Sinclair School of Nursing, University of Missouri, Columbia, MO.
Sinclair School of Nursing, University of Missouri, Columbia, MO.
J Am Med Dir Assoc. 2018 Jan;19(1):83-85. doi: 10.1016/j.jamda.2017.10.012. Epub 2017 Nov 28.
As part of the Missouri Quality Initiative (MOQI) to reduce hospitalizations for long-stay nursing home residents, this article describes reasons MOQI advanced practice registered nurses (APRNs) recommended medication order changes as part of their medication review process as well as the outcomes of their recommendations.
Cross-sectional descriptive study of MOQI APRN-conducted medication reviews.
Long-stay nursing homes participating in the MOQI project.
Seventeen MOQI APRNs recorded medication reviews for 3314 long-stay residents residing in 16 Midwestern nursing homes over a 2-year period.
APRNs conducted medication reviews and made recommendations for medication order changes to residents' medical providers.
The MOQI medication review database was used to abstract data.
There were 19,629 medication reviews recorded for 3314 residents during the 2-year period. Of the 19,629 reviews, 50% (n = 9841) resulted in recommended order changes of which 82% (n = 8037) of order changes occurred. More than two-thirds of recommendations were because of changes in the residents' plans of care. Other recommendations included adjusting and/or discontinuing medications that had the potential for harm.
Resident care needs are dynamic, resulting in the need for frequent medication order changes. MOQI APRNs, because of their advanced pharmacological education and daily presence in the nursing home, are uniquely positioned to ensure residents' medications aligned with their overall goals of care while minimizing risk of harm.
作为密苏里州质量倡议（MOQI）减少长期护理院居民住院治疗的一部分，本文介绍了 MOQI 高级实践注册护士（APRN）在其药物审查过程中建议药物医嘱变更的原因，以及他们的建议的结果。
对 MOQI APRN 进行的药物审查的横断面描述性研究。
参与 MOQI 项目的长期护理院。
在两年期间，17 名 MOQI APRN 记录了 16 家中西部护理院的 3314 名长期居住居民的药物审查。
APRN 对居民的医疗服务提供者进行药物审查并提出药物医嘱变更建议。
使用 MOQI 药物审查数据库提取数据。
在两年期间，为 3314 名居民记录了 19629 次药物审查。在 19629 次审查中，有 50%（n=9841）导致了建议的医嘱变更，其中 82%（n=8037）的医嘱变更发生了。超过三分之二的建议是因为居民护理计划的变化。其他建议包括调整和/或停止可能造成伤害的药物。
居民的护理需求是动态的，因此需要频繁进行药物医嘱变更。由于 MOQI APRN 具有先进的药理学教育背景和在护理院的日常存在，他们能够确保居民的药物与他们的整体护理目标保持一致，同时最大限度地降低伤害风险。
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