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1
Myhre, Teri Ann, and University of Lethbridge Faculty of Arts and Science. "Medication safety practices : a patient's perspective." Thesis, Lethbridge, Alta. : University of Lethbridge, School of Health Sciences, 2007, 2007. http://hdl.handle.net/10133/626.
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Medication administration constitutes a key element of acute care delivery, while errors in the process threaten patient safety. The purpose of the study is to explore patients’ perceptions, attitudes and beliefs about the safety practices utilized by nurses when administering medications. Specifically, the study addresses patients’ perceptions of nurse behaviours regarding safe medicine administration, patient behaviours, patients’ perceptions and nurse behaviours regarding pain medicine, patients’ perceptions of nursing care, and patients’ perceptions of their participation/accountability in care. The results identify key safety issues from a patients’ perspective to focus change strategies that will improve patient care.<br>x, 125 leaves ; 29 cm
2
Long, Trisha L. "Medication Information Management Practices of Older Americans." Master's thesis, School of Information and Library Science, 2007. http://hdl.handle.net/1901/391.
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This paper presents the results of a survey of 30 adults aged 55 and older, who had taken multiple prescription medications in the past two years. The purpose of the study was to determine how older adults manage their medication information currently, what information they save and share, and how they wish to manage medication information in an electronic environment, such as a personal health record. Adults in the survey shared information most frequently with their doctors, and with friends and family. They usually shared basic information about a medication, including its name, dose, and the frequency with which it is taken. Nearly half used an artifact, such as a list, to keep track of and share their information. Nearly a third of participants desired to keep an electronic record, suggesting that a percentage of the older adult population would be open to using electronic records to manage medication information.
3
Shaeffer, Joseph. "Increasing Awareness of Proper Disposal Practices of Unwanted Household Medications in Muskingum County, Ohio." Otterbein University / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=otbn1596205993309345.
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4
Hystad, Jennifer Lee. "Understanding seniors medication-taking practices through empowerment education." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape3/PQDD_0014/MQ60130.pdf.
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5
Adams, Adrine S. "Evaluating primary care providers' prescription medication practices among geriatric patient." Thesis, University of Phoenix, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3574902.
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<p> The purpose of this quantitative meta-analytic study was to investigate the prescribing medication practices of primary care providers among elderly patients 65 years of age and older. Two statistical analyses were conducted on approximately 3 million geriatric patients in a variety of health care settings throughout the United States. The first meta-analysis involved 26 peer-reviewed studies that compared the prescribing medication practices of primary care providers among geriatric patients in the United States with the prescribing practice recommendations of the Beers Criteria. The second meta-analysis involved 8 peer-reviewed studies that compared the prescribing medication practices in America of physicians who received training in geriatric medicine with physicians who received training in general medicine. The predictor variable (i.e., independent or observed variable) was the prescribing medication practices of primary care providers. The outcome variable (i.e., dependent or expected variable) was the prescribing practice recommended by the Beers Criteria. The third variable was the moderating variable of physician training in geriatric medicine. The first findings revealed that primary care providers in the United States prescribed potentially inappropriate medications to geriatric patients. The second findings indicated that physicians without training in geriatric medicine prescribed more potentially inappropriate medications than those with training in geriatric medicine. Serious health care dilemmas among the geriatric population are high incidences of inappropriate dispensation of prescriptions by primary care providers. Inappropriate prescriptions are common in geriatric clinical settings among primary care providers who function in a fragmented medication prescription system and who lack training in geriatric medicine.</p>
6
Rice, Cameron R. "Review and Implementation of Orthopedic Patient Medication Education Best Practices." Wittenberg University Honors Theses / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=wuhonors162402923964133.
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Chong, Wei Wen. "Medication adherence in depression: Exploring roles and practices of healthcare providers." Thesis, The University of Sydney, 2013. http://hdl.handle.net/2123/9559.
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Non-adherence to antidepressant medications is a major barrier to the effective treatment of depression. Healthcare providers are an important point of intervention in addressing adherence-related problems. The objective of the research in this thesis was to explore the potential roles and current practices of healthcare providers in improving antidepressant medication adherence, particularly from a patient-centred approach. Findings from a systematic review highlight the importance of multifaceted interventions involving a collaborative effort from all healthcare providers. In a qualitative study, healthcare providers from various disciplines identified patient education and building partnerships with patients as key approaches to improving antidepressant medication adherence. Although healthcare providers expressed support towards shared decision-making (SDM) in mental healthcare, a number of barriers were perceived to hinder an interprofessional approach to SDM. In addition, a simulated patient study identified areas for improvement in community pharmacists’ practice, including the provision of key educational messages on antidepressant medications and patient-centred communication behaviours. This study also demonstrated the utility of Roter Interaction Analysis Method (RIAS) in analysing brief consultations at community pharmacy counters. The findings gained collectively from this research may inform the development of future adherence interventions that target the improvement of collaborative patient-centred practices in depression care.
8
Sefidaniforough, Ayda. "Investigating practices around medication administration to people with swallowing difficulties living in aged care facilities." Thesis, Queensland University of Technology, 2019. https://eprints.qut.edu.au/132201/1/Ayda_Sefidaniforough_Thesis.pdf.
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Swallowing solid oral medications whole is a daily struggle for people who have swallowing difficulties. In aged care facilities, healthcare workers frequently modify medications for residents, e.g. crush tablets or open capsules, to make the medicines easier to administer, and swallow. These practices are not always safe and can put residents at risk of adverse effects. Through the use of interviews, surveys, and observations, this project investigated barriers and facilitators to giving medicines to aged care residents with swallowing difficulties, and then proposed the design of an intervention program to improve safe medication practices for these residents.
9
Khan, Rizwan Ahmad. "Self-medication with antibiotics : Practices among Pakistani students in Sweden and Finland." Thesis, Södertörns högskola, Institutionen för livsvetenskaper, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:sh:diva-12754.
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Background: Self-medication with antibiotics is a global phenomenon and potentialcontributor to human pathogen resistance to antibiotics. Amongst Pakistanis, antibioticself-medication rates are high. At present, no data is available on prevalence and practicesof self-medication with antibiotics among Pakistani students abroad. Aim: The aim of this study was to assess prevalence and comparative practices ofPakistani students in Sweden and Finland regarding self-medication with antibiotics. Methods: The study used an anonymous cross-sectional Web-based questionnaire surveywith convenience census sampling targeted to Pakistani students in Sweden and Finland.Questionnaire asking use of antibiotics and six-month recall of antibiotic self-medicationbefore the survey was administered to the 9333 potential respondents. Data was analyzedusing statistical software R version 2.8.1. Descriptive statistic was used to analyze theresults. Associations were tested using Pearson's Chi-squared test. Findings: Response rate was 2.3% after five reminders. Of 213 participants (mean age27.9 years), 151 were from Sweden and 57 were from Finland. One hundred eleven(52.1%) reported antibiotic self-medication in their life time and forty two percent knewthat it could be injurious to health. Sixty-eight participants (31.9%) did self-medicationwith antibiotics during their stay in the study countries and almost all used oral antibiotics.Unrestricted pharmacy sale was the commonest source (37%) of such antibiotics.Common symptoms triggering antibiotic self-medication were respiratory (42.6%) andoro-dental (13.2%). Preferred antibiotics were broad spectrum Penicillin (41.2%),Macrolides (23.5%) and Quinolones (6.2%). Almost all (98.8%) antibiotics for suchmedication were obtained from Pakistan. About 27% reported that they would considerself-medication with antibiotics in future. The most common reason for antibiotic selfmedicationwas affordability of health care consultation and antibiotics (23.9%). Therewas no significant difference between the self-medication practices of participants basedon country of studentship (p=0.6). Self-medication rates were not significantly lower instudents who were aware that it may harm (p=0.2) and is unsafe (p=0.2). Conclusion: High prevalence of self-medication with antibiotics among participants is amatter of concern from individual and public health perspective. There is need to augmentawareness and implement legislations to promote judicious and safe practices. Furtherstudies are needed concerning resistance impact of antibiotic self-medication. Key wards: self-medication, antibiotics, Pakistani students, abroad, practices
10
Chrisinger, Laura. "Policies and practices associated with medication administration in Ohio public elementary schools." Connect to this title online, 2004. http://hdl.handle.net/1811/180.
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Thesis (Honors)--Ohio State University, 2004.<br>Title from first page of PDF file. Document formatted into pages; contains 24 p.; also includes graphics (some col.). Available online via Ohio State University's Knowledge Bank. Includes bibliographical references (p. 20-21). Available online via Ohio State University's Knowledge Bank.
11
Rizzo, Michael L. "The Prescribing Knowledge, Attitudes, and Practices among Nurse Practitioners in Maine towards Benzodiazepines." Fogler Library, University of Maine, 2004. http://www.library.umaine.edu/theses/pdf/RizzoML2004.pdf.
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12
Gartoulla, Rintu Prasad. "Ethnomedicine and other alternative medication practices : a study in medical anthropology in Nepal." Thesis, University of North Bengal, 1992. http://ir.nbu.ac.in/handle/123456789/335.
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13
Lilley, Christine Megan. "Psychological predictors of children's pain and parents' medication practices following pediatric day surgery." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/NQ56577.pdf.
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14
Paul, Yvonne. "Exercise practices, dietary habits and medication usage among persons with Type-I diabetes." Diss., University of Pretoria, 2002. http://hdl.handle.net/2263/28990.
