Module 01 Content

1.

Top of Form

Many people in the US, particularly the elderly, take more than one prescribed medication. CDC (2014) reported that between 2009 and 2012 nearly 48% of persons asked used at least one prescription drug, 22% used three or more prescription drugs, and nearly 11% used five or more.

In a recent study published by the Mayo Clinic, seven out of 10 Americans take at least one prescription drug. The most commonly prescribed drug is antibiotics — taken by 17 percent of Americans — followed by antidepressants and opioids — each taken by 13 percent of Americans. In addition, findings showed that:

· Even more staggering than the CDC findings, currently more than half of Americans take two prescription medications, and 20 percent of Americans are on at least five prescription medications.

· More women than men receive prescription medications.

· Antidepressant prescriptions are more common among women than men and are most common among women ages 50 to 64.

When people take multiple medications, there is a greater risk of confusion about which medications are taken when they are taken, and what they are being taken for. There is also a higher risk for drug interactions and increased side effects and adverse reactions.

Sometimes because of the sheer number of medications being prescribed, they may be forgotten, become too much of a bother, or a financial burden which can significantly impact client compliance and lead to poor health outcomes.

In this written assignment, you will be interviewing a client who is taking multiple prescribed medications (three or more) and submitting a written paper describing the findings from the interview. You will then develop a Client Teaching Plan. Your instructor will assist you in the selection of the client. You must achieve a “pass” in this assignment to satisfactorily fulfill the requirements for the Pharmacology course.

The three parts of this assignment are:

Interview with a client who is taking multiple medications (polypharmacy). You must prepare the client before the interview by explaining why you are conducting the interview. You can say “My assignment is to find out about the medications you are taking so I can determine if you need more information about what you are taking”. You must always get permission from the client to conduct the interview and you must tell the client how the information will be used. You can say, “I will not be using your name in the information I share and I will be submitting it to my instructor only for this student assignment”. If there is important information that needs to be communicated to you, your doctor, family, or nurse, my instructor will assist me in following up on this”. Tell the client you will take no more than 30-45 minutes for the interview.

There may be a family member or significant other present during the interview. That is fine. Be sure to identify who answered a question and if possible always have the client answer first. Always thank the client (and others) when you complete the interview.

Do not use recording equipment for this interview. Have a notepad and pencil or pen and explain that you will be taking notes. When the interview is over, go to a quiet place and take some time to fill in any information you did not jot down. If you wait, you will not remember.

When setting the environment for the interview, make sure the client (and others) are comfortable and you are comfortably seated facing the client. If possible, interview in a quiet place. Ask questions slowly giving the client time to answer. Pay attention to the client's hearing and ability to respond to the questions. Be sure your non-verbal communication demonstrates you are calm and relaxed.

Use the following interview question guidelines when conducting the interview. Be aware that the client may not be able to answer each of the questions with detailed information. Collect as much information as the client is able and willing to give you. Remember you are the interviewer so you will be collecting information and not making any comments about the information shared by the client except to ask for further clarification if you are not sure what was said or need more detail if it is available.

1. What medications are you taking?

1. Before the interview research each of the medications. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.

For the following questions, paraphrase the client's answers for your written paper.

1. How long have you taken each of these medications?

1. Do you know why you are taking these medications?

1. Who told you about the medications and why do you need to take them? Were you able to ask any questions about the medications and if so were they answered so you understood what was said?

1. How do you feel about taking these medications?

1. Are you taking other medication purchased “over the counter” such as in a drug store? If so, what is it and why are you taking it?

1. How and when do you take your medications?

1. Do you have any difficulty taking the medications? If so, what happens and how do you deal with any difficulties?

1. Have you ever felt any uncomfortable feelings and body reactions to taking these medications? If so, what were they and how were they handled?

1. If you had the above reaction, did they take you off the medication and replace it with another medication? Were you told why this happened?

1. Do you have any reason not to take the medications?

1. Have you ever not taken the medication? If so, what was the reason?

Ask a final question about whether the client would like to tell you anything further about their medications.

