Staff nurses in many medical settings such as Skilled Nursing Facilities are at the forefront of patient care. Many patients in these particular settings are typically suffering from some type of cognitive impairment often related to dementia syndrome, behavioral disturbances or prior mental health conditions. Many mental health symptoms are managed by second generation antipsychotics. This class of medication placed the patients at risk for metabolic syndrome.
Many providers will not necessarily follow the prescribing guidelines when initiating treatments that consist of second generations antipsychotics. The prescribing guidelines are typically reinforced after a psychiatric consultation. Nurses initial admission assessment can help determine patients at increased risk for becoming overweight, obese, pre-diabetic, diabetic, hypertensive, or dyslipidemic.
…show more content…
Metabolic syndrome significantly influences future cardiovascular disease morbidity and mortality (Vancampfort et al., 2013).
Predictive indicators of cardiovascular disease are abnormal visceral adiposity, insulin resistance, increased blood pressure, elevated triglyceride levels, and low high-density lipoprotein (HLD) cholesterol levels (Mitchell, 2011). Staff nurses with adequate teachings and screening tools can advocate for patients at risks by early identification and interventions.
Practice Change
The practice change in my project is to provide education and a screening tool for nurses to identify patients taking second-generation antipsychotics. When patients are identified early, proper monitoring can be established. Early treatments can be considered thus promote patient overall care outcome.
Population The population of interest is psychiatric-mental staff nurses. Intervention My proposed intervention will be atypical second generation antipsychotics pharmacology program and screening tool for complications. Comparison The comparison will be routine second generation antipsychotics medication management. Outcome Second generations antipsychotic pharmacology program and screening tool will increase nurse efficacy in SGA patient management. Timing This is to be completed in an 8 weeks timeframe. Feasibility There is no expense required from the facility in which this practice change project is to occur. This practice change may enhance staff knowledge. This practice change may promote patient care outcome. References Mitchell, A.J., Vancampfort, D., Sweers, K., Winkle, R.V., Yu, W., De Hert, M. (2011). Prevalence of metabolic syndrome and abnormalities in schizophrenia and related disorders-a systematic review and meta-analysis. Oxford Journals, 39(2). 306-318. doi: 10.1093/schbul/sbr148. Vancampfort, D., Vansteelandt, K., Correll, C. U., Mitchell, A.J., De Herdt, A., Sienaert, P., Probst, M., De Hert, M. (2013). Metabolic syndrome and metabolic abnormalities in bipolar: A meta-analysis of prevalence rates and moderators. The American Journal of Psychiatry, 170(3), 265-274. Retrieved from http://dx.doi.org/10.1176/appi.ajp.2012.12050620
Classical antipsychotic treatments are commonly used to treat schizophrenic patients with major positive symptoms of schizophrenia, such as Thorazine, Haldol, and Stelazine (Gleitman et al., 2011). Antipsychotic treatments are usually administered with a variety of psychosocial treatments including social skills training, vocational rehabilitation, supported employment, family therapy, or individual therapy (Barlow & Durand, 2014). This is to reduce relapse and help the patient improve their skills in deficits and comply in consuming the
For example: if hypertension goes untreated then it could potentially lead to stroke, heart attacks, and untimely death. Early detection and improve patient outcomes by educating the patient on lifestyles changes and effective drug treatment. It is important for the patient to alter their eating habits, as well as their sedentary lifestyles and monitor their blood pressure levels. Feasible and affordable screening approved by the patient is also important: for example, electronic monitoring can make it easier for the patient to obtain their levels without causing harm and cost effective. (page 125)
The cost of Medical equipment plays a significant role in the delivery of health care. The clinical engineering at Victoria Hospital is an important branch of the hospital team management that are working to strategies ways to improve quality of service and lower cost repairs of equipments. The team members from Biomedical and maintenance engineering’s roles are to ensure utilization of quality equipments such as endoscope and minimize length of repair time. All these issues are a major influence in the hospital’s project cost. For example, Victory hospital, which is located in Canada, is in the process of evaluating different options to decrease cost of its endoscope repair. This equipment is use in the endoscopy department for gastroenterological and surgical procedures. In 1993, 2,500 cases where approximately performed and extensive maintenance of the equipment where needed before and after each of those cases. Despite the appropriate care of the scope, repair requirement where still needed. The total cost of repair that year was $60,000 and the repair services where done by an original equipment manufacturers in Ontario.
1. What is the difference between a. and a. Which K, S, and A pertain to the care you provided to the patient you have chosen? Why do you need to be a member? K- Describe the limits and boundaries of therapeutic patient-centered care. S- Assess levels of physical and emotional comfort.
-Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005. Web.