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The aim of this study was to gain insight into the exercise practices, in conjunction with dietary habits and medication routine of insulin dependent diabetics. The study design adopted for the study was that of descriptive and analytical survey. The gathering of data was conducted over a period of seven months using a questionnaire as a data collection instrument, which was administered to 200 insulin dependent diabetics utilizing the outpatient facilities at 12 hospitals in Kwa-Zulu Natal. In determining the respondent's attitude towards exercise, the significant (p<0.001) overall majority (85%) had a positive attitude towards exercise. In probing the perceived efficacy of exercise as a therapeutic modality, a significant (p<0.001) majority (93%) of the respondents stated that exercise/sport is beneficial to a diabetic. Of the overall sample, the significant (p<0.001) majority (68%) of respondents were active participants in exercise (exercisers) versus 32% who were not active (non-exercisers). The profile of the exercisers indicated that the significant (p<0.001) majority participated in exercise of an aerobic type at frequency of 4 or more times per week, at an intensity eliciting an approximate heart rate of between 110 to 130 beats per minute corresponding with an RPE of 11 to 13, for a duration of 20 to 45 minutes. A significant (p<0.001) overall majority (98%) stated that a good diet is an important factor when trying to achieve near normoglycemia. In probing the respondent's knowledge as to what group certain types of food belong to, an overall significant (p<0.001) majority (82%) was accurate in this regard, while significantly (p<0.1) more exercisers (84%) were aware of correct food grouping than non-exercisers (67%). In probing their knowledge of the normal range of blood glucose levels, an overall significant (p<0.001) number of respondents (66%) stated a correct response, while exercisers (67%) were significantly (p<0.1) more knowledgeable than non-exercisers (52%) in this regard. The significant (p<0.001) majority of respondents injected themselves three and more times a day (54%), before meals (71%), in the thigh (35%) and abdominal areas (48%), as opposed to the gluteal area (10%) and the arm (8%). The mean overall dosage of long-acting insulin (12.2 units) and short-acting insulin (10.5 units) for lunch was significantly lower (p<0.1) than for breakfast and supper, however there was no significant difference (p>0.1) between the breakfast and supper dosages. The same pattern was observed for non-exercisers and exercisers. The respondent's knowledge of good diabetic management goals reflected that a significant (p<0.001) overall majority (83%) were aware that diet, insulin and exercise are all important constituents in obtaining good diabetic management, while significantly (p<0.1) more exercisers (84%) than non-exercisers (71%) were aware of this. A significant (p<0.001) majority (83%) of non-exercises stated that they were willing to participate in exercise, but cited time constraints and physical discomfort, inter-alia, as antecedents to non-participation. In conclusion, the results indicated that the provision of educational support for insulin dependent diabetics to overcome the perceived barriers to exercise would increase participation, enhance appropriate exercise prescription and compliance to this important aspect of the diabetic regimen.<br>Dissertation (MA (Human Movement Science))--University of Pretoria, 2002.<br>Biokinetics, Sport and Leisure Sciences<br>unrestricted
15
Miller, Kristi. "Effect of Root Cause Analysis on Pre-Licensure, Senior-Level Nursing Students’ Safe Medication Administration Practices." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etd/3432.
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Aim: The aim of this study was to examine if student nurse participation in root cause analysis has the potential to reduce harm to patients from medication errors by increasing student nurse sensitivity to signal and responder bias.
Background: Schools of nursing have traditionally relied on strategies that focus on individual characteristics and responsibility to prevent harm to patients. The modern patient safety movement encourages utilization of systems theory strategies like Root Cause Analysis (RCA). The Patient Risk Detection Theory (Despins, Scott-Cawiezell, & Rouder, 2010) supports the use of nurse training to reduce harm to patients.
Method. Descriptive and inferential analyses of the demographic and major study variables were conducted. Validity and reliability assessments for the instruments were performed.
The Safe Administration of Medications-Revised Scale (Bravo, 2014) was used to measure sensitivity to signal. The Safety Attitudes Questionnaire (SAQ; Sexton et al., 2006) was used to assess responder bias; this was the first use of this instrument with nursing students.
Results: The sample consisted of 125 senior-level nursing students from three universities in the southeastern United States. The SAQ was found to be a valid and reliable test of safety attitudes in nursing students. Further support for the validity and reliability of the SAM-R was provided. A significant difference in safety climate between schools was observed. There were no differences detected between the variables.
Conclusion: The results of this study provide support for the use of the SAQ and the SAM-R to further test the PRDT, and to explore methods to improve nursing student ability to administer medications safely.
16
Page, Meredith Ann. "Prescribing in teaching hospitals:exploring social and cultural influences on practices and prescriber training." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/6258.
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Medicines are a fundamental healthcare intervention, but the benefits they provide depend entirely on the way in which they are used. This begins with prescribing, a complex task with substantial risks. Systematic evaluation of biomedical factors may be viewed as an essential component of this task, but prescribers also integrate an array of individual, social, cultural, environmental and commercial factors into their prescribing decisions. Furthermore, social and cultural characteristics of the prescriber’s workplace may influence how well prescribing decisions are carried out. Whilst numerous research efforts have helped to construct an in-depth understanding of non-biomedical influences on GP’s prescribing patterns, the characteristics of corresponding sorts of influences in teaching hospitals have not been well determined. In hospitals, supervised medical trainees, registrars and consultants prescribe within the framework of medicines management systems involving nurses, pharmacists and patients. Currently, little is known about whether each of these groups has distinct beliefs, attitudes and values that may affect either prescribing behaviour or how prescribing skills of medical trainees are acquired. The aim of this study was to explore the social and cultural dynamics of prescribing and prescriber training in teaching hospitals. To do this, established qualitative methods were employed. Junior doctors, registrars, consultants, nurses, and pharmacists from two metropolitan teaching hospitals were sampled purposively and invited to participate in semi-structured interviews. A brief questionnaire was used to collect demographic and contextual information. In the interviews, participants were asked about their attitudes towards prescribing, their perceptions of roles and responsibilities, how they communicated prescribing decisions, their perceptions of influences on prescribing, and their perceptions of factors contributing to prescribing errors. Participants were also asked for their opinions on various aspects of new prescriber training. Sampling proceeded until redundancy of themes was established. A pilot study was conducted with one participant from each professional group to optimise the interview schedule, and then using this tool, a further 38 participants were interviewed. In total, eight consultants, eight registrars, nine junior doctors, eleven pharmacists, and seven nurses participated. Using reiterative content analysis of a third of all transcripts, a coding scheme was developed, which was used to label and categorise the remaining transcripts. Categories were further developed and refined. The resultant core themes were cross indexed against the five different health professional types using thematic charts to explore patterns. The main lines of enquiry for this research were mapped, the properties of these categories and interrelationships explored in detail, and a model of the prescribing process was developed. Prescribing at the teaching hospitals was a complex process consisting of multiple steps undertaken by several different health professionals of varying levels of experience from three different health care disciplines. Because of the intricate separation of responsibilities, the operation of the process was highly reliant on the behaviours of each player and their relationships with each other. Key prescribing decisions associated with patient admissions were made, almost exclusively, by medical teams. Prescribing was therefore chiefly characterised by factors influencing the behaviours of the doctors. Their behaviours were influenced by factors relating to their individual characteristics (eg, knowledge, skills, experience); but also by a web of socio-cultural determinants inherent to the environment in which they worked. These factors were related to: the organisational structure of the prescribing process; the knowledge characteristics of the doctors; the communication patterns they used; the underlying assumptions they made about prescribing; and the work environment.
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Page, Meredith Ann. "Prescribing in teaching hospitals:exploring social and cultural influences on practices and prescriber training." University of Sydney, 2008. http://hdl.handle.net/2123/6258.
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Master of Pharmacy<br>Medicines are a fundamental healthcare intervention, but the benefits they provide depend entirely on the way in which they are used. This begins with prescribing, a complex task with substantial risks. Systematic evaluation of biomedical factors may be viewed as an essential component of this task, but prescribers also integrate an array of individual, social, cultural, environmental and commercial factors into their prescribing decisions. Furthermore, social and cultural characteristics of the prescriber’s workplace may influence how well prescribing decisions are carried out. Whilst numerous research efforts have helped to construct an in-depth understanding of non-biomedical influences on GP’s prescribing patterns, the characteristics of corresponding sorts of influences in teaching hospitals have not been well determined. In hospitals, supervised medical trainees, registrars and consultants prescribe within the framework of medicines management systems involving nurses, pharmacists and patients. Currently, little is known about whether each of these groups has distinct beliefs, attitudes and values that may affect either prescribing behaviour or how prescribing skills of medical trainees are acquired. The aim of this study was to explore the social and cultural dynamics of prescribing and prescriber training in teaching hospitals. To do this, established qualitative methods were employed. Junior doctors, registrars, consultants, nurses, and pharmacists from two metropolitan teaching hospitals were sampled purposively and invited to participate in semi-structured interviews. A brief questionnaire was used to collect demographic and contextual information. In the interviews, participants were asked about their attitudes towards prescribing, their perceptions of roles and responsibilities, how they communicated prescribing decisions, their perceptions of influences on prescribing, and their perceptions of factors contributing to prescribing errors. Participants were also asked for their opinions on various aspects of new prescriber training. Sampling proceeded until redundancy of themes was established. A pilot study was conducted with one participant from each professional group to optimise the interview schedule, and then using this tool, a further 38 participants were interviewed. In total, eight consultants, eight registrars, nine junior doctors, eleven pharmacists, and seven nurses participated. Using reiterative content analysis of a third of all transcripts, a coding scheme was developed, which was used to label and categorise the remaining transcripts. Categories were further developed and refined. The resultant core themes were cross indexed against the five different health professional types using thematic charts to explore patterns. The main lines of enquiry for this research were mapped, the properties of these categories and interrelationships explored in detail, and a model of the prescribing process was developed. Prescribing at the teaching hospitals was a complex process consisting of multiple steps undertaken by several different health professionals of varying levels of experience from three different health care disciplines. Because of the intricate separation of responsibilities, the operation of the process was highly reliant on the behaviours of each player and their relationships with each other. Key prescribing decisions associated with patient admissions were made, almost exclusively, by medical teams. Prescribing was therefore chiefly characterised by factors influencing the behaviours of the doctors. Their behaviours were influenced by factors relating to their individual characteristics (eg, knowledge, skills, experience); but also by a web of socio-cultural determinants inherent to the environment in which they worked. These factors were related to: the organisational structure of the prescribing process; the knowledge characteristics of the doctors; the communication patterns they used; the underlying assumptions they made about prescribing; and the work environment.
