Paper Presentation

Report
Concerns in Medication Safety in
Regards to the Older Adult Population
Stephanie A. Ball, Taylor W. Brickley, Macey F. Davenport, Kelly
L. Erexson, Emily K. Falcon, Cierra N. Witten
Introduction
Key Ideas
The use or a collaborative care team is instrumental to
medication safety in the older adult population.
Knowledge of the natural aging process has been proven
to be effective in reducing medication administration
errors.
Informatics should be used to prevent errors.
The collaborative care team must have extensive
pharmacological knowledge.
Collaborative Care
Without clear
communication medication
errors can occur and it is up
to every member of the
team to check and double
check for medication safety
in regard to the older adult.
Medication safety is
dependent on this
multidisciplinary approach
with an emphasis on
communication (Choo, et al.
2010).
Collaborative care is the
combining of many
disciplines within the
healthcare institution to
provide the best care
possible
Collaborative
Care
AORN suggests that in order
to prevent medication
administration errors the
nurse must re-read the
original orders before
administering the drug and
there must be clear
communication between
healthcare professionals
(Webinar).
Knowledge of the natural aging process has been proven to be
effective in reducing medication administration errors in older
adults.
Some of these risk factors include cognitive problems, diseases
processes, socioeconomic status, living independently, and the
use of multiple medications (Fialova & Onder, 2009, p. 641).
The susceptibility of the older adult to chronic disease also can
negatively influence medication administration in many ways.
Cognitive problems and diseases processes can impair the
ability to remember to take medications or to take them as
prescribed.
Pharmacology Knowledge
The healthcare team must not only have an excellent
understanding of the physiological changes of the older adult,
but also pharmacological knowledge and knowledge of the
potential issues that may arise from providing the medication
(Tweddle, 2009 p. 938).
This involves knowledge of the actions, interactions, potential
adverse reactions (including side effects and allergic reactions),
usual dose, route and approved use, basic pharmacokinetics of
the drug and the patient’s response to it (Choo et al. 2010, p.
857).
Taking too many medications at a time can have not only drugon-drug reactions, but also that in the older population this
many drugs causes an enormous safety risk.
The nurse plays the pivotal
role in collaborative care
where they can voice
problems to other members of
the team or even question
physician orders (Choo et al.
2010, p. 859). Not only is the
nurse responsible for
administering medications,
but he or she also must clearly
communicate their actions to
all members of the healthcare
team.
The use of informatics is one
of the core competencies of
the Institute of Medicine. Due
to the fact that the nurse is
the front line for medical
administration it is important
for nurses to be involved in
both the design and
implementation of any new
informatics system (Choo et
al. 2010, p. 858).
Education
The IOM has stressed the application of quality improvement.
There must be an increase in safety education for healthcare
professionals in order to help prevent errors (Finkelman &
Kenner, 2013, p. 367).
Polypharmacy
When older adults have several treatments at the same time it
can lead to medication errors, such as a higher chance of
adverse drug interactions (Fialova & Onder, 2009, p. 641).
Method
Having an organizational method for all their medications can be
one of several effective methods of medication safety practices.
Legal & Ethical Issues
Legal & Ethical Issues
Evidence Based Practice
Evidence based practice combines research and its results to help create safe and
effective patient care.
One of the IOM’s focuses is on the implementation of evidence-based practice.
The use of evidence based practice methods help to ensure that medications are
being safely administered to our elderly population.
In order to provide safe delivery of medications, the nurse must have the
knowledge about the many changes that occur with aging, the medications the
individual is taking, and how to educate the healthcare professionals on the
effects these factors have on medication administration in the elderly population.
Evidence based practice provides healthcare providers with this knowledge and
allows them to implement systems to reduce errors and maintain safety.
Evidence Based Practice
Conclusion
 The knowledge of the collaborative healthcare team,
informatics, and the older adult themselves all
function together to help avoid medication errors and
promote medication safety.
 There is not a single method that has been proven to
work for this population.
 Research did provide varied ways to help prevent
medication errors in the geriatric population, and
some key identifiers for those older adults who may
need some assistance with their medications.
References

Association of periOpritive Registered Nurses. (2014). Medication Safety [Webinar]. In
Periop 101 Individual Modules. Retrieved from
http://www.aorn.org/Secondary.aspx?id=26250&terms=medication%20safety

Choo J., Hutchinson A. & Bucknall T (2010). Nurses’ role in medication safety. Journal of
Nursing Management 18, 853-861. doi:10.111/j.1365-2834.2010.01164.x

Fialová, D. & Onder, G. (2009). Medication errors in elderly people: contributing factors
and future perspectives. British Journal of Clinical Pharmacology 67(6), 641–645.
doi:10.1111/j.1365-2125.2009.03419.x

Finkelman, A. & Kenner, C. (2013). Professional Nursing Cncepts: Competenies for
Quality Leadership. Burlington, MA: Jones & Bartlett Learning.

Hall, C. (2002). ). Special Considerations for Geriatric Population. Critical Care Nursing
Clinics of North America 14, 427-434.

Tweddle, F. (2009). Covert medication on older adults who lack decision-making
capacity. British Journal of Nursing 18(15), 936-939.

Wang C., Fetzer S., Yang Y., Wang J. (2013). The Impacts of using community health
volunteers to coach medication safety behaviors among rural elders with chronic
illnesses. Geriatric Nursing 34,138-145. doi:10.1016/j.gerinurse.2012.12.013
Image references
 [Untitled photograph of healthcare team]. Retrieved April 23,
2014 from: http://www.hahnemannhospital.com/enus/education/pages/default.aspx
 pharmMedSelect-Automated-Dispensing-Machine. Retrieved
April 25, 2014 from:
http://adaircountyhealthsystems.org/pharmacy.html
 [Untitled photograph of nurse with automated system].
Retrieved April 25, 2014 from:
http://www.qatarisbooming.com/article/heart-hospitalpharmacy-implements-automated-prescription-system
 Interprofessional-collaborative-team. Retrieved April 25, 2014
from:
http://ipep.arizona.edu/sites/default/files/uploads/styles/b
log_post/public/field/image/interprofessional-collaborativeteam.jpg?itok=a1mV7VUW

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