point in their lives a lot is going on, there is degenerative changes, multiple disorders, caregiver problems, missed or delayed diagnosis. On average, elderly patients have 6 diagnosable disorders, which their primary care giver might be unaware of A disorder in one organ system can weaken another system, exacerbating the deterioration of both and leading to disability, dependence, and, without intervention, death . The nurse should also pay particular attention to certain common geriatric symptoms (eg, delirium, dizziness, syncope, falling, mobility problems, weight or appetite loss, urinary incontinence) because they may result from disorders of multiple organ systems. Occasionally, problems of elderly patients are related to neglect or abuse by their caregiver (see Elder Abuse).The nurse also should consider the possibility...
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...Falls: Risks, Facts, Prevention Falls: Risks, Facts, Prevention The following information is a compilation of the teaching plan utilized for the community teaching assignment. The information presented includes statistical analysis and detailed information on potential risks of injury and death related to falls among the elderly. It also highlights prevention methods that can be utilized in an attempt to decrease Emergency Room visits secondary to falls. My target audience consisted of 18 senior citizens who reside at Heartfield Assisted Living Facility in Cary, NC. The median age of this group was 78 years old. A wheelchair with faulty brakes, oxygen tubing and a quad cane were used for props and demonstrations of safe vs. unsafe use. My teaching plan followed the pamphlet that was created for the teaching assignment. I chose this format as I felt it would be helpful to provide a resource for seniors to reference after completion of the session. The title of the pamphlet is Falls: Risks, Facts, Prevention; Understanding potential hazards and how to promote safety. The pamphlet/teaching was broken down into three categories: facts and statistics related to falls in the elderly, fall risks and prevention methods. An “Are you at Risk”? question and answer segment was also included to create awareness for individuals who believe they are practicing safety. This encouraged participants to analyze their...
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...The most common inappropriate individual behaviors in older adults are counting as sedentary behavior, tobacco exposure, alcohol consumption, medication misuse, polypharmacy, and fear of falls. Hence, these unhealthy behaviors reflects diminished physical activities, decreased physical reserves and vulnerability (sacropenia) which lead to frailty in older adults. Many researches reveal that the modification interventions of individual unhealthy behaviors are more reliable in health promotion for frail older adults. However, the individual behavioral in frail older adults are associated with socioeconomic pattern of health and social and culture within their...
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...Comprehensive geriatric assessment is defined as a multidisciplinary diagnostic and treatment process that identifies medical. Psychological and functional limitations of a frail older person in order to develop a coordinated medical management of illness. It requires evaluation of multiple issues including physical, cognitive, affective, social, financial, environmental and spiritual components that influences an older persons by a team of health professionals may identify a variety of treatable health problems and lead to a better outcome. However, it is initiated through the primary care clinician or by a clinician caring for a patient in the hospital setting. The content of assessment varies depending on the settings of care. CGA is not available in all settings due to issues related to the tie required for evaluation, need for coordination of multidisciplinary specialties and lack of reimbursement for some components. Overall elements of comprehensive geriatric assessment includes: Physical Health-This focuses on medication use and the risk for malnutrition, falling, incontinence and immobility. The physical examination seeks to identify specific diseases or conditions for which curative, restorative, palliative or preventive treatment may be available. Special attention is directed towards visual or hearing impairment, nutritional status and conditions that may contribute to frailty and falling or difficulty in ambulation. Mental Health-Cognitive, behavioral and emotional...
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