Vigilance in Patient Education
Many prescriptions get filled but are not taken correctly. In my discussions with nurses from different specialties, one common theme prevailed. There’s not enough time spent on medication teaching, especially discharge medications from the hospital. It can be crucial, making sure the patient understands how to take their medications.
A few years ago, Mr. Brown was given a prescription for Coumadin 10 mg daily, which was filled with 5 mg tablets. The directions stated 10 mg daily, but the patient thought it was OK to take 5 mg in the morning and 5 mg in the evening. When the nurse discovered this during a home health visit, she called the physician who wondered why the patient’s protime (PT) blood tests were abnormal. When the correction was made in the timing of the medication, the patient’s blood levels straightened out.
Mrs. Driver was an elderly lady who had been given instructions in insulin administration for her ailing husband when he was in the hospital. At home, Mrs. Driver continued the insulin injection as ordered, but when a nurse visited the home, she discovered that Mrs. Driver was using a test bottle of normal saline for her husband’s injections. This lack of awareness resulted in her husband’s having very elevated blood sugars.
I cannot assume my patients understand how to take their medications. So, I go through my routine with them. Explain what the prescribed medication is for. Ask the patient about his perception of what the medication is for, and not just because the doctor ordered it. Ask if money is a problem affording the medication. Describe in detail how often the patient is to take the medication. Tell them how to recognize side effects and what to do about them. Talk about the importance of completing the whole prescription and not stopping as soon as they feel better. Include how their other medication and over-the-counter medications work together. Make sure they know whether the medication is to be taken with a meal or on an empty stomach. And identify the common Latin abbreviations such as bid, tid, ac, etc.
We all have had cases in which patients are not compliant. Spouses use each other’s medications. A patient takes a half a tablet to make the prescription last longer. Nurses need to teach and assist our patients in whatever way we can. We will make a difference and reach our goal of improving our patient’s health in this way.
Deloris Parker, RN
Utilization Review, Riverside Home Health
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