18
Cronje, Liza. "Intravenous medication safety practices of registered nurses in neonatal and paediatric critical care areas." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/20035.
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Thesis (Mcur)--Stellenbosch University, 2012.<br>ENGLISH ABSTRACT: A literature study showed that the topics of medication safety and medication error prevention
have been studied in depth. Findings from the literature revealed that medication errors are
reported to be common in neonatal and paediatric ICUs, that more than half of these errors are
preventable and that risk reduction measures protect patients against untoward outcomes or
adverse events (Clifton-Koeppel, 2008:72). If and when there is a failure in the process of safe
medication administration, it results in a medication error, which is defined as a breach of one or
more of the five rights of medication administration (Institute for Safe Medication Practices Alert,
2007:1).
Medication administration, which is predominantly a nursing task, is of high risk and high volume
in the intensive care unit (ICU). The accuracy of intravenous medication administration is critical
for a neonatal and paediatric ICU patient since it can potentially heighten the patient’s
vulnerability if further harm is caused. In view of the complexity of medication administration for
neonatal and paediatric ICU patients, researchers confirm the diverse role of the registered
nurse in safe medication administration practices.
The purpose of the study was to describe the perceptions of registered nurses (RNs) regarding
the factors that influence IV medication safety practice in the neonatal intensive care unit
(NICU); paediatric intensive care unit (PICU); and paediatric cardiac intensive care unit (CSICU)
in Saudi Arabia. The study objectives were set to describe the actual factors that have an
influence on IV medication safety practices of RNs working in these ICUs; to determine the
knowledge of registered nurses in the selected ICUs with regard to safe intravenous medication
administration practices and to describe nursing medication administration strategies that are
focused on medication error prevention.
A quantitative research approach was selected for this study which had a descriptive, survey
design. An 85% non-probability purposive sampling method was used to draw a sample (n=103)
of the target population of NICU-, PICU- and CSICU-registered nurses (N=121) who were
responsible for administering intravenous medication at King Faisal Specialist Hospital and
Research Centre in Jeddah (KFSHRC-J). A self-administered questionnaire with closed-ended Likert and open-ended question was
designed to describe the objectives under study. A pilot study was conducted to pre-test the
questionnaire. A quantitative method was used to analyse the study data. MS Excel was used
to capture the quantitative data after which it was analysed using descriptive statistics by means
of STATISTICA 9 software. The open–ended questions (indicating “other” and Question 70)
were also interpreted quantitatively after exploring the main aspects in the responses. The main
findings were that multiple perceived factors influence the intravenous medication safety
practices of RN’s working with neonatal and paediatric ICU patients in a particular Saudi
Arabian tertiary hospital. It was found that these nurses’ had knowledge regarding safe
medication administration practice that constitutes that all five medication rights have to be
checked through nursing ‘double-checks’ in the steps of medication administration, as the
method of checking as per hospital policy. However, from the findings, it is reflected that RNs
perceptions of completely and correctly checking medication rights through complete and
independent nursing ‘double-checks’, do not match the steps required by policy and that their
knowledge is inadequate. It is evident from the perceptions of RNs that they are aware of the
multiple factors influencing IV medication safety practice in this vulnerable patient setting. As
perceived by RNs, it is possible to implement more safety strategies. Key recommendations on
conclusion of the study include that there are more nursing medication administration strategies
that could still be implemented for medication error prevention. These strategies relate to
medication safety awareness, the role of the nurse and nursing managers, mandatory staff
education, and review of knowledge and skills.<br>AFRIKAANSE OPSOMMING: Gebaseer op ʼn literatuurstudie blyk dit dat medikasieveiligheid en voorkoming van
medikasiefoute reeds in diepte bestudeer are. Bevindings dui daarop dat medikasiefoute
algemeen voorkom in neonatale en pediatriese intensiewesorgeenhede, dat meer as die helfte
daarvan voorkombaar is, en dat maatreëls om risiko te vermindering pasiënte teen
voorkombare uitkomste beskerm (Clifton-Koeppel, 2008:72). Indien en wanneer die proses vir
veilige medikasietoediening faal, kom ʼn medikasiefout voor, wat gedefinieer word as die
verbreking van een of meer van die vyf medikasieregte (Institute for Safe Medication Practices
Alert, 2007:1).
Medikasietoediening is hoofsaaklik ʼn verpleegtaak, wat ʼn hoërisiko- en hoëvolume-taak behels.
Die akkuraatheid van intraveneuse medikasietoediening is kritiek vir neonatale en pediatriese
intensiewesorgpasiënte, aangesien hul weerloosheid verhoog word indien verdere skade
veroorsaak word. Omrede medikasietoediening vir neonatale en pediatriese
intensiewesorgpasiënte kompleks is, bevestig navorsers dat geregistreerde verpleegkundiges
se rol ten opsigte van veilige medikasietoediening veelsoortig is.
Die doel van die studie was om die persepsies van geregistreerde verpleegkundiges
aangaande die faktore wat medikasieveiligheid in die neonatale en paediatriese intensiewe
eenhede in Saoedi-Arabië beinvloed, te beskryf. Studiedoelwitte is gestel om die spesifieke
faktore te beskryf wat aanleiding gee tot medikasietoedieningsfoute in die genoemde
intensiewesorgeenhede; om geregistreerde verpleegkundiges in die geselekteerde
intensiewesorgeenhede se kennis van veilige medikasietoediening te bepaal; en die
medikasietoedieningstrategieë wat op die voorkoming van medikasietoedieningsfoute fokus, te
beskryf.
ʼn Kwantitatiewe navorsingsbenadering is geselekteer vir die studie wat ʼn beskrywende
navorsingsontwerp gehad het. ʼn 85% nie-waarskynlike gerieflikheidsteekproef is gebruik om ʼn
steekproef (n=103) te selekteer vanuit die teikenpopulasie geregistreerde verpleegkundiges
(N=121) wat verantwoordelik was vir medikasietoediening in die geselekteerde
intensiewesorgeenhede by King Faisal Specialist Hospital and Research Centre, Jeddah
(KFSHRC-J). ʼn Self-geadministreerde vraelys met geslote Likert- en oop-eindevrae is opgestel om die
gestelde studiedoelwitte te ondersoek. ʼn Vooraf-toetsing van die vraelys is tydens die
loodsstudie uitgevoer. ʼn Kombinasie van kwantitatiewe en kwalitatiewe metodes is gebruik vir
die ontleding van die studie-data. Die kwantitatiewe data is op MS Excel ingevoer, waarna
beskrywende statistiek deur middel van Statistica 9-sagteware gebruik is om dit te ontleed. Die
studie het hoofsaaklik bevind dat veelvuldige faktore die veiligheidspraktyk ten opsigte van
intraveneuse medikasie van geregistreerde verpleegkundiges wat met neonatal en pediatriese
intensiewesorgpasiënte in ʼn spesifieke tersiêre hospitaal in Saoedi-Arabië werk, beïnvloed. Dit
blyk dat hierdie verpleegkundiges se kennis voldoende is aangaande ‘n veilige medikasie
toedieningspraktyk wat bestaan uit die kontrolering van al vyf medikasieregte deur
verpleegkundige dubbel-kontrolering, soos beskryf is in die hospitaalbeleid. Volgens die
bevindinge blyk dit egter dat die verpleegkundiges se persepsie van volledige and korrekte
verpleegkundige dubbel-kontrolering, nie met die stappe volgens die hospitaalbeleid
ooreenstem nie en dat hulle kennis onvoldoende is. Dit is duidelik dat die verpleegkundiges
bewus is van die veelvuldige faktore wat intraveneuse medikasieveiligheidpraktyk vir weerlose
pasiënte beïnvloed. Die verpleegkundiges se persepsie is dat daar meer verpleegkundige
medikasietoedieningstrategieë is wat geïmplementeer kan word om medikasiefoute te voorkom,
insluitende veiligheidsbewustheid ten opsigte van medikasie, die rol van verpleegkundiges en
verpleegbestuurders, verpligte personeelopleiding, en hersiening van kennis en vaardighede.
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Aziz, Omer. "An exploration of the practice of prescribing and use of medicines, with a special focus on self-medication practices in the context of developing reform within the health care system in Kurdistan-Iraq." Thesis, De Montfort University, 2017. http://hdl.handle.net/2086/16083.
