Medication monitoring for people with dementia in care homes: the feasibility and clinical impact of nurse-led monitoring
- PMID: 24707218
- PMCID: PMC3951004
- DOI: 10.1155/2014/843621
Medication monitoring for people with dementia in care homes: the feasibility and clinical impact of nurse-led monitoring
Abstract
Objectives: People with dementia are susceptible to adverse effects of medicines. However, they are not always closely monitored. We explored (1) feasibility and (2) clinical impact of nurse-led medication monitoring.
Design: Feasibility "before-and-after" intervention study.
Setting: Three care homes in Wales.
Participants: Eleven service users diagnosed with dementia, taking at least one antipsychotic, antidepressant, or antiepileptic medicine.
Intervention: West Wales Adverse Drug Reaction (ADR) Profile for Mental Health Medicines.
Outcome measures: (1) Feasibility: recruitment, retention, and implementation. (2) Clinical impact: previously undocumented problems identified and ameliorated, as recorded in participants' records before and after introduction of the profile, and one month later.
Results: Nurses recruited and retained 11 of 29 eligible service users. The profile took 20-25 minutes to implement, caused no harm, and supplemented usual care. Initially, the profile identified previously undocumented problems for all participants (mean 12.7 (SD 4.7)). One month later, some problems had been ameliorated (mean 4.9 (3.6)). Clinical gains included new prescriptions to manage pain (2 participants), psoriasis (1), Parkinsonian symptoms (1), rash (1), dose reduction of benzodiazepines (1), new care plans for oral hygiene, skin problems, and constipation.
Conclusions: Participants benefited from structured nurse-led medication monitoring. Clinical trials of our ADR Profile are feasible and necessary.
References
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- National Patient Safety Agency (NPSA) Safety in Doses: Medication Safety Incidents in the NHS. London, UK: National Patient Safety Agency; 2007.
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- HSC, (Health Service Commissioner for England) Care and Compassion? Report of the Health Service Ombudsman on ten investigations into NHS care of older people. Parliamentary and Health Service Ombudsman, The Stationery Office, London, UK, 2011, http://www.ombudsman.org.uk/care-and-compassion/downloads.
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- Gabe M, Murphy F, Davies G, et al. Adverse events and nurse-led medication monitoring. Journal of Nursing Management. 2011;19(3):377–392. - PubMed
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- Jordan S. Adverse events: expecting too much of nurses and too little of nursing research. Journal of Nursing Management. 2011;19(3):287–292. - PubMed
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