Cap Project

Running head: MEDICATION EDUCATION

MEDICATION EDUCATION 2

Medication education is a process of teaching from the nurse to the patients to help the patients understand the medication they are receiving such as the therapeutic use, precaution, side effect, and how to handle each medication carefully. Medication education is important in patients` care because it can treat patients’ causative health problem or reduce it if they take the medication the proper way. Also, it can help the patient to stay safe while taking their medication such as learning about the medication side effect and the drug interaction. In order for the patient to use the medication and stay safe while taking the medication, patients need a proper teaching method. However, most patients do not receive the proper education on their medication from their nurses, mostly because of the shortage of time the nurse has with each patient during her medication administration and daily rounding. Lack of medication education became one of the major issues in Resurrection Medical Center (RMC) on the medical surgical unit. This project examines the current practice of medication education in the RMC unit, reviews the literature for best practice indications, identifies an evidence-based solution, and discusses the implementation of this solution in the unit.

Current Practice and Unit Support

Patient lack of education on medication is one of the major issues in the medical surgical unit in RMC due to a variety of reasons. One of the reasons is there are a shortage of staff which leads to work overload, so each nurse has more than four patients to care for during the day. The nurses feel burned out and overwhelmed. Then, they try to prioritize tasks based on the care of patients not their education. Unfortunately, medication teaching is not their priority because most nurses believe that it is the pharmacist`s responsibility to explain medication with proper education. As a result, patients end up getting discharged without proper understanding of the medication. I chose this topic because it is a major issue on this unit and evidence based practice can be used to find a solution to reduce the issue. The RMC unit has already started to work on the medication education issue by having nurses and nursing students write each medication on a white board placed in each patient room. Writing the medication on the board is a good way to start, but it does not give a full education about the medication for the patient. I spoke with nurse manger about this topic and the nurse open on new solutions with evidence based practice to help fix the issue of the medication education in this unit.

Literature Review

To better understand the issue, the literature regarding medication education was consulted. Browen, Rotz, Patterson, and Sen (2017) administered a cross sectional survey to nurses servicing internal medicine, cardiology, or medical-surgical patients. Their first objective was to examine nurses’ attitudes and behaviors regarding the provision of patient medication education. Then, their other objectives were to determine if nurses’ medication education attitudes explained their behaviors, described nurses’ confidence in patient medication knowledge and abilities, and identified challenges to improvements for medication education. The result of the study showed that 90% of the nurses who participated in the study believe that it is important to provide education on medication with a positive attitude toward patient education. However, they rarely provided it because they never had enough time due to work overload as has witness in RMC unit. The results for the other objectives were that patients had higher confidence with understanding the medications and what it is prescribed for and following medication instruction. While, the nurses had a lower confidence about the patient knowledge toward the medication especially there side effects. Some of the challenges that some patients faced during patient education was communication due to the language barrier. Which later in the study that communication was solved by calling interpreter while educating the patients on their medication.

In addition, Talbot (2018) reviewed the lack of medication education on patients in her unit. She stated that when she asked her patients to tell her something about their medication, their response were disheartening. She also stated “Most of my patients couldn’t say why they were taking certain medications. Many of them explained that they took them ‘because the doctor told me to” (Talbot, 2018, 3). In similarity, after the writer made rounds and asked the patients about the medication they were receiving even at home, they did not seem to have the proper knowledge about the medications. Talbot (2018) came up with a plan: first, every patient was required to fill out a survey sheet that consisted of questions about patients` medication and if they were explained properly during admission. Second, she came up with a medication sheet that explained to patient each medication with their side effect. The results of the study were patient understanding of the medication went up from 62.5% to 100% and from 12.5 to 71.4% for the understanding of the medication side effects.

Literature Review: Solution/Intervention

Despite the fact of the limited information provided to solve the issue of medication education, some projects and suggestions were tested and performed to help improve medication teaching for patient. Prochnow, Meiers, and Scheckel (2019) discussed the issue of the medication teaching for patient in their Quality Improvement article and they came up with teach back method before and after education by using one group pre- and post-education design with RNs, patient, and caregivers. RNs (n = 25) were observed in patient and caregiver education and surveyed in confidence in the teach-back method before and after education. Patients’ (n = 74) and caregivers’ (n = 33) knowledge was assessed. The result of the study was with teach-back, both patients and caregivers recalled the purpose and side effects of new medications which also lead to an increase in Healthcare Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores from 6% to 10%.

In addition, Jones, and Coke (2016), discussed the issue of the lack of medication teaching in their article. The team of the study included interdisciplinary team such as nursing, pharmacy, finance, quality education, and informatics. They implemented a study in two medical surgical units which the study included suggestions such as using medication sheet paper during discharge, medication alert in the electronic medication record, random rounding, and teach back method. The result of the study was successful which increased patient education about the new medication during discharge. When patients were asked about their new medication in those two medical surgical units, they were successfully able to provide the right information about their medication purpose and side effect. The study showed that on average each month 42% of the patients discharged from those two units understanding to the medication increased by 4% and 11.4%.

Implementation/Intervention

After reviewing the literature, the intervention for RMC medical surgical unit will be medication teaching sheets. First, the medication sheets will be presented to the unit and unit manager. Then, after approval a picture will be printed of the medication teaching sheet to patients, caregivers, and family. The medication teaching sheets will include colorful pictures of the new medication that the patient is receiving, its purpose, and side effects. Due to the diversity of RMC unit, the medication teaching sheets will be provided in four languages: Arabic, English, Spanish and Polish. The medication teaching sheets will be provided during care and patient discharge.

To enhance medication education compliance among patients in RMC unit, the medication teaching sheets will be provided to patient, care givers, and family. Medication teaching sheets will improve patient medication education by having a visual picture of the medication they are receiving and also by having a written handout to go back to after discharge. According to Talbot (2018) Data was collected and showed that the medication sheets are affective. The results of the study were patient understanding of the medication went up from 62.5% to 100% and from 12.5 to 71.4% for the understanding of the medication side effects after they received the medication teaching sheets.

The medication sheets will be printed and placed in nursing station and the nurse manger will be responsible to remind every nurse in the unit to give those sheets to patients while giving them their medications and during discharge. To evaluate the patient understanding to the medication after receiving the medication teaching sheets, the patient will be asked to teach back what they have learned about the medication such as the purpose and the side effect. Other follow up evaluation for patients who receive medication teaching sheets is to call back the patient after discharge and ask them again about the new medication they are receiving.

References

Browen, J.F., RotZ, M.E., Patterson, B.J., & Sen, S. (2017). Nurses` attitudes and behaviors on patient medication education. Pharmacy practice, 15(2), 1-5.

Jones,T. R, & Coke, L. (2016) Impact of Standardized New Medication Education Program on Postdischarge Patients’ Knowledge and Satisfaction. journal of nursing administration, 46)0), 535-540.

Prochnow, J. A., Meiers, S. J., & Scheckel, M. M. (2019). Improving patient and caregiver new medication education using an innovative teach-back toolkit. journal of Nursing Care Quality, (34), 101–106.

Talbot, B. (2018). Improving patient medication education. Nursing, 48(5), 58-60.