Branding problem with palliative care
There is a branding problem with palliative care in that it is associated with end of life, hospice or serious illness. Palliative care is also symptom management – skilled clinical… Continue reading
Multiple Chronic Conditions (MCC) means that a person is living with two or more chronic conditions at the same time. Currently, 1 out of 3 adult Americans have MCCs and for persons 65 and older 4 out of 5 Medicare Beneficiaries and a growing number of children have MCCs. This is the largest patient population and users of healthcare resources accounting for 64% of all clinician visits, 70% of all inpatient stays, 83% of all prescriptions, 71% of all healthcare spending, and 93% of Medicare spending.
Palliative care is symptom management in persons with multiple chronic conditions. The focus is on quality of life and not death. Palliative care should be integrated into the routine management of symptomatic chronic conditions such as heart failure, chronic obstructive pulmonary disease, cancer, chronic kidney disease and others. The effective management of symptoms prevents disease exacerbation, reduces hospitalization, maintains physical functioning, and improves quality of life.
Palliative care is a team-based approach of healthcare professionals who provide interdisciplinary care to meet the complex care needs of patients living with limited-life threatening conditions.
Managing symptomatic multiple chronic conditions, prevents escalation and worsening of the underlying conditions. Proactive interventions to reduce the burden of symptoms such as pain, depression, insomnia, shortness of breath and others improves quality of life and promotes the ability to engage in meaningful and important activities.
More on Medication Safety...
The nurse’s role in medication safety
Patients have long associated trust and respect with nursing. However, recent incidents of nurses delivering inappropriate medications (wrong drug, wrong dose) have led to catastrophic consequences. Most notoriously, former nurse RaDonda Vaught was stripped of her nursing license and charged with reckless homicide and abuse of an impaired adult. She inadvertently injected the powerful paralyzer Norcuron (vecuronium bromide) into a 75-year-old patient for whom the provider had ordered Versed (midazolam).
Anticholinergics: Adverse effects
Anticholinergics, widely used in clinical practice for an extensive range of diseases, exert effects on circulation, respiration, alertness, and vision by blocking the action of acetylcholine (a neurotransmitter) within the cholinergic system.
Benzodiazepines
Providers prescribe benzodiazepines (BZDs)—also known as anxiolytics, hypnotics, muscle relaxants, anticonvulsants, and amnestic medications—to manage several symptoms and conditions, including anxiety, insomnia, alcohol withdrawal, sedation, muscle spasms, agitation, and seizures.
Opioids: Follow the evidence
To ensure safety and effective care, nurses must maintain their knowledge and understanding of opioid pharmacologic properties and best practices when caring for patients with acute and chronic non-cancer pain.