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This research has been undertaken to evaluate factors with an association with the practice of self-medication amongst respondents living within three cities within Kurdistan. The research was designed to be a cross-sectional one by arranging for data collection through the direct interviewing of respondents via the use of a questionnaire that had been prepared previously. In total, the investigation involved 627 pharmacist participants, 647 general participants, and 28 interviewees from various age groups. An explanatory design is a mixed methods approach with two phases, with quantitative data collection in the first phase, and qualitative data collection in a second; data collection was conducted using a non-probability convenience sampling technique. The primary reason for self-medication practice was that participants with previous experience of attending to the same disease. The information source regarding self-medicated drugs were previous prescriptions, community pharmacies and friends. The most common indication for self-medication was the common cold or fever/headache/infection, the drugs used to treat these conditions being most commonly antibiotics, then painkillers and preparations for coughs. From the general public, a sample of 647 participants was taken that consisted of 38.4% females and 61.6% males, with participant ages ranging from 18-70 years. Within the study, 12.4% of the cohort had a degree level of education from a university. Moreover, 243 participants had the belief that it was an acceptable practice to purchase antibiotics without a prescription. Self-medication was practiced by 14/28 of the interviewees, and 28/28 (100%) of the interviewees held the belief that the pharmacy always has someone with knowledge of medicines, and who can advise and provide medication. There were 627 pharmacist participants, of which 28.1% were female and 71.9% were male, and 57.2% of them holding a Diploma in Health Institution, and 39.2% of them having a Bachelors Pharmacy degree. 20.7% of participants disagreed with keeping records for the dispensing of drugs, and approximately 20% of participants had little or no ideas regarding the characteristics of pharmacy practice that are considered professional. It was discovered that, if asked by the customer, advice was provided by 82.5% of community pharmacists. The sale of antibiotics was the most common, followed by pain-killers. A 95.5% proportion of pharmacists sold all of the medicines as OTC medicine without prescription. In conclusion, medicines are used by the people of Kurdistan in an inventive way, with suggestions provided by lay people and members of family or friends, which is acted upon without a qualified healthcare professional being consulted.
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Berdunov, Vladislav. "Investigation of the economic impact of different patterns of medication monitoring in general practices." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/32912/.
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Medication monitoring is used in primary care to guide treatment and protect the patient from adverse drug events (ADEs). Early detection of ADEs may prevent their development and avoid serious or permanent effects to patient health. Published guidelines for the conduct of medication monitoring in UK primary care recommend monitoring in patients with long-term prescription of certain cardiovascular medications, including angiontensin-converting enzyme inhibitors (ACEI), loop diuretics and amiodarone. Although much evidence exists on the practice of monitoring of these medications in primary care, few studies have considered the effect of carrying out monitoring at different frequencies during long-term therapy on the risk of ADEs. Similarly, evidence of the economic effect of regular monitoring of these medications is sparse. As a consequence, policy-makers rely primarily on evidence from expert opinion as a basis for recommendations and compliance to guidelines in practice is poor. This programme of research aimed to gain an understanding of the nature of monitoring of ACEI, loop diuretics and amiodarone in primary care in England, and investigate the effectiveness and cost-effectiveness of monitoring in accordance with current guidelines. Using electronic health records from the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES), a cohort study was carried out in order to quantify the effect of monitoring the study medications at different frequencies during the course of long-term therapy. Weights based on propensity scores were used to control for confounding arising from non-random assignment into alternative monitoring regimens in retrospectively observed data. The time-to-event analysis found that conducting thyroid function tests (TFT) in amiodarone therapy below the recommended interval of once in 6 months was associated with more than a two-fold increase in the hazard rate of hypothyroidism (HR 2.79; 95% CI 1.42,5.47), thyrotoxicity (HR 2.57; 1.40,4.74) and major adverse cardiovascular events (HR 2.13; 1.31,3.45), when comparing against a group of patients monitored according to guidelines. Conversely, conducting urea & electrolyte monitoring in ACEI therapy below recommended frequency was associated with a reduced rate of hyperkalaemia treated in primary care (HR 0.57; 0.42,0.77) and hospital admission (HR 0.13;0.02,0.95). In addition, monitoring urea & electrolytes during loop diuretic therapy below recommended frequency was associated with a lower hazard rate of hypokalaemia or hyponatraemia treated in primary care (HR 0.17; 0.06,0.45). These findings support current recommendations on frequency of regular monitoring in the case of amiodarone TFT monitoring, but not in the case of ACEI or loop diuretics. The results of the time-to-event analysis of amiodarone monitoring were used to populate a decision-analytic model designed in order to estimate the cost-effectiveness of different strategies of monitoring medication, compared to recommended practice. This analysis demonstrated that conducting TFT at recommended frequency yielded modest cost savings per patient (£129, compared to less frequent monitoring and £192 compared to more frequent monitoring option) and utility gains per patient (0.0245 quality-adjusted life-years (QALYs) compared to less frequent monitoring and 0.0543 QALYs compared to more frequent monitoring option). The probabilistic model estimated that the recommended frequency strategy had a 97% probability of being a cost saving option compared to the two alternatives. These findings support the current policy of encouraging 6-monthly monitoring of TFT in amiodarone therapy. This programme of research has demonstrated that medication monitoring is potentially effective and cost-effective in amiodarone therapy, but did not find regular monitoring of ACEI or loop diuretic therapy to be effective. Observational research using routinely collected electronic health records can be used to gauge both the clinical and cost-effectiveness of medication monitoring in order to guide practice in this area and improve the safety of medications in primary care.
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Hangauer, Jason. "Medication Monitoring in the Schools: An Investigation of Current Practices of Florida School Psychologists." Scholar Commons, 2012. http://scholarcommons.usf.edu/etd/4065.
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Prevalence rates of youth prescribed psychotropic medications have risen dramatically over the past decade. Many of these medications are prescribed to treat symptoms of a disorder that occur in the school setting. Some medications have negative side effects that can inhibit academic and social performance. School psychologists have been identified as professionals who are equipped to assist in monitoring both the beneficial and negative effects of medications for youth attending school. This study investigated the practices, training, types of disorders for which medication monitoring occurs, facilitators, and barriers to school psychologists engaging in medication monitoring in the schools. Survey data from 166 members of the Florida Association of School Psychologists were collected and analyzed. Seventy four percent of respondents endorsed medication monitoring as an appropriate role for school psychologists. Approximately half of the respondents in this study reported engaging in medication monitoring over the past school year. Over half the sample reported receiving training related to medication monitoring. Weak relationships were found among demographic and training variables and reported medication monitoring practices. Additionally, none of the interactions between demographic, professional background, and training variables was predictive of medication monitoring practices. Implications of these findings are discussed in relation to developing strategies to promote the medication monitoring practices of school psychologists.
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Leckey, Donna. "Therapeutic Non-pharmacological Interventions and PRN Psychotropic Medication Administration Practices of Mental Health RNs." Thesis, Carlow University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3681319.
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<p> PRN psychotropic medication administration is a common practice used by psychiatric RNs in acute inpatient mental health settings to manage anxiety and agitation in patients, and as a result, there are high incidences of PRN psychotropic medication administration (Mugoya & Kampfe, 2010). There is limited documentation indicating that therapeutic non-pharmacological interventions are utilized prior to PRN psychotropic medication administration (Curtis et al., 2007). The purpose of this scholarly project was to determine what non-pharmacological interventions are used by mental health RNs prior to or in lieu of administering PRN psychotropic medication to manage anxiety and agitation in adult psychiatric hospitalized patients. Another aim of this project was to determine what factors influence mental health RNs' decisions to administer PRN psychotropic medications. A descriptive study was conducted. Two survey-type self-reporting tools were used. Twenty RNs completed Nursing Surveys. Thirteen RNs completed both Nursing Surveys and Nursing Intervention Tracking Forms. Findings from this study revealed that non-pharmacological interventions successfully resolved problems over 1/3 of the time and may prevent the use of PRN psychotropic medications. In cases where PRN psychotropic medication was not administered, distraction was the non-pharmacological intervention most often used. The most common factor influencing RNs' decisions to administer PRN psychotropic medications was a high level of anxiety persistent after non-pharmacological interventions were used. This study reinforces the importance of RNs using non-pharmacological interventions to manage patients exhibiting signs or symptoms of anxiety or agitation.</p>
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Roberts, Lance L. "Leadership safe practices snd their relationship with hospital deployment of the medication reconciliation innovation." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/879.
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Within the last decade there has been considerable national attention focused upon hospital quality and patient safety performance. Improvements in performance have been realized, but the rate of improvement has been slow. There is an increasing consensus that new ideas and national strategies are needed to accelerate improvement efforts in addressing quality/safety issues. Currently, within the hospital setting more attention is being paid to the role of leadership starting with the board of trustees in addressing gaps in performance. Organization-wide awareness of critical gaps in performance, accountability structures, and organizational ability are considered critical facilitators of improvement efforts. The characteristics of awareness, accountability, ability, and action are components of a "4A" conceptual framework that is used most prominently by the National Quality Forum (NQF) in their Safe Practices for Better Healthcare toolkit to frame governance and leaderships' responsibilities in establishing leadership structures and systems to ensure the safety of patients and staff.
This study utilizes the National Quality Forum's version of the 4A model to frame an empirical examination of the relationship between leadership structure and system characteristics and hospitals' implementation of the medication reconciliation innovation. A Patient Safety, Culture, and Leadership survey was used to capture Iowa hospital CEO/Quality Leaders' perceptions of board and leadership awareness and accountability characteristics. And, on a quarterly basis since mid-2006 a separate web-based survey has captured Iowa hospital Quality Leaders' perceptions of medication reconciliation implementation.
Both cross-sectional and longitudinal analyses were conducted to examine the relationship between leadership structures and systems and hospital-wide deployment of the medication reconciliation initiative.
This study finds evidence that board-level awareness characteristics - the time the board spent in meetings on quality and safety issues, and the frequency of board receipt of a formal quality/safety report - were positively related to hospitals' early efforts to deploy the medication reconciliation initiative. Over time hospitals' financial ability was positively related to deployment of this initiative.
Further research should focus on how healthcare governance and leadership teams can use the elements of leadership structures and systems safe practices to effectively create and sustain a culture of safety.
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Ngoasong, Michael Zisuh. "The role of global health partnerships in shaping policy practices on access to medication in Cameroon : theory, models and policy practices." Thesis, University of Nottingham, 2010. http://eprints.nottingham.ac.uk/11949/.