Cipher, D. J., Hooker, R. S. and Guerra, P. (2006). Prescribing trends by nurse practitioners and physician assistants in the United States. Journal of the American Academy of Nurse Practitioners, 18, 291–296.
Dimension of Nursing Practice: Practice- Provides leadership in the application of the nursing process to patient care, organizational processes and/or system, improving outcomes at the program or service level.
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Patients who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. There is a great need for nursing interventions in conducting a patient medication review also known as “brown bag”. As nurses obtain history data from patients at a provider visit, the nurse should ask “what medications are you taking?” and the answer needs to include over-the-counter medications as well. If the response does not include any medications other than prescribed meds, it is incumbent upon the nursing professionals to question the patient further to ensure that no over-the-counter medications or supplements are being consumed. This is also an opportunity for the nurse to question about any adverse reactions the patient may be experiencing resulting from medications. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients continuing to take medications that have been discontinued by the physician. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Morris, D. 2008 using antipsychotics in primary care source: independent Nurse. Pp. 35 – 6
Polypharmacy among the elderly is a growing concern in U.S. healthcare system. Elderly who have comorbities and take multiple medications are at a higher risk for potential adverse drug reactions. Elderly who take over-the-counter medications, herbs, and supplements without consulting their physician are at risk for adverse reactions associated with polypharmacy. Polypharmacy can result from patients having multiple prescribers and pharmacies, and patients who continue to take medications which have been discontinued by the physician. There is a great need for nursing interventions regarding polypharmacy, including medication reviews also known as “brown bag”. As nurses obtain history data and conduct a patient assessment, it is essential to review the patients’ medications and ask open-ended questions regarding all types of medications in which the patient is taking. In addition, the patient assessment is also an opportunity for the nurse to inquire about any adverse reactions the patient may be experiencing resulting from medications. Nurses are in a unique position to provide early detection and intervention for potentially inappropriate medications and its associated adverse drug reactions.
Even though supporters state antipsychotic drugs can help treat children with schizophrenia and bipolar disorders, some doctors prescribe these drugs to children that do not meet the requirements from the FDA. Critics of modern Psychiatry state “the profession has invested too heavily in technologies such as brain imaging and psychotropic drugs, leading many psychiatrists to the false conclusion” of diagnosing a mental illness in a child. (Psychiatry) Children are most likely to be prescribed with antipsychotic drug for aggression and disruptive behavior rather than for hallucinations and hearing voices. Torsten Weisel, a neurologists, states they need many years to accurately diagnose a mental illness. (Children and Antipsychotic Drugs). Often children enrolled in Medicaid have a greater chance to be prescribed with an antipsychotic drug than private insured children because it would be less expensive than
Furthermore, antipsychotic medications do not cure schizophrenia, but they do reduce the symptoms. In addition, the dosage given to the patient varies from patients and according to their mental disorder. Some new antipsychotic medications since to be better than the first drugs invented. Drugs such as Zyprexa or genetic names olanzapine, Risperdal generic name risperidone or Clozapine, which is has been extensively used to treat the negative symptoms of patients with schizophrenia. Antipsychotic medication like many other medications has side effects which consist on: drowsiness, restlessness, muscle spasm, tremors, dry mouth, and blurring of vision (First M.B., Tasman, A.2006, p.265).
... options and therapist should have full discloser regarding medications (pros and cons) with clients. When working with individuals with a mental illness, safety should always be foremost in the therapist mind. If not being on medications or stopping using medications put someone at a greater risk for hurting themselves or others medications should more than likely be part of the treatment plan. With this definition in mind the issue of collaborating between those struggling with a mental illness and professionals I feel is the most important issue brought up in these websites. If therapist do not view themselves as the “expert” and instead listen to their clients and their individual experiences, the client’s treatment plan will be the one best suited for them. Clients are the expert of the illness they are dealing with and therapist inform their understanding.
The overall diagnosis of the condition is based on the patients’ medical and lifestyle history before they are to access the patients’ lipid profile. The doctor would want the patient to also be healthy and...
In the case study with the patient Mary lee, she began showing a few different symptoms such as restlessness, muscles twitching, little muscle control, agitated, and not aware/more confused about simple things. When Mrs. Lee went for a checkup for these symptoms it was noted that she had a rapid irregular heart rate also the patient's blood pressure was elevated since her last visit. Soon after the psychiatrist asked if Mrs. Lee was taking any other medications since he prescribed her Lexapro. Mrs. Lee was also taking Flexeril for her neck and muscle pain. After getting all this information the psychiatrist diagnosed Mrs. Lee with serotonin syndrome. He also switched her medications from Lexapro to Prestig.