Discharge Medication Education

1
Discharge MedicationEducation
Sarah Harne-Britner, MSN, RN, CCRN Cardiovascular
Clinical Nurse Specialist
2
Mrs. Rogers Discharge Medications
30 units
Lantus
morning
Lisinopril
10 mg
daily
12.5 mg
bid
Coreg
81 mg
morning
ASA
40 mg
morning
Lasix
Lipitor
20 mg
morning
3
AHA STEMI Medications
Nitrates
Antiplatelets
Beta Blockers
Antidiabetic
Antilipemics
Ace Inhibitors
4
Mrs. Rodgers Discharge Medications
Are these appropriate for her? Anything you
would add/change?
5
Mrs. Rodgers is being discharged on six
medications.Will she will take all of them
correctly?
6
Medication Adherence in the Elderly
Patient Factors

• Medication Education
• Disease Education
• Self-administration Programs
• Symptom Self-Monitoring

• Medication Reminders
• Clear discharge instructions
• Follow-up phone calls
• Medication monitoring

Medication Adherence
Medication Administration Factors
Medication Factors

• Dose Modification
• Medication review by pharmacist

7
Assessing Medication Adherence

• Do you miss any medications?

When is the last time you missed a medication?
VS
8
Educational Tools
Micromedex Patient Care Notes
9
(No Transcript)
10
Educational Tools
Micromedex Spanish
11
Medication Schedule Card
12
Medication Wallet Card
Write out Twice a day
Lopressor
bid
25 mg
13
Polypharmacy and Dosing

• Dose modification
• trying to reduce number of doses per day
• Once/day dosing increases adherence
• Polypharmacy
• Review by pharmacist to look for duplication,
  need and interactions

14
Follow-up After Discharge

• Discharge phone calls
• Home health referral
• Cardiac rehab
• CHF clinic