KIM WOODS ONLY

This is the next part due using the same aggregate, Geriatric taking multiple medication in Mississippi.

Review the Weekly Guide.

Write a 350 to 700 word paper with the following information:

Formulate two outcome goals that are specific to your aggregate.

Base your outcome goals (objectives) on the data you collected in previous weeks. Each outcome goal (objective) must include an action verb, the result you expect, the target, and the time frame. See pages 288-289 of Stanhope and Lancaster (2010) for examples of how to word your outcome goals (objectives).

Address the following questions:

· What intervention(s) must happen to meet your outcome goals?

· Who would need to be influenced to enact the program?

· Would the cost for it be feasible? Discuss two reasons why or why not.

 

Attached is the paper with data obtained

Running

head: COMMUNITY HEALTH PROJECT 1

COMMUNITY HEALTH PROJECT 9

Community Health Advocacy Project – Part Four

Jeanette Walker

Nur/544

September 01, 2013

Amy Negovan

Community Health Advocacy Project – Part Four

1. Do patients possess somebody who will help them once they have got queries concerning his or her own medicines? The goal of home based care is to enable patients to have functional independence and to help patients stay at home. The question of whether the patients will have somebody who will help them when they have queries concerning their medication becomes vital. Home care providers may not be available full time to assist the patient with necessary guidance and if available they may not have the necessary skill to provide such guidance and thus creating the need to consult the physician or other healthcare providers in a central office. Data reveals that:

A. The number of home healthcare visits per 1,000 Medicare enrollees increased from 3,822 in 1992 to 8,376 in 1996. Home healthcare visits increased because of a growth in the coverage criterion for the Medicare home healthcare benefit. In 2001, home health care visits declined after 1997 to 2,295 per 1,000 because of changes in Medicare payment policies for home healthcare resulting from implementation of the Balanced Budget Act of 1997. The rates increased thereafter to 3,409 per 1,000 in 2007 (Federal Interagency Forum on Aging related Statistics, 2010).

B. “In the United States, the rate of home health care use for women aged 65 and over was 55% higher than the rate for men” (Jones, Harris-Kojetin, & Valverde, 2012)

2. What are the advantages of utilizing public health and home care regarding medication concerns or queries? Literature research done on medication management of residents receiving home healthcare revealed improvement of medication management. An advantage of using home based care such as nurses, pharmacists, and physicians regarding medication query is unnecessary and duplicate drugs (Ellenbecker, Samia, Cushman, & Alster, 2008).

A. A study regarding elderly patients 2 days after hospital discharge found 64 percent were taking at least one drug that was not ordered, 73 percent failed to use the prescribed drug according to instructions, and 32 percent were not taking all medications transcribed at discharge. Another challenge in medication reconciliation is the determination of what medications elderly adults are taking at home. One study found 49 percent of community-based elderly adults are keeping storage of old prescribed drugs from the year before, and 6 percent admitted they self-prescribed medications (Hughes, 2008).

B. The American Society of Health-System Pharmacists estimated that over 34% of older citizens are prescribed drugs by more than one doctor, and 72% use drugs they were prescribed over 6 months ago (Paley, 2011).

3. Are there any disadvantages of utilizing public health and home care? If so what are the disadvantages? Public health and home care has its own disadvantage. Practically one-third of older home based residents have a probable medical problem, thus leading to elderly taking unsuitable drugs (Ellenbecker et al., 2008). Data reveals:

A. An adverse drug event (ADE) is described as harm encountered by patients as a result of exposure to a medication, and ADE accounts for virtually 700,000

emergency department visits

and 100,000

hospitalizations

each year. ADEs affect almost 5% of hospitalized individuals, making them one of the

most common

types of inpatient errors (

Agency for Healthcare Research and Quality

, 2005).

B. Studies suggest that practically 15% of individuals discharged after hospitalization experience a medication discrepancy. The five most common medication concerns were anticoagulants, diuretics, angiotensin-converting enzyme inhibitors, lipid-lowering agents, and proton pump inhibitors. (Agency for Healthcare Research and Quality, 2005).