Write a paper describing your research and findings about the medications being taken and the interview results. Report your findings in a 3-5 page written paper. In your paper include the reason for each medication, the drug classification, the route of administration, the dose, and possible side effects/adverse reactions.

Use accurate and appropriate spelling and grammar and APA Editorial Format for sources used in your written paper.

Develop a teaching plan for this client based on your findings. Based on the findings from the interview, develop a 2-3 page teaching plan to include the following:

1. List one goal for this teaching plan

1. Describe two to three teaching resources that might be used

1. Identify two teaching strategies that can be used based on the client interviewed

1. List specific client instructions regarding the medications what adverse reactions they should be aware of/and what to do

1. Identify at least one factor that may negatively influence adherence to the medications and how it can be overcome

1. If, appropriate, describe how the family might be involved in ensuring the client is on a proper and safe medication regime

Bottom of Form

due 10- 6-23 @ 10 am

PLEASE FOLLOW ALLL DIRECTION 

Make a follow-up of a student's weekly discussion and respond with your opinion regarding to her post

——You don't have to post this in APA format necessarily, it's just giving feedback to the student .

Claire Steininger

Identify and describe practice barriers for all four APNs' roles in your state and discuss these barriers on a state and national level. The four roles include the nurse midwife, nurse anesthetist, nurse practitioner, and clinical nurse specialist.

Nurse midwives often struggle with scope of practice limitations and the necessity for collaborative agreements, which can sometimes disrupt their ability to provide comprehensive care. Nurse anesthetists may face restrictions, such as supervision requirements and inconsistent reimbursement policies, limiting their autonomy in anesthesia care. Nurse practitioners and clinical nurse specialists confront barriers like collaborative agreements and scope of practice restrictions, which can affect their capacity to deliver primary and specialized care independently. These state-level obstacles are further complicated by variations in laws and regulations across the country. At the national level, lack of consistency and autonomy make it challenging for APNs to provide consistent, high-quality healthcare (Peterson, 2018).

Identify forms of competition on the state and national level that interfere with APNs' ability to practice independently.

At the state level, one form of competition arises from established healthcare hierarchies and interests. Physicians' groups and medical associations often lobby for laws and regulations that restrict APN autonomy to protect their traditional roles in healthcare. With a limited scope of practice, APNs are sometimes forced to adhere to physician regulations. On the national level, Medicare reimbursement rates and federal funding allocations can be influenced by powerful stakeholders, including pharmaceutical companies, insurance providers, and large healthcare systems. These sources may advocate for regulations that favor their interests instead of that of others (Galvani et al., 2020).

Identify the specific lawmakers by name at the state level (i.e., key members of the state's legislative branch and executive branch of government)

In Florida, the governor Ron DeSantis, is the head of the executive branch. Jeanette Nunez is the lieutenant governor, Ashley Moody is the attorney general, Jimmy Patronis is the chief financial officer, and Wilton Simpson is the agricultural commissioner. On the legislative side, the senate president is Kathleen Passidomo, the house speaker is Paul Renner, the majority leader for the senate is Ben Albritton and for the house is Michael Grant. Lastly, the minority leader for the senate is Lauren Book and for the house is Fentrice Driskell (BallotPedia, 2022).

Discuss interest groups that exist at the state and national levels that influence APN policy.

At the state level, physician groups often advocate for policies that maintain their traditional roles and may oppose measures that grant APNs greater autonomy. Oppositely, nursing associations like the American Association of Nurse Practitioners (AANP) and American Association of Nurse Anesthetists (AANA) work to advance APN practice, pushing for full scope of practice and reimbursement policy changes to enhance access to care. On the national level, there are also national nursing organizations like the National Council of State Boards of Nursing (NCSBN) and the National Council of Nurse Practitioners (NCNP) that actively advocate for APN policy changes that can promote independent practice (Brom et al., 2018).

Discuss methods used to influence change in policy in forms of competition, state legislative and executive branches of government, and interest groups.