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This thesis argues that health policy practices on access to medication in Cameroon have been shaped by global health partnerships (GHPs), with the result that the capacity of the state has been undermined and the national health system fragmented, with no resultant reduction in the incidence and burden of malaria and HIV I AIDS. GHPs have played an increasing part in relation to access to medication in a number of developing countries in Africa, defined in terms of potential and actual access to pharmaceuticals and healthcare services. GHPs are supposed to provide a better policy response to the practical problem of access to medication by combining the expertise of UN agencies, the pharmaceutical industry, international civil society organizations, national government and local groups to formulate and implement country-specific policies. Ostensibly, they are able to bridge the gap between medical technology and the public health needs of poor societies. Neither of these claims can be substantiated. Theoretical approaches to models, embodied knowledge and social constructionism are used to provide a conceptual framework to study the role of GHPs on access to medication. GHPs are conceptualised as 'models' that occupy the intermediate position between theory and policy practices, within which are found three major narratives, based on public health, economistic and human rights approaches to the issue of access to medication. These narratives became embodied within GHPs, and are analysed to show how they shape different elements of policy practices. The operation of GHPs within a 'transcalar network', this 'social space' in which global-national-local linkages are formed and interactions take place is also examined. Global and national (country-specific) perspectives on the emergence of the GHP as a facilitator of access to medication are identified, and the role of GHPs in determining national health policy and local delivery practices for achieving access to medication for the poor and most vulnerable population is investigated. Two programmes in Cameroon are used as case studies: 1) National Malaria Programme created on Roll Back Malaria partnership guidelines and 2) National HIV/AIDS Programme created on Accelerating Access Initiative and Equitable Access Initiative guidelines respectively. The empirical evidence from this thesis supports a critical evaluation. GHPs emphasise specific medical intervention programmes, and are effective only in this narrow technical sense. Even though their efforts have not reduced the incidence and burden of malaria and HIV I AIDS, they have legitimised the direct intervention of international agencies, private corporations and civil society organizations at the local level. The GHPs' pursuit of 'quick results' has fragmented the national health system and undermined the role of the state. This thesis suggests that the key to reducing disease burden and improving public health is a strengthened national health system, one that the current GHP model does not offer. Developed to address the supposed failure of African states to ensure access to medication, GHPs have further marginalised the role of the Cameroon state, thereby reducing its capacity to protect and advance the health of its citizens.
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Mackey, Theresa R. "A comparison of the pharmaceutical practices of head athletic trainers at the NCAA Division 1 level in the treatment of athletic injuries." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1117111.
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The purpose of this study was to identify the pharmaceutical practices of head athletic trainers in the treatment of athletic injuries at the National Collegiate Athletic Association (NCAA) Division I level. Another purpose was to determine if head ATCs and their staffs are compliant with the Federal and State guidelines relating to the dispensing and administering of prescription and over-the-counter OTC medications.Previous research indicated that widespread problems exist with the pharmaceutical practices of athletic trainers in the athletic setting. Due to these problems, the health care of student-athletes is being compromised and athletic trainers, physicians, pharmacists and universities are at risk for legal ramifications.A packet consisting of a cover letter explaining the purpose and voluntary nature of the study, the instrument, and a self-addressed stamped envelope was mailed out to the 312 Division I head athletic trainers on March 17, 1998. The 34 item instrument was specifically developed for the study and it covered areas dealing with the pharmaceutical practices of athletic trainers. A response rate of 60% (N= 188) was obtained for the study.The results were analyzed using descriptive statistics which consisted of means, standard deviations, and frequencies. The results indicated that prescription and OTC medications are provided in a majority of the athletic training rooms. The results indicated that a large number of athletic trainers dispense and administer prescription medications to student-athletes. This means that a number of ATCs are not following the Federal and State pharmaceutical guidelines. As a result of these findings, it is evident that widespread problems still exist in the pharmaceutical practices of athletic trainers at the NCAA Division I level. These practices could lead to compromised health care for the student athletes and serious legal ramifications for ATCs, physicians, and the universities.<br>School of Physical Education
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Duncan, Colleen S. "Assessment of the effects of risk-counselling (Motherisk) on prescription medication self-management practices, an exploratory study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0026/MQ50454.pdf.
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Quispe-Cañari, Jean Franco, Evelyn Fidel-Rosales, Diego Manrique, et al. "Self-medication practices during the COVID-19 pandemic among the adult population in Peru: A cross-sectional survey." Elsevier B.V, 2021. http://hdl.handle.net/10757/655713.
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Self-medication impacts both negatively and positively the health of people, which has become evident during the COVID-19 pandemic. The study aimed to assess the prevalence of self-medicated drugs used for respiratory symptoms, as COVID-19 preventive, for its symptoms or once tested positive. To determine the perception of symptom relief and demographic variables that promote self-medication in Peru. We performed a cross-sectional, analytical, multicenter study in 3792 study respondents on the use, the reason for use, and perception of relief after the use of six drugs during the quarantine period. An online questionnaire was developed, pretested and submitted to the general public. Multivariable logistic regression was used to ascertain factors that influence an individual's desire to self-medicate, associations were considered significant at p < 0.05 and using region (coast, mountain and jungle) as cluster group. The majority of respondents self-medicated with acetaminophen for respiratory symptoms and mainly because they had a cold or flu. It was observed that all the surveyed drugs (acetaminophen, ibuprofen, azithromycin, penicillin, antiretrovirals and hydroxychloroquine) were consumed for various symptoms including: fever, fatigue, cough, sneezing, muscle pain, nasal congestion, sore throat, headache and breathing difficulty. Over 90% of respondents perceived relief of at least one symptom. Multivariable logistic regression showed that older people have a higher frequency of antiretroviral self-medication, respondents who currently have a job had a higher frequency of penicillin self-medication, and that respondents from the Andes consumed less acetaminophen, while the ones from the rainforest consumed it more. There were significant percentages of self-medication, including drugs without sufficient scientific evidence. Age, region where one lived and job status were variables associated with self-medication frequency. Continuous awareness and sensitization about the risks of self-medication are warranted.<br>Revisión por pares
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Bergeron, Marie. "Pratiques diagnostiques et thérapeutiques dans la prévention et le traitement de l'ostéoporose et adhésion des patients." Thesis, Lyon, 2018. http://www.theses.fr/2018LYSE1334/document.
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L'ostéoporose est une maladie qui fragilise la structure osseuse et provoque des fractures qui ont des conséquences individuelles et sociétales importantes. Certains traitements ont démontré leur efficacité dans la réduction du risque de fracture, mais il s'avère que les prises en charge diagnostiques et thérapeutiques, ainsi que l'adhésion thérapeutique des patients ne sont pas optimales, réduisant ainsi les bénéfices de ces thérapeutiques en pratique réelle. Nous nous sommes tout d'abord intéressés aux pratiques de prise en charge diagnostiques et thérapeutiques et avons (i) quantifié l'augmentation massive des dosages sériques de vitamine D entre 2008 et 2013 et montré qu'elle était essentiellement due à une augmentation du nombre de patients recevant un seul dosage et (ii) montré que la proportion de patientes initiant un traitement anti-ostéoporotique suite à une fracture du poignet ou de l'humérus entre 2009 et 2011 demeurait faible en France (9%). Suite à ce constat, nous nous sommes interrogés sur l'efficacité et l'efficience des interventions visant à améliorer la prise en charge des patients à risque de fracture ostéoporotique. Notre revue de la littérature a montré que ces interventions avaient une efficacité significative sur la prescription de densité minérale osseuse mais un impact plus limité sur la prescription de traitement. Les interventions de type « structurelles » et celles consistant en un envoi de matériel éducationnel aux patients et ou professionnels de santé étaient des stratégies dominantes d'un point de vue médico-économique et les interventions avec un échange éducationnel étaient coût-efficaces. Enfin, chez des patients initiant un traitement par bisphosphonate oral nous avons comparé l'adhésion thérapeutique entre le princeps et le générique. Contrairement à notre hypothèse de départ, le fait d'initier le traitement avec un médicament générique n'était pas associé à une baisse de l'adhésion thérapeutique<br>Osteoporosis is a silent disease that weakens the patient's bone structure and causes fractures that have significant individual and societal consequences in terms of health and dependence. Treatments have been shown to be effective in reducing the risk of fracture, but it appears that diagnostic and therapeutic management and medication adherence of patients at risk of osteoporotic fracture are not optimal, which may minimize the benefits of these therapies in real practice. Initially, we focused on diagnostic and therapeutic management practices and showed that (i) the massive increase in reimbursements for vitamin D dosages observed between 2008 and 2013 was essentially due to an increase in the number of patients receiving a single dosage and not to intensive follow-up of a restricted population particularly at risk of deficiency, and (ii) the proportion of patients initiating anti-osteoporotis treatment following a wrist or humerus fracture between 2009 and 2011 remained low in France (9%). Following this observation, we questioned the effectiveness and efficiency of interventions aimed at improving the management of patients at risk of osteoporotic fracture. Interventions to improve the management of patients who have had a fracture or at risk of fracture had significant efficacy on bone mineral density prescription but a more limited impact on treatment prescribing. We have shown that "structural" interventions and those consisting of sending educational materials (for patients, health professionals or both) were dominant strategies from a medico-economic point of view, and that interventions with educational exchange were cost-effective. Finally, we compared the therapeutic adherence (implementation and persistence) of patients initiating oral bisphosphonate therapy between those taking the brand drug and those taking the generic drug. Initiating treatment with a generic drug was not associated with a decrease in therapeutic adherence
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Kampman, Kelley M. "Mothering on MATs: The Influence of Intensive Mothering and Biomedicalized Addiction Treatment on Opioid Addicted Women's Mothering Practices." Case Western Reserve University School of Graduate Studies / OhioLINK, 2021. http://rave.ohiolink.edu/etdc/view?acc_num=case1612955976182.
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Pylypa, Jennifer Jean 1969. "Self-care and self-medication practices in two California Mexican communities: Migrant farm worker families and border residents in San Diego County." Thesis, The University of Arizona, 1997. http://hdl.handle.net/10150/278600.