4. Has there ever been a time when an elderly person was unable to get a prescription filled because of lack of funds or resources? Elder Americans are accounted for approximately one-third of medical spending in the United States. The cost of medical expenses is four times the amount of money to treat a 65 year old for healthcare in annually than it does to treat a 40 year old. However, individuals age 65 and older have health care insurance, such as Medicare, Medicare pays the expenses and has not been aggressively involved in promoting a enhanced delivery system for the elder (Day,2013). Data reveals:

A. “10.3 percent of the elderly population ages 65 and older were unable to obtain or delayed in obtaining necessary prescription medicines in 2010 on a national level” (Healthy People, 2013).

B. Data gap: Only 25 states with the largest population in 2010–2011 were collected and Mississippi was not included (Centers for Disease Control and Prevention, 2012).

5. Do elderly patients abuse prescribed drugs? Statistics suggest that drug abuse among older Americans is significant and growing.

A. . A study in Annals of Epidemiology projected that the number of individuals age 50 and older abusing prescription medications may increase 190% over the next two decades from 911,000 in 2001 to almost 2.7 million by 2020 (John Hopkins Medicine, 2010).

B. 6.1 percent of individuals aged 12 years and older reported nonmedical exploit of any psychotherapeutic medications in 2008 (

Substance Abuse and Mental Health Services Administration, Center for Behavioral

Health Statistics and Quality, 2013).

Medication Questionnaire

Name____________________________ DOB______________________

Ethnicity____________________ Sex___________________ Age______

Education level_______________ City ____________________________

Medical Diagnoses______________________________________________

_____________________________________________________________

1. Are you taking any medications? Yes No

2. If so, how many? ________

3. Are you allergic to any medications? Yes No

4. Provide a list of allergies, if answered yes to above question____________________

______________________________________________________________

5. Do you know what the medications treat? Yes No

6. Before the doctor prescribed you medication, did you try a diet change? Yes No

7. Do you take any over the counter medicine? Yes No

8. Do you take your medicine on a regular basis? Yes No

9. How often do you visit the doctor? Weekly Biweekly

Monthly

Yearly

10. Do you see the same doctor? Yes No

11. Do you take your medication with you on every visit? Yes No

12. If the doctor prescribes you new medication, does he explain it? Yes No

13. Does the doctor order any labs to monitor lab values of the medication? Yes No

14. Have you experienced any side effects of your medication? Yes No

15. If yes, provide a brief explanation___________________________________________

____________________________________________________________________________________________________________________________

16. Have you ever been prescribed the same medication twice? Yes No

17. Have you ever ask the doctor to review your medication for a decrease? Yes No

18. When you have questions regarding medication, who do you contact? _____________

19. Have the amount of medication you take increased within the last year? Yes No

References

Agency for Healthcare Research and Quality. (2005). Medication errors. Retrieved from

http://psnet.ahrq.gov

Agency for Healthcare Research and Quality (2005). Posthospital medication

discrepancies: prevalence and contributing factors.
Retrieved from http://psnet.ahrq.gov

Centers for Disease Control and Prevention. (2012). National health interview survey

2011. Retrieved from

http://www.cdc.gov

Day, T. (2013). The American perspective on aging and health. National Care Planning

Council. Retrieved from http://www.longtermcarelink.net

Ellenbecker, C., Samia, L., Cushman, M., & Alster, K. (2008). Patient safety and quality

in home health care.

Retrieved from http://www.ncbi.nlm.nih.gov

Federal Interagency Forum on Aging related Statistics (2010). 2010 Older Americans:

Key indicators of well-being. Retrieved from

http://www.agingstats.gov

Healthy People. (2013). Healthy people 2020 objective topic area. Retrieved from

http://www.healthypeople.gov

Hughes, R. (2008). Medication management of the community-dwelling older adult.

Retrieved from http://www.ncbi.nlm.nih.gov

John Hopkins Medicine. (2010). Drug abuse and the elderly. Retrieved from

http://www.johnshopkinshealthalerts.com

Jones, A., Harris-Kojetin, L., & Valverde, R. (2012). Characteristics and use of home

health care by men and women aged 65 and over. National Health Statistics Report, 52(), 12.

Paley, A. (2011). Managing medications for elderly patients. Retrieved from

http://www.pharmacytimes.com

Substance Abuse and Mental Health Services Administration, Center for Behavioral

Health Statistics and Quality. (2013). The NSDUH report: Nonmedical Use of prescription-type drugs. Retrieved from

http://www.samhsa.gov