T​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​eaching Plan

This activity is designed to give you an opportunity to apply theoretical pharmacology knowledge to a clinical setting, and reinforce therapeutic communication skills. A well-planned teaching plan can provide information needed to assist the patient to be knowledgeable about his/her current medication regimen. Once the patient is educated, then together the patient and health professionals can evaluate the efficacy or non-efficacy of the medication regiment. The treatment of chronic illnesses commonly includes the long-term use of pharmacotherapy. Although these medications are effective in combating disease, their full benefits are often not realized because approximately 50% of patients do not take their medications as prescribed. Factors contributing to poor medication adherence are myriad and include those that are related to patients (e.g., suboptimal health literacy and lack of involvement in the treatment decision–making process), those that are related to physicians (e.g., prescription of complex drug regimens, communication barriers, ineffective communication of information about adverse effects, and provision of care by multiple physicians), and those that are related to health care systems (e.g., office visit time limitations, limited access to care, and lack of health information technology). Because barriers to medication adherence are complex and varied, solutions to improve adherence must be multifactorial. Mayo Clin Proc. 2011 Apr; 86(4): 304–314. Patient Mr. Mathewson is a 68-year-old white, male who has been seen in the Emergency Department (ED) with an exacerbation of his chronic illnesses that include a history of hypertension, asthma, rheumatoid arthritis, COPD/heart failure. As part of the assessment, the nurse in the ED was able to determine that Mr. Mathewson has not been taking his medications as prescribed and has made lifestyle choices such as a poor diet and lack of physical activity. Due to the symptoms exhibited in the ED, he is admitted to the hospital. Following stabilization, he will be discharged on the following medications from the drug classifications that are listed below. • Lisinopril and Hydrochlorothiazide (Ace inhibitor) (1​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​0mg/12.5mg po daily) • Carvedilol (Coreg) (Beta blocker) (25mg po daily) • Digoxin (250mcg po daily) • Albuterol Inhaler (2 puffs q 4h as needed) • Prednisone (60mg po daily) Develop a teaching plan for this patient based upon his history, the information provided and then gained from the assessment and the medication list. Don’t make this complicated but think outcome. Part 1 (20 points) a. From the information provided, what are TWO expected goals/objectives and outcomes that you desire for your patient? The goals/objectives would be what you would determine as you work your way through the nursing process. You only need to provide the two expected goals/objectives. b. Evaluation criteria. What criteria are you going to use to evaluate your patient’s compliance with his medications? i.e. return demonstration for the inhaler. What you are trying to do here is to link the objective(s) to the desired outcome and then how would you evaluate whether or not the objective(s) have been met. Part 2 (15 points) Include separate medication information for each medication listed above; this is similar to information found on the medication sheets that you receive from the pharmacy or the medication cards that you make when you were a nursing student. Part 3 (15 points) Develop a discharge planning tool that would be helpful for your patient to use at home in an effort to be compliant with his medication? Be creative and provide the tool. Information that you need to consider are: • Name, dosage of the medication • What is the purpose of the medication? • How should the medication be taken? • What time of the day to take the medication? • What are the key side effects? You will find several sources on the web that will assist you not only with your teaching plan but with the medication tool that you will provide for your patient upon discharge. I have attached a couple of samples for you. Here is a resource article that you might find interesting and helpful www.clinicaladvisor.com In search area, type Transition from Inpatient to Outpatient OR https://www.clinicaladvisor.com/geriatrics-information-center/adherence-and-hypertension-in-the-geri​‌‍‍‍‌‍‍‌‍‌‌‍‍‍‌‍‌‌‌‍​atric-patient/article/492892/