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Although medical anthropologists have recently taken up the study of medication use in both developing and developed nations, the medication practices of immigrants remain unstudied. The current research reports on self-medication practices among two California Mexican immigrant communities: immigrant families living along the California-Mexico border, and migrant farm worker families residing in illegal encampments and substandard housing in San Diego's North County. Medication and health seeking practices are found to be influenced by both political-economic forces, and the sociocultural context in which California Mexicans live. The U.S.-Mexico border area is considered as a special context for self-medication, since it permits border-crossing into Tijuana for the purpose of buying Mexican pharmaceuticals at low cost without a prescription. The popularity of injections and the cross-border purchasing of injectable antibiotics and vitamins are discussed as a case study.
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Calhoun, McKenzie L. "Weight Loss Medication Update." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/6887.
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De, Nadai Alessandro Stevens. "Alliance and Mechanisms of Medication Adherence in Pediatric Psychiatric Practice." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4882.
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Psychiatric medications have been established as an efficacious treatment for pediatric psychopathology (Comer, Olfson, & Mojtabai, 2010), with approximately 3.9% of American children receiving psychotropic medication in a given year (Olfson, Marcus, Weissman, & Jensen, 2002). However, medication adherence for these conditions is suboptimal, with over 50% of children discontinuing treatment before the period recommended for full therapeutic benefit (e.g., Gau et al., 2006; Murray, de Vries, & Wong, 2004). This is highly problematic because pediatric psychopathology is associated with substantial functional impairment and reduced quality of life, as well as increased risk for suicidality (e.g., Bridge, Goldstein, & Brent, 2006; Kessler, Berglund, Demier, Jin, Merikangas, & Walters, 2005).
Unfortunately, few empirical data exist about variables that may relate to medication adherence in pediatric pharmacotherapy. However, the psychotherapy literature has identified several potent mechanisms of behavior change that may be related to adherence, including therapeutic alliance, motivation for behavior change, and expectancies for positive treatment outcomes. We aimed to evaluate the role of these factors in a sample of 65 outpatient youth ages 7-17 years and their families, where questionnaires evaluating these constructs were administered at patients' first session with a new psychiatric provider. Study results revealed several associations with adherence among these hypothesized predictors, with parental motivation for child behavior change being a particularly robust predictor of adherence. Results are discussed in the context of a new pathway to progress in pediatric psychiatry, where instead of focusing predominantly on development of new pharmacological agents, identifying methods to adjust the therapeutic relationship may be indicated in order to maximize patient outcomes in pharmacotherapy.
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Cure, Laura Leonard. "Usefulness of Medication Scanners in Clinical Practice: A Systematic Review." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/6004.
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Thousands of people die each year due to preventable medication errors. Barcode medication administration (BCMA) systems can reduce medication errors at the point of care, thus increasing patient safety. The purpose of the project was to gather evidence regarding BCMA usefulness in reducing medication errors. Kurt Lewin's 3-step change theory was used to guide this project. The nature of this project was a systematic review of the literature pertaining to the effectiveness of using BCMA systems to reduce medication errors in at the point of care in the hospital setting. The Johns Hopkins nursing evidence-based practice model and tool kit was used to evaluate each article. The review comprised one systematic review, one integrative review, and 6 before-and-after observational studies. The results of each study indicated that the use of a BCMA system could reduce medication errors but not completely eliminate them. The findings of this project contribute evidence that BCMA systems can assist the clinician in safely administering medication. Dissemination of the evidence will contribute to a positive change by promoting greater understanding of the effectiveness of using BCMA systems in all areas that administer medication.
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Calhoun, McKenzie L. "Novel Anti-Diabetic Medications." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6885.
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Bennett, Joanna. "Community psychiatric nurse practice in assessing side effects of antipsychotic drugs." Thesis, University of Hertfordshire, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309696.
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Petty, Duncan Robert. "The effect of pharmacist led clinical medication review in general practice." Thesis, University of Leeds, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.399909.
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George, Tamuno Raymond. "Generic Drugs : Physician Prescribing Practices for Brand Name and Generic Medications." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/2655.
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Brand-name drug costs continue to create a burden for many US seniors who receive care from healthcare institutions. Generic medication is as therapeutic as is brand-name drugs and, in most cases, costs far less. Despite this cost difference, physicians continue to prescribe brand-name drugs. The purpose of this cross-sectional study was to explore physicians' patterns of prescribing brand-name drugs over generic drugs. This study was guided by the medical home model, which was developed in 1967 by the American Academy of Pediatrics. The study incorporated a purposeful sampling approach with a sample size of 151 physicians. Multiple linear regression was used to examine the associations between cost of treatment using generic medications and determinants of physicians' pattern of prescribing brand-name medications over generic medications. There were no statistically significant associations between physician belief of cost using generic medications and determinants of physicians' pattern of prescribing brand-name medications over generic medications, suggesting that physicians' prescription patterns are not solely determined by cost of the drug to the patients. The positive social change implication of this study is in the awareness that it generates among physicians, with evidence to suggest the need for more education on the utility of generic drugs instead of brand-name medications.
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Polaha, Jodi, William T. III Dalton, and Blake M. Lancaster. "Parental Report of Medication Acceptance Among Youth: Implications for Every Day Practice." Digital Commons @ East Tennessee State University, 2008. https://dc.etsu.edu/etsu-works/6746.
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Lall, Seema. "The Lived Experience of Making a Medication Administration Error in Nursing Practice." Thesis, Adelphi University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10610421.
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<p> Medication administration is an important task performed daily by nurses and is one of the key aspects of safe patient care. The multiple and varied roles of nurses, complexity of workplace, chaotic and technical nature of the work environment may result in cognitive overload that may overwhelm nurses, which may possibly lead to medication errors. All medication errors committed are considered serious events but some may consequently be harmful to patients. Research indicates that when medication errors occur the concern is usually for the patients involved in the incident. However, making a medication administration error has a lasting effect on the nurse as well as the patient (Schelbred & Nord, 2007; Treiber & Jones, 2010).</p><p> This study examined what it was like to make a medication error for eight registered nurses through in-depth and focused face to face interview using the descriptive phenomenological approach rooted in the philosophical tradition of Husserl. Two interviews were carried out with each participant and the research data were generated from a total of sixteen interviews and field notes. The transcripts were analyzed using the seven-step methodological guidelines developed by Colaizzi for data interpretation to understand the meaning of the nurses lived experiences of making medication errors.</p><p> Five theme categories emerged: Immediate <i>Impact: Psychological and Physical Reactions; Multiple Causes within Chaos: Cognitive Dimensions; Embedded Challenges: Healthcare Setting; Organizational Culture: Within the Place/Within the Person; Dynamics of Reflection: Looking Forward</i>. The essential structure of the phenomenon of making a medication administration error included the realization that a profound experience had happened to them. This resulted in physical and emotional upheavals, a threatened professional status, with low self-esteem and confidence. An overwhelming workload, a stressful work environment and ill-treatment by peers were descriptions of the cause of the errors. Nurses did offer ways to improve the system but felt their concerns were often not valued. Implications for nursing practice to improve patient outcomes, and for nursing education, to radically change the teaching of medication administration were formulated.</p>
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Webb, Melessia D. "“Licensed Practical Nurse Intravenous Push Medications: Innovative Curriculum Implementation”." Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etsu-works/8495.
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McKnight, David. "Medication incidents in a private hospital : frequency, type, causes and outcomes." Thesis, Curtin University, 2011. http://hdl.handle.net/20.500.11937/1254.
