This is just rewrite to avoid plagiarism                                       

A medication error is an error (of commission or omission) at any step along the pathway that begins when a clinician prescribes a medication and ends when the patient actually receives the medication (Agency for Health Care Research and Quality, 2019). 

In a study conducted by Da Silva and Krishnamurthy (2016), they state that preventable medication errors impact more than 7 million patients and cost almost $21 billion annually across all care settings. About 30% of hospitalized patients have at least one discrepancy on discharge medication reconciliation. Medication errors are an underreported burden that adversely affects patients, providers, and the economy. The study involved a 71-year-old female who accidentally received thiothixene (Navane), an antipsychotic, instead of her anti-hypertensive medication amlodipine (Norvasc) for 3 months. She sustained physical and psychological harm including ambulatory dysfunction, tremors, mood swings, and personality changes and had multiple hospital visits within the 3 months. Despite the many opportunities for intervention, multiple health care providers overlooked her symptoms. Admission medication reconciliation (MED REC) revealed that she was taking metoprolol, doxazosin, alprazolam, citalopram, and thiothixene (Navane) 10 mg twice daily. Upon review of her pill bottles, it was found that her outpatient pharmacy accidentally dispensed Navane (an antipsychotic) instead of Norvasc, and she dutifully took this medication for 3 months. The written prescription was deemed legible. A diagnosis of thiothixene-related drug-induced Parkinsonism was made. Thiothixene was discontinued and her clinical status improved.

Da Silva and Krishnamurthy (2018) note that important steps to prevent medication error include clear patient instructions with indications for use on every prescription, utilization of EHR medication import (when available) to review outpatient prescription history, and creating a culture within the medical field of error discussion. Possibilities include medication teams who review admission and discharge reconciliations, team rounding with a pharmacist, encouraging postgraduate trainees and faculty to question indications and utility of medications, and distribution of national and institution data regarding errors, and adverse events. Mandatory training should occur for those providers who fail to document and reconcile medications properly.

As a nurse practitioner it is important to monitor the patient especially when poor treatment response occurs or unusual symptoms develop, it is imperative that a review of medications and pill bottle review be part of the initial evaluation. I will implement and use multilevel safeguards, starting with error recognition. Medical error was recently described as the third leading cause of death and only by creating a culture of humility, communication, and teamwork can we learn from our mistakes and hope to decrease preventable errors.

References

Agency for Health Care Research and Quality. (2019). Medication Errors and Adverse Drug Events. Retrieved from https://psnet.ahrq.gov/primers/primer/23/Medication-Errors-and-Adverse-Drug-Events

Da Silva, B., Krishnamurthy, M. 92016). The alarming reality of medication error: a patient case and review of Pennsylvania and National data. Retrieved from https://www.tandfonline.com/doi/full/10.3402/jchimp.v6.31758

 

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Medication Management Assignment 

Purpose: To gain an understanding of complex medication regimen and the importance of the nurse’s role in patient teaching and safe administration of drug therapy.

Assignment:

You will have a total of 2 weeks to complete this project.

Follow the medication regimen that was given to you for a period of 7 days. You should also attempt to follow dietary guidelines based on your probable health conditions (i.e., diabetic, low salt, low fat, etc,) as well as monitor you weight, heart rate, and blood sugars if needed. You are encouraged to start the regimen in the next 2 days, but you should not start any later than the end of the week. It is expected that you take all “medications” as directed unless you have intolerance to glucose, allergies to one of the products, or are lactose intolerant.

Write a 3 page (APA, not including title or reference Page) reflective paper about your experience. Specifically address: A) any barriers you encountered in being adherent to your medication regimen B) any barriers you encountered in following dietary guidelines C) any tools you utilized to help you complete the exercise, which could improve patient safety D) the importance of patient preferences, values and background in providing patient centered care, and E) any other lessons you learned from this exercise.

Grading Rubric

Medication schedule (completed and on time) _____40

Reflective paper (with all required components)  _____40

Grammar/spelling/APA format _____10

Survey completion _____10

Total  _____10

These are the names of medications the patient is taking the diagnosis for these drug will be hypertension and diabetes.

Digoxin 0.125 mg tabs, 

Take 1 tab by mouth daily.

Hydrochlothiazide 25 mg tabs

Take 1 tablet by mouth twice daily.

Glyburide 3mg tabs

Take 1 tablet by mouth daily.

Multivitamin tabs 

Take 1 tablet by mouth daily 

Folate 1 mg tabs 

Take 1 tab by mouth daily

 

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Here is the list of medication that I have been taking as the patient for a week.

