Nursing Care Improvement Plan: Medication Adherence in Patients

This report reflects on the Institute of Medicine's call for improved nursing practices and focuses on enhancing patient medication adherence. The author, drawing from personal nursing experience, identifies issues with medication management, particularly among patients with multiple prescriptions, and proposes a solution: incorporating regular phone calls into the nursing process. The rationale behind this is to provide immediate support, address patient confusion, and promote adherence without additional costs. The report outlines the initial steps required for implementing this change, including convincing senior management and providing evidence-based support from studies that demonstrate the effectiveness of phone call interventions. The goal is to improve patient care by reimagining healthcare processes, specifically focusing on enhancing the patient experience by effectively managing their medication concerns through the use of phone calls.

Running head: NURSING
Nursing
Name of the student:
Name of the University:
Author’s note

1NURSING
The Institute of Medicine’s report advocates for the need of better education for a nurse
so that they are able to meet demand for care and make improvements within the health care
system. The video by Robert Wood Johnson Foundation (2009) explained how innovative ideas
by nurse helped in assessing the status of work done by nursing team and how small changes like
giving patients with fall risk a red sock made staffs about the need to intervene and provide fall
reported support to this patient. Personally, during my nursing practice, I have also identified
areas where I found improve care and bringing new practice related reform was necessary. This
paper will reflect on the changes that I would like to improve care and the steps to achieve it.
During my nursing practice, I have observed how people with multiple medication orders
are confused about their dosing and timing. They often mess it up leading to poor adherence to
medication orders. Although we provide briefings to patient regarding the medications
prescribed and encourage them to use apps that give reminders about their scheduled medication,
this does not work as many patients are not comfortable in using mobile applications. This
problem is particularly common for low educated patients and those are older than 60 years old
(Yap, Thirumoorthy & Kwan, Y. H. (2016). In response to this issue of patient, I would to
change the way medication adherence advice is given to patient. Instead of relying on just one
meeting to explain the medications prescribed, I want to make regular patient’s phone a
necessary part of the nursing process. This is the simplest yet effective way to reach out to
patient, give them at the moment support during confusion about any medication and promote
medication adherence. It does not involve any additional cost. However, this can work to provide
the opportunity to fulfil out-of-hour care needs of patient. Hence, I would like to make telephone
conversation a daily part of nursing care so that each patient receives at least weekly support on
medication management issues.

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As patient phone calls are not part of usual nursing care, the first action that I will have to
implement to improve medication adherence problem of patients include convincing my senior
managers regarding making this practice a norm. One-on-one discussion would help to explain
the purpose of this practice change and the way it will become a part of the normal nursing
process. The main intention of any innovative effort is to improve patient care experience and
nurse act as innovators by reimagining health care process (Thomas, Seifert & Joyner, 2016). My
plan is linked to improving patient experience of care too as their medication managements
concerns could be managed well by phone calls. To create an appropriate environment that
fosters innovation, I will have to change mindsets and give evidence on the effectiveness of new
process. A study by Huang et al. (2014) investigating about phone call intervention has proved
that phone call interventions improves adherence to complex therapies and medications. Thus,
this evidence will be used as a basis to prove my point and get all the support needed to
implement my proposed idea.

3NURSING
References:
Huang, D., Sangthong, R., McNeil, E., Chongsuvivatwong, V., Zheng, W., & Yang, X. (2013).
Effects of a phone call intervention to promote adherence to antiretroviral therapy and
quality of life of HIV/AIDS patients in Baoshan, China: a randomized controlled
trial. AIDS research and treatment, 2013.
Robert Wood Johnson Foundation (2009). Transforming Care at the Bedside: Empowering
Better Nursing Care. Retrieved from: https://www.youtube.com/watch?v=_CtXFdITU8w
Thomas, T. W., Seifert, P. C., & Joyner, J. C. (2016). Registered nurses leading innovative
changes. OJIN: The Online Journal of Issues in Nursing, 21(3).
Yap, A. F., Thirumoorthy, T., & Kwan, Y. H. (2016). Medication adherence in the
elderly. Journal of Clinical Gerontology and Geriatrics, 7(2), 64-67.