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Background: Medication Safety has become a major health issue in Australia and internationally. Medication use is a part of most people lives with around seven in ten Australians and nine in ten older Australians having taken at least one medication over a two week period. But the taking of medications is not devoid of risk to the patient and a subsequent cost to society. This risk of an adverse outcome can be due to a predictable or idiosyncratic direct effect of the medication (adverse drug reaction) or a breakdown in the systems involved in the management of medications (medication incident). Although the risk of an adverse outcome is low and most medication incidents do not cause any harm, the volume of medications in use dictates that the problem when quantified is still significant. Following the publication of major patient safety studies it has become possible to estimate that almost 2 to 3 per cent of all hospital admissions are related to problems with medicines with an annual cost of $380 million.In 2002, following the publication of the Second National Report on Patient Safety ―Improving Medication Safety‖ it became apparent that despite medication safety issues growing in awareness in public hospitals, the same could not be said for private hospital practice which catered for about one third of all admitted patient episodes in Australia. Later that year a first step was taken with the Private Health Industry Quality and Safety workshop with representatives from most private hospitals attending. This meeting highlighted that medication safety practices at St John of God Hospital Subiaco was not aligned very well with public sector hospitals and that a number of deficiencies existed requiring urgent attention.Aims: This study had a broad range of aims. These were as follows: 1. To chronicle the development of medication safety procedures at St John of God Hospital Subiaco, nationally and internationally. 2. To quantify and uniformly classify, medication incidents reported from different sources in a private hospital. 3. To develop and assess a range of contributing factors as to why the medication incidents occurred. 4. To quantify the clinical significance of reported medication incidents. 5. To develop strategies to minimise/reduce the incidence of medication incidents in the future. 6. To investigate the influence of pharmacy ownership, location and employment of clinical pharmacists on medication incident reporting practices in Australian private hospitals.Method: The study was conducted in different phases. Initially the focus was a retrospective review of reported medication incidents in the hospital based on the date of occurrence of the medication incident rather than the date of review by a pharmacist. Secondly all incidents were then classified using a standardised format using the origin of the error. These included prescribing errors by medical practitioners, dispensing error by pharmacists and administration errors by nursing staff. Standard sub-categories were devised by St John of God Health Care, the national body coordinating the practices of all St John of God Hospitals, but in some instances they were noted to be too general. This led as part of this study to the development of more specific and sensitive categories for dispensing errors.Due to the realisation that medication error was now seen as a systems failure it was appropriate then to assess the risk to the patient and/or the organisation for a particular incident as well as determine some measure of harm to the patient. The level of risk associated with a medication incident was ranked according to the consequence of the incident and the likelihood of it recurring. Allied to this, a determinant of harm suffered by a patient following an incident or error was devised and promoted which differentiated harm into potential and actual harm.To further gauge private hospital medication safety practices, a national survey was undertaken of Australian private hospitals to gain an insight into the methodology used to collect and collate medication incidents and the roles played by pharmacy services in that process. In particular the survey sought to determine the influence of the ownership and location of the pharmacy service on those practices along with the employment or not of clinical pharmacists.Results: The classification of medication incidents by the date of occurrence aided in the assessment of why an incident occurred as it now became possible to study whether the ward location and day or time of an incident contributed in any way to causing that error. The classification of medication incidents by their origin in the medication cycle, highlighted that most incidents were reported by nursing staff and were therefore heavily weighted towards administration errors, which embodied their core medication function.The development of knowledge and understanding surrounding the causes and contributing factors associated, in particular with administration and dispensing medication errors, has helped to retrain caregivers to seek ways to avoid the incident in the future rather than focusing on any individual blame for what is a system failure.The clinical significance of a particular incident both to the patient and to an organisation can be more adequately assessed if a risk stratification and harm model is in place. This is apparent when dispensing errors were assessed as clinically significant to the pharmacy department but from a hospital perspective were noted only to have a potential for harm. In contrast, while the majority of administration errors had the potential for harm, some did cause actual harm.With the awakening of the need to improve our medication practices, the Pharmacy Department and the Hospital have committed to embracing more fully those practices more commonplace in public hospitals. These included having an active Drug and Therapeutics Committee and the implementation of clear medication polices and guidelines. Other initiatives have been embraced such as the use of standardised medication charts and ensuring a strong focus on medication reconciliation at the transitions of care. This included the employment of more clinical pharmacists to service areas such as preadmission and high risk areas such as Intensive Care and Oncology.The survey, with a response rate of 43%, highlighted that pharmacy services in private hospitals in Australia were either located On Site (52.8%) or Off Site (47.2%) and were either Hospital Owned (22.2%) or Contracted Out (77.8%). On Site pharmacy respondents were significantly more likely to be involved in the review of medication incidents (p = 0.047), have a policy on medication safety (p = 0.024), employ more clinical pharmacists (p = 0.006) and have a higher mean number of medication incidents reported (p = 0.001) as compared to Off Site pharmacies. Pharmacy providers who employed clinical pharmacists were more likely to be involved in the review of medication incidents (p = 0.02). Hospital Owned services were more likely to report a higher number of medication incidents (p = 0.011) and be On Site whilst Contracted Out services were more likely to be Off Site (p = 0.026).Medication safety has grown to become an international phenomenon. Two of the World Health Organisations top five priority areas to improve patient safety worldwide involve medication usage. In Australia, the formation of an active Australian Commission on Safety and Quality in Health Care, has provided leadership to all hospitals both private and public whilst at state level Medication Safety Groups drive more local state based issues. The willingness of some private hospitals to embrace fully the concept of medication safety is very evident at St John of God Health Care where a national medication reference group was set up to lead all their hospitals along a common path and this has been complemented recently by the formation of a medication safety committee at the Subiaco campus.Conclusion: The safe use of medicines is still a major issue. Medication errors are now recognised to be a system failure. Great progress has been made to improve the system of how we manage medications in our hospitals, but the system must continue to evolve. Gaps still exist that need addressing to make our hospitals safer. The various private hospital models that exist lend themselves to differing levels of service and participation in medication safety. It is vital that the Australian Council for Health Care Standards, the private health insurers and the Commonwealth Health Department develop a higher expectation from all private hospitals to ensure systems are in place so that patients are safe regardless of the health care environment they enter.
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Edwards-Ingram, Ywone. "Medicating slavery: Motherhood, health care, and cultural practices in the African diaspora." W&M ScholarWorks, 2005. https://scholarworks.wm.edu/etd/1539623482.
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A sophisticated exploration of the intricacies of motherhood and health care practices of people of African descent, especially the enslaved population of Virginia, can shed light on their notions of a well-lived life and the factors preventing or contributing to these principles. I situate my dissertation within this ideal as I examine how the health and well-being of enslaved people were linked to broader issues of economic exploitation, domination, resistance, accommodation, and cultural interactions. Historical and archaeological studies have shown that the living and working conditions of enslaved people were detrimental to their health. Building on these findings, I explore how aware were blacks of these impediments to their well-being and the pursuit of a wholesome life, and what means these populations employed to change the negative tangibles and intangibles of slave societies. These questions are best studied from a multi-disciplinary perspective and by using a variety of evidence.;Therefore, I collate and wed diverse selections of documentary evidence---a complex assortment of texts covering history, oral tradition, and narratives---with material cultural evidence, mainly from archaeological excavations and historic landscapes, to show the complex web of objects, beliefs, and practices that constituted this arena of well-being and autonomy. I discuss how issues of well-being intertwined with gender and race relations and how these were played out in many acts of motherhood and child care, struggles over foods and health care, other verbal and physical fights, and how the landscape and objects were implicated in social relations. I focus on Virginia but use examples from other slave societies for comparative purposes.;Blacks juxtaposed their cultural ways with those of whites and, at times, found the latter below black standards for a wholesome life. Therefore, while being open-minded toward some practices and beliefs from whites, blacks continued to maintain separate activities. This dissertation presents and interprets the ideals and practices of enslaved blacks and their descendants and shows how they created and reinforced their identity as a people capable of caring not only for themselves, but for whites as well.
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Agbeli, Martha Ofeibea. "Reducing Antipsychotic Medication Use in Long-Term Care Settings." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7454.
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The prescription rate of antipsychotics in patients with dementia varies between 20% and 50% for the common and troubling neuropsychiatric symptoms experienced by patients with dementia. The use of these antipsychotic medications has been linked with increased risk of morbidity and mortality due to associated Parkinsonism, over sedation, gait disturbances, cognitive decline, and cardiovascular adverse events. The purpose of this project was to assess whether development of an evidence-based clinical practice guideline (CPG) for a long-term care facility would increase awareness about issues that govern the safe use of antipsychotic medications. The conceptual framework for the project was Watson's model of caring. The Fineout-Overholt tool was used to rank and score information retrieved following an extensive literature review. An expert panel made up of 2 medical doctors and 4 nurse practitioners had 100% agreement that objectives were clear; content was relevant and easy to understand; the CPG was well-organized and easy to follow; and knowledge learned would be used in practice. From 66.6% to 83.3% agreed that the CGP led to an improved understanding of dementia, neuropsychiatric symptoms, medication adverse events, and nonpharmacologic interventions. The expert panel agreed to launch the CPG upon implementation of an educational program for frontline nursing staff and a behavioral log to track occurrence and frequency of behaviors and the use of nonpharmacologic interventions and their effectiveness in managing behaviors. Safe implementation of this CPG might be adapted to other long-term facilities to optimize dementia care, which would bring about a positive social change.
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Williams, Kevin. "Using experiential learning to facilitate pharmacy students' understanding of patients' medication practice in chronic illness." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1003955.
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This study originates from experiences which led me to question the way pharmacists are equipped to advise and support the medicine-taking practice of patients using chronic medication. The study offers a critical theoretical consideration of underlying perspectives informing pharmacy education. I propose following a critical realist ontological perspective, a social realist understanding of social structure and human agency, and a sociocultural epistemology. Based on these perspectives, I consider a sociological critique of ‘health’, ‘disease’, ‘illness’ and ‘sickness’ perspectives on medicine-taking, and of pharmacy as a profession. I then propose an experiential learning approach, with an emphasis on developing reflexivity through affective learning. I follow this with an illustrative case study. Following a critical discourse analysis of student texts from the case study, I conclude that there is evidence that experiential learning may prove useful in developing pharmacy students’ reflexive competency to support the provision of pharmaceutical care to patients using chronic medications.
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Ernawati, Desak Ketut. "Medication safety in Indonesia: Expanding pharmacists’ role through Interprofessional Education (IPE) and Interprofessional Practice (IPP)." Thesis, Curtin University, 2015. http://hdl.handle.net/20.500.11937/2047.
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This study undertaken in Indonesia, examined how the pharmacist's role could be expanded into medication safety. It explored the feasibility of implementing interprofessional education as a means of fostering interprofessional practice. While also looking at pharmacy students' readiness to engage in interprofessional learning and graduates' perceptions of their preparedness to deliver patient care, a clinical pharmacy service pilot was also conducted to document need. Facilitators and barriers to education and practice change were also explored.
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Chang, Vicki, and Stephanie Campbell. "An Evaluation of Student Pharmacist Admission Medication Histories at a Level 1 Trauma, Academic Medical Center: A Descriptive Study." The University of Arizona, 2017. http://hdl.handle.net/10150/624163.
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Class of 2017 Abstract<br>Objectives: The purpose of this study is to demonstrate the effect of using advanced pharmacy practice experience (APPE) students in the collection of admission medication history at an academic teaching hospital prior to pharmacist review.
Methods: The study is a retrospective, descriptive study. Using electronic medical records, the study looked at patients admitted to specific floors during a two-month period. The primary outcome was number of discrepancies found by the APPE students. The secondary outcome was the type of discrepancy found (omission, duplication, wrong dose, wrong frequency, wrong dosage form, and medications the subject no longer takes). Results: Over eight weeks, the APPE students identified 2,666 discrepancies, which equates to approximately 4.71 ± 4.76 discrepancies per patient. The majority of these discrepancies were identified as omissions of therapy (39.1%), followed by medications the patients were no longer taking (29.8%), and wrong dosing frequencies (18.1%).
