护士执业人员主导的脱处方捆绑干预措施,以减少在急性后护理环境中的多药率
1SSM Health Dean Medical Group, Madison, Wisconsin.
Journal of the American Association of Nurse Practitioners
|September 3, 2024
概括
一个抑郁症的干预显著减少了药物在后急性护理居民. 这项质量改进项目降低了多药房的费率,通过基于证据的实践和药剂师合作改善了患者的治疗结果.
科学领域:
- 老年人药房 老年人药房
- 药物治疗 药物治疗
- 提高质量 提高质量
背景情况:
- 后急性护理 (PAC) 居民经历了高的多药剂率,增加了药物不良事件和急诊室访问的风险.
- 全国90%以上的PAC居民使用五种或以上的药物,需要有针对性的降低处方策略.
研究的目的:
- 解决基于证据的实践 (EBP) 在PAC环境中减轻处方的缺陷.
- 实施一个捆绑的停止处方干预措施,以减少多药房的费率.
主要方法:
- 一个中西部PAC环境中的质量改进项目使用了RE-AIM模型.
- 数据追踪了5个月的干预前后处方率.
- 一个捆绑的EBP干预包括一个脱处方框架,药剂师合作和EBP指导方针.
主要成果:
- 49名患者接受了抑郁症治疗包,获得了处方药的26.67%的减少.
- 平均每位患者被处方了5.55种药物.
- 在85种不同的治疗药物类别中观察到减少.
结论:
- 执业护士对于在PAC环境中成功启动抑郁症的关键.
- 综合药剂师协作和EBP降低了PAC居民的处方率.
- 该模型显示了PAC患者治疗结果可持续改善的潜力.
相关概念视频
Drug Therapy
40
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
40
Desensitization and Tachyphylaxis
1.6K
Tachyphylaxis is described as a rapid decrease in response to a drug after repeated or continuous administration of the same drug dose. It is a phenomenon where the body becomes less responsive to a particular substance or intervention over time, requiring higher doses or stronger interventions to achieve the same effect. It results from adaptive changes in the body's receptors, signaling pathways, or physiological processes that occur in response to prolonged exposure to a stimulus.
1.6K
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
104
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
104
Psychosis: Goals of Pharmacotherapy
113
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
113
Antidepressant Drugs: MAOIs and Other Agents
205
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
205
Drug Abuse and Addiction: Pharmacological Phenomena
448
Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
448