1. Captopril 25mg tabs, take by mouth twice a daily.

2. Senokot 8.6 mg tabs, take by mouth twice a daily.

3. Acetaminophen 500mg caps, take by mouth twice daily.

4. Furosemide 40mg tabs, take by mouth daily.

5. Simvastatin 10mg tabs by mouth twice daily.

So my diagnosis for this medication is Congestion heart failure. Based on these medications that am taking 

I took these meds for one week. The Furosemide1 I had to weight myself daily. Started Sunday my weight was 151. 1 Monday 151.4, Tuesday was 151.3, Wednesday 151.5, Thursday 151.0, Friday 151.1 Saturday 150.3.

The Captopril, I had to take my pulse every time I took this med. If less than 60 cannot take it if above 100 cannot take it. Sunday it was 64, Monday 72, Tuesday 68 Wednesday 66 Thursday 70, Friday 78 Saturday 76. Answer these questions

  

Write a 3 page (APA, not including title or reference Page) reflective paper about your experience. Specifically address: A) any barriers you encountered in being adherent to your medication regimen B) any barriers you encountered in following dietary guidelines C) any tools you utilized to help you complete the exercise, which could improve patient safety D) the importance of patient preferences, values and background in providing patient centered care, and E) any other lessons you learned from tis exercise.

 

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Hi, Based on This information, please answer these questions carefully:

   

You are assigned a new admission. The client’s diagnoses include:

   

1) Dementia 

2) Parkinson’s disease 

3) CVA with residual L-sided weakness 

4) Osteoporosis 

5) Urinary incontinence 

6) Recurrent UTIs 

7) Hypertension 

8) CAD; stent 2 years ago 

9) CHF (EF 30%) 

10) Atrial fibrillation 

11) Hyperlipidemia 

12) Osteoarthritis, especially hips and knees 

13) Macular degeneration 

14) Type 2 DM 

15) Peripheral neuropathy 

16) Chronic renal insufficiency 

17) Anemia 

18) Hypothyroidism 

19) COPD on oxygen 

20) Diverticulosis

   

The client’s medication list includes: 

   

1) donepezil (Aricept) 5 mg PO daily 

2) Sinemet 10/100 PO TID 

3) aspirin 325 mg PO daily 

4) warfarin (Coumadin) 5 mg PO qHS 

5) tolterodine (Detrol) 2 mg PO BID 

6) atorvastatin (Lipitor) 40 mg PO qHS 

7) insulin (long-acting and sliding scale) 

8) gabapentin (Neurontin) 300 mg PO TID 

9) iron sulfate 325 mg PO TID 

10) trazodone 50 mg PO qHS 

11) levothyroxine 50 mcg PO daily 

12) furosemide (Lasix) 60 mg PO BID 

13) potassium chloride 20 mEq PO daily 

14) metoprolol 100 mg PO BID 

15) lisinopril 20 mg PO daily 

16) amlodipine 10 mg PO daily 

17) acetaminophen 1,000 mg PO TID 

18) docusate sodium 100 mg PO BID 

19) polyethylene glycol powder (Miralax) 17 g PO daily 

20) tiotropium (Spiriva) 18 mcg inhaled daily 

21) montelukast (Singulair) 10 mg PO daily 

22) fluticasone/salmeterol (Advair) 100/50 inhaled BID 

23) Albuterol/Atrovent nebulizers PRN for wheezing 

24) multivitamin one PO daily 

25) vitamin E 400 IU PO daily 

26) calcium carbonate 500 mg PO TID 

27) vitamin D 800 units PO daily 

28) kava root 100 mg PO QID

29) nitrofurantoin (Macrobid) 100 mg PO qHS

  

Based on your review of the three references found in the library guide under readings and the information in the case study:

1) Explain which of these medications you would have concerns in administering to an elderly client and why. 

2) Discuss what alternatives you would recommend to either the client or provider (as appropriate).

3) Describe the teaching you would provide and/or information you would need to ensure that the client understands related to the medication regimen prior to discharge. 

 

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1. After reading the articles on meditation and viewing the videos, try out meditation. Here are the guidelines:
   1. Perform Self-Meditation for six (6) days. ( dont worry about the six days! just type about and said that you did meditation for 6 days and answer all the questions! 150 to 200 words simple.)
   2. Monitor and record your heart rate before and after each meditation session.
2. After you have experienced practicing meditation, report on the following:
   1. How did you feel about this assignment?
      • Were you comfortable or not performing the task on meditation? Explain why or why not.
   2. Describe the health benefits and different types of meditation therapies available?
   3. Describe the effects of meditation throughout your day-to-day activities and work.
   4. Do you believe mediation is a useful alternative and complimentary alternative to healthcare? Explain why or why not.
   5. Would you continue to use meditation?
3. Find evidenced-based research article on meditation and attach to this post
4. Remember to include your heart rate tracking before and after each meditation section to this post. 
5. Post must be 150-200 words.
6. MUST BE APA STYLE WITH REFERENCE PAGE.)

 

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