Conclusions: APPE students assisted the medication reconciliation process by identifying numerous medication discrepancies which may have prevented patient harm. APPE students are an underutilized resource and prove to be an asset to the healthcare team.
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Olaniyan, Janice Oluwagbemisoye. "Prevalence and nature of medication errors in children and older patients in primary care." Thesis, University of Hertfordshire, 2016. http://hdl.handle.net/2299/17173.
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AIM: To conduct a systematic literature review on the existing literature on the prevalence of medication errors across the medicines management system in primary care; To explore the systems of error management in primary care; to investigate the prevalence and nature of medication errors in children, 0-12 years, and in older patients, ≥65 years, in primary care; and to explore community pharmacists' interventions on medicines-related problems. METHODS: 1) Systematic literature review; 2) Questionnaire survey of Primary Care Trusts (PCTs), Clinical Commissioning Groups (CCGs) and NHS Area Teams; 3) Retrospective review of the electronic medical records of a random sample of older patients, ≥65 years old, and children 0-12 years old, from 2 general practices in Luton and Bedford CCGs, England; 4) Prospective observation of community pharmacists' interventions on medicines-related problems and prescribing errors from 3 community pharmacies in Luton and Bedford CCGs in England. DATA ANALYSIS: Quantitative data from records review were analysed using Microsoft Excel on data extracted from an Access database. Statistical tests of significance were performed as necessary. Descriptive statistics were conducted on quantitative data from the studies and inductive qualitative analyses were conducted on aspects of the questionnaire survey. RESULTS: • The systematic literature review demonstrated that medication errors are common, and occur at every stage of the medication management system in primary care, with error rates between ≤1% and ≥90%, depending on the part of the system studied and the definitions and methods used. There is some evidence that the prescribing stage is the most susceptible, and that the elderly (over 65 years) and children (under 18 years) are more likely to experience significant errors, although very little research has focussed on these age groups. • The questionnaire survey of PCTS, CCGs and NHSE demonstrated that national and local systems for managing medication errors appeared chaotic, and need to be better integrated to improve error learning and prevention in general practice. • The retrospective review of patients' medical records in general practices demonstrated that prescribing and monitoring errors are common in older patients and in children. 2739 unique prescription items for 364 older patients ≥65 years old were reviewed, with prescribing and monitoring errors detected for 1 in 3 patients involving about 1 in 12 prescriptions. The factors associated with increased risk of errors were: number of unique medications prescribed, being ≥75 years old, being prescribed medications requiring monitoring, and medications from these therapeutic areas: corticosteroid, NSAID, diuretic, thyroid and antithyroid hormones, statins and ACE-I/ARB. 755 unique prescription items for 524 younger patients 0-12 years old were examined, with approximately 1 in 10 prescriptions and 1 in 5 patients being exposed to a prescribing error. Factors associated with increased risk of prescribing errors in younger patients were: being aged ≤10 years old, being prescribed three or more medications, and from similar therapeutic areas as above. Majority of the errors were of mild to moderate severity. • Community pharmacists performed critical interventions as the last healthcare professional defense within the medicines management system in primary care. However, this role is challenged by other dispensary duties including the physical aspects of dispensing and other administrative roles. CONCLUSION Prescribing and monitoring errors in general practice, and older patients and children may be more at risk compared to the rest of the population, though most errors detected were less severe. Factors associated with increased risk for errors in these age groups were multifaceted. The systems for periodic laboratory monitoring for routinely prescribed drugs, particularly in older patients, need to be reviewed and strengthened to reduce preventable hospital admissions. Antibiotic dosing in children in general practice needs to be regularly reviewed through continued professional developments and other avenues. As guidance on local arrangements for error reporting and learning systems are less standardised across primary care organisations, pertinent data from adverse prescribing events and near misses may be lost. Interventions for reducing errors should therefore explore how to strengthen local arrangements for error learning and clinical governance. Community pharmacists and/or primary care pharmacists provide an important defence within the medicines management system in primary care. Policy discussions and review around the role of the pharmacist in primary care are necessary to strengthen this defence, and harness the potential thereof.
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Mushunje, Irvine Tawanda. "Willingness to pay for pharmacist-provided services directed towards reducing risks of medication-related problems." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1008053.
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Pharmacists as members of health care teams, have a central role to play with respect to medication. The pharmaceutical care and cognitive services which pharmacists are able to provide can help prevent, ameliorate or correct medication-related problems. There are however many barriers to the provision of these services and one of the barriers commonly cited by pharmacists is the lack of remuneration for their expert services. The aim of this study is to ascertain if patients in South Africa are willing to pay for pharmacist-provided services which may reduce medication related problems, and thereby determine the perceived value of the pharmacist-provided services, by patients. The study will also seek to determine factors that influence willingness to pay (WTP), including financial status, gender, race, age and level of education. In addition the perceived value of the pharmacist‘s role in patient care, by third party payers (SA Medical Aid providers) and their WTP for pharmacist-provided services (such as DSM) on behalf of patients through their monthly premiums will also be investigated. The study was conducted as a two-phase process: the first phase focused on the opinions of patients and the second phase on the medical aid companies. In phase-1 a convenience sample of 500 patients was recruited by fifty community pharmacies distributed throughout the nine South African provinces. Data collection, consisting of telephonic administration of the questionnaires, was conducted and the survey responses were captured on a Microsoft Excel® spreadsheet. All the captured information was analyzed using descriptive statistics, box and whisker plots, analysis of variance (ANOVA) and regression analysis. In phase-2, medical aid schemes that are registered with the Council of Medical Schemes (CMSs) of South Africa were included in this research. A fifteen point questionnaire was completed electronically via e-mail by willing medical aid participants. Data was analyzed using descriptive statistics only. Only 233 or 88.6 percent, of the 263 participating respondents, were willing to pay at least one rand towards pharmacist-provided services. On average respondents were willing to pay R126.76 as out-of-pocket expenses. Respondents‘ WTP increased as the risk associated with medication-related problems was reduced due to pharmaceutical care intervention. Of the 263 respondents who took part in this research, fifty percent were willing to pay at least R100 for a risk reduction of 30 percent, R120 for a 60 percent reduction and approximately R150 for a greater than 90 percent risk reduction. It was also found that the respondents‘ willingness to pay was influenced by their age, earnings, racial grouping, employment status, medical aid status and their level of satisfaction with pharmacist-provided care services. Of the thirty-one open medical aid schemes only eight (25.8 percent) participated in the study. Findings indicate that all the participating medical aid respondents were unwilling to pay for pharmacist-provided care services, although they perceived pharmacists as very influential healthcare providers and as having a significant role to play in reducing medication-related problems. In conclusion it was found that majority of participants were willing to pay for pharmacist-provided services directed towards reducing risks associated with medication-related problems. Until pharmacists are able to prove pharmaceutical care‘s utility and cost-effectiveness to third-party payers, pharmacists must look to the patient for reimbursement.
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Patel, S., and McKenzie L. Calhoun. "CHADS2 versus CHA2DS2-VASc Utilization for Medication Management by Providers (CHUMP) Study." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6899.
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Leveille, Deborah. "Deliberate Practice of IV Medication Procedures by Student Nurses: Feasibility, Acceptability, and Preliminary Outcomes: A Dissertation." eScholarship@UMMS, 2015. https://escholarship.umassmed.edu/gsn_diss/42.
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Background: Medication errors continue to be one of the most prevalent problems in healthcare related to patient safety, often resulting in injury or death, with higher incidences of error occurring with intravenous medications. The purpose of this study was to explore the use of deliberate practice (DP) with second-degree nursing students in developing and maintaining fundamental intravenous medication management practices required for safe practice.
Method: This was a feasibility study using a two-arm, single-blind, randomized controlled trial design. Vygotsky’s Zone of Proximal Development model was used to explore the use of a DP teaching intervention to achieve competency in skills associated with safe IV medication management. A convenience sample of first-year, first-semester nursing students enrolled in an accelerated graduate program (N = 32) were invited to participate; 19 enrolled, and 12 completed the study. Students (n = 12) received three 30- minute one-on-one practice sessions at 2-week intervals with an expert nurse (the intervention group focused on IV skills and the control group on skills unrelated to IVs). Pre- and post-intervention instruments tested participants’ confidence with IV management and safety skills. The primary outcome was their ability to safely administer and monitor IV medications during a 20-minute videotaped medication administration scenario.
Results: Low recruitment (19 of 32) and high attrition (37%) were observed. Participants completing the study (5 in the intervention group and 7 in the control group) reported that the time required to attend the sessions was not burdensome (91.7%); time allotted was adequate (100%); 100% reported positive experience; 91.7% found the DP sessions essential to learning. Change in confidence scores for IV skills were not significant (P = 0.210), but were higher in the intervention group (2.97–4.14 = 1.50 change) compared to the control group (2.71–3.77 = 1.04 change). Significant differences were found in overall medication administration skills between the control and intervention groups (t [-2.302], p = 0.044) in favor of the intervention group, particularly with medication preparation skills (p = 0.039). Overall raw scores were low in both groups; only 16–42 (26%–70%) of the total 60 steps required for safe practice were completed. Participants scored lowest in the evaluation phase, with all participants performing less than 50% of the 14 steps.
Conclusion: Even though participant satisfaction was high, significant attrition occurred. Students reported the DP sessions to be beneficial and they felt more confident in performing skills, but three 30-minute sessions (90 minutes) were not adequate to develop, maintain, or refine all the IV-management skills associated with safe medication practices. Determining the length and duration of DP sessions as well as comparing the efficacy of DP sessions between individual and group sessions with varying doses and frequencies is needed to advance our understanding of using DP within nursing education.