Some methods used to influence change in policy include political campaigns and quality and safety initiatives. Supporting candidates who are sympathetic to APN issues and policy changes through campaign contributions and grassroots mobilization can influence election outcomes, ultimately affecting the composition of legislative and executive branches. APNs can also participate in quality and safety initiatives to demonstrate a commitment to high-quality care and patient well-being can enhance their credibility and influence (Cullerton et al., 2018).

 

 

BallotPedia. (2022). 
Florida's State Legislature. ballotpedia. 

https://ballotpedia.org/Links to an external site.

Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018). Leveraging health care reform to accelerate nurse practitioner full practice authority. 
Journal of the American Association of Nurse Practitioners, 
30(3), 120–130. 

https://doi.org/10.1097/JXX.0000000000000023Links to an external site.

Cullerton, K., Donnet, T., Lee, A., & Gallegos, D. (2018). Effective advocacy strategies for influencing government nutrition policy: a conceptual model. 
The international journal of behavioral nutrition and physical activity, 
15(1), 83. https://doi.org/10.1186/s12966-018-0716-y

Links to an external site.

Galvani, A. P., Parpia, A. S., Foster, E. M., Singer, B. H., & Fitzpatrick, M. C. (2020). Improving the prognosis of health care in the USA. 
Lancet (London, England), 
395(10223), 524–533. https://doi.org/10.1016/S0140-6736(19)33019-3

Peterson M. E. (2018). Barriers to Practice and the Impact on Health Care: A Nurse Practitioner Focus. 
Journal of the advanced practitioner in oncology, 
8(1), 74–81.

 Reply

What steps do you take to locate primary and peer-reviewed research articles when performing a literature search?

What resources are available to you to engage in a meaningful and successful literature search?

As you have explored throughout this course, Walden University provides vast resources for student support to ensure success in their academic program of study. When it comes to research and using Library resources, several support mechanisms are available to you as well.

Taking the first step to think about a research topic or area of interest and filtering that topic using a series of keywords and operations will be a fundamental component for performing a literature search in Walden Library’s databases. While the ultimate goal is to produce a set or results that match your search criteria, you must keep in mind that that the quality of the research articles obtained will likely vary. Thus, you must critically examine and analyze the aims of the research produced and how it aligns, confirms, or negates your topic or area of research. As you develop proficiency in this area, you will discover that you can extract content themes and frameworks to enhance future research and the need to identify additional research support.

For this Assignment, consult the Walden Library webinars and resources provided. These resources serve as a general good first step for performing literature searches and engaging with the databases of research available to you. Think about a research topic or area of interest to focus on for this Assignment. Then, search the Walden Library to locate and retrieve peer-reviewed research articles that pertain to your topic or area of interest. 

6-paragraph assignment in which you do the following:

•  a 1-pararaph introduction of how you conducted your literature search and the databases consulted in your search in relation to your practice area or area of interest. Be specific and provide examples.
• a 1-paragraph summary of each of the articles you have selected (a total of 3 paragraphs).
•  1 paragraph that synthesizes the three articles using a scholarly voice.
•  a final paragraph in which you discuss the differences between summarizing and synthesizing research. Be specific and provide examples.

• Shea, C. M., Jacobs, S. R., Esserman, D. A., Bruce, K., & Weiner, B. J. (2014). Organizational readiness for implementing change: A psychometric assessment of a new measureLinks to an external site.. Implementation Science, 9(7), 1–15.
• Walden University. (2021). DNP capstone resources NURS 8702 and NURS 8703Links to an external site.. Office of Research and Doctoral Studies. https://academicguides.waldenu.edu/research-center/program-documents/dnp-8702-8703
• Walden University. (n.d.). Subject research: Nursing.Links to an external site. Walden Library. https://academicguides.waldenu.edu/library/subject/nursing
• Walden University. (n.d.). Using evidence: Synthesis.Links to an external site. Writing Center. https://academicguides.waldenu.edu/writingcenter/evidence/synthesis
• Westlake, C. (2012). Practical tips for literature synthesis. Clinical Nurse Specialist,Links to an external site. 26(5), 244–249. https://doi.org/10.1097/NUR.0b013e318263d766