Improving Medication Quality: Risks, Benefits, and Nursing Strategies

This assignment delves into the quality use of medicines, specifically focusing on a case study involving a 75-year-old patient, Mr. Fazio, who is prescribed multiple medications for hypertension and hyperlipidaemia. The assignment identifies and explains significant risks associated with morphine, Glyceryl Trinitrate, and Ondansetron, including mental illness, mood swings, kidney disease, heart attacks, breathing difficulties, and chest pain. It then proposes various nursing strategies to prevent or manage these risks, such as effective communication, dietary considerations, proper monitoring, and oxygen provision. Furthermore, the assignment explores the clinical benefits of patient participation in medication management, including information sharing and risk elimination, and suggests nursing strategies to enhance Mr. Fazio's participation, such as providing comprehensive information and fostering effective communication. The analysis draws upon multiple research papers and journals to support its findings, providing a comprehensive overview of medication safety and patient care.

Quality use of Medicines

Table of Contents
QUESTIONS...................................................................................................................................1
Q1a. Identify and explain two significant risks that may be associated with the use of these
medicines.....................................................................................................................................1
Q1b. Nursing strategies a nurse may implement to prevent/manage the risk.............................2
Q2a. Clinical benefits of patient participation in medication.....................................................3
Q2b. Nursing strategies that could be implemented to enhance Mr. Fazio’s participation in his
medication management..............................................................................................................3
REFERENCES................................................................................................................................5

QUESTIONS
Q1a. Identify and explain two significant risks that may be associated with the use of these
medicines
As per the medical chard provided, there are three different type of medicine that are
being given to patient and that is Mr. Fazio who is 75 years old. As per the history of patient, he
has hypertension, and hyperlipidaemia. Further, there are different issues that are caused because
of medicine that is given. With this respect, three type of medicine that are provided to Mr. Fazio
are morphine, Glyceryl Trinitrate and Ondansetron. More specifically, below given are the two
significant risk due to morphine:
Mental illness: As per the Medication chart, patient is given 1 to 2 MG doses and one of
the major risk that can be faced by patient is related with mental illness. Due to age factor the
time that is taken by patient is more with young people and with dose of morphine, the patient
can face issues in related with loss of memory (Davis, 2014).
Mood swings: As from the past records, patient has hypertension and due to doses that is
given of morphine will raise the issues to serious condition. The emotional that patient has gets
erratically affected and they fail to have same mood for long period. Further, it becomes to
control anger and patient can become violent.
Below given are the two risk due to Glyceryl Trinitrate:
Kidney disease: The doses provided to patient for this medicine is about 300 to 60
microg. As per the doses that is given to patient, it can be stated that there is inverse impact over
kidney and as per the age, as per the case, the patient may have serious issues (Wagner, Quick
and Ross-Degnan, 2014). It will affect the health and patient may reach out to serious condition.
Heart attack: Patient will face serious issues in respect to heart attach. This medicine is
given in order to make the heart function in proper manner. However, when the doses given are
not proper, then it may have negative impact over heart and this can also lead to heart attacks.
Below given are the two risk that is faced due to Ondansetron
Difficulty breathing: As per the case, Mr. Fazio was given with the dose of 4mg that also
after every 4 hours. This can cause the risk of breathing. Further, the patient is of 75 years of age
and so that risk of him to get proper air is high (Dartnell, Heaney and Zuo, 2015).
1

Chest pain: This is another type of problem in which patient can get chest pain. Lungs
get negatively affected in case the dose is not maintained. In such condition the patient is high
risk of getting cheats pain and this may lead to serious problems (Tran and Bero, 2015).
Q1b. Nursing strategies a nurse may implement to prevent/manage the risk
There are different type of strategies that are being implemented by nurses in order to
reduce the rate of risk that can cause to patient. In order to reduce the rate of mental health and
mood-swings, below given are the strategies that are followed by nurses:
Communication: When nurses have effective communication, then they get to develop
strong relationship with their patient. Generally at the age of 75 the support from family member
is not that much and when there is effective communication used by patient, then it becomes
helpful enough for them to reduce the mental pressure that patient have in relation with the heath
condition (Patounas, Lau and Nissen, 2016). There are conditions in which patient doe not share
their problem as they may be scared. These type of condition arise, when there is ineffective
communication. Further, all the issues that are faced by patient whether it may be for getting
something all should be considered and they should be provided.
Below given are the strategies that can be implemented in order to reduce the risk of kidney:
Maintaining proper diet: As per the dose provided, it is important to make sure that all
the food related products provided should be of high nutrients (Onder, Bonassi and Trifirò,
2014). The type of dose that was given to patient as per the case for Glyceryl Trinitrate raises the
risk for kidney disease and it is important that nurses provide proper diet.
Below given are the strategies to reduce heart attacks:
Proper monitoring: With a time gap of one hour, blood pressure should be measured.
This will enable to know the issues that may be faced and as per the evaluation, they should be
given the medicine. This is an effective way to reduce the risk of heart attacks.
Below given are strategy to reduce the risk of breathing:
Providing oxygen: Nurses should make sure that oxygen should be made ready in case
any type of issues is faced by patient in relation with breathing (Ballard, Peterson and Beggs,
2013). As per the case, patient should be kept under observation so that they will be able to
reduce the risk.
Strategy reduce the risk of chest pain:
2

Chest pain assessment: This assessment is made by identify ting the area were pain has
raised. Further, one of the effective steps can be taken is that reduce the blood supply to heart.
Supply of oxygen should be raised.
Q2a. Clinical benefits of patient participation in medication
There are different type benefits clinically that is received when there is effective
participation of patients in medication. In this context, below given are few of them:
Information: When patient take part the medication, they nurse get to provided them with
proper information towards the services that they will be providing (Mostafavi, Salek and
Walker, 2015). This beyond the monitoring that is made by nurses, patients know better about
the type of issues that are faced by them. When patient have adequate information provided by
nurse will enable them to support healthcare team to convey the issues that are faced by them.
Small changes that took place can be conveyed and immediate steps can be take by nurses to
reduce the problems that are faced by patient.
Information to others: When information is conveyed to patient, then they also help in
delivering information to other like family members or friends. This way it enables to make sure
that other get benefited with the information provided. When patient know that what all
medications are to be provided, they have the confidence over it and this is helpful for them to
overcome the problems or the health issues effectively (Sluggett, Caughey and Gilbert, 2014).
When patients know the services that they will receive, then any type of errors that are made by
nurses will be identified and as per the issues nurses can take up proper steps for it.
Eliminating risk: The changes in body can be felt more easily by patient when they are
given with any type of medication. In this context, when they face any type of problem, then
immediate step can be taken to over come them and better services can be delivered by nurses.
Q2b. Nursing strategies that could be implemented to enhance Mr. Fazio’s participation in his
medication management
There are different type of strategies that are implemented by nurses through which
participation of patients can be raised. In this context, for the case of Mr. Fazio, below given
strategies can be used to enhance participation:
Providing information: Participation of patient is not effective when they do not have
proper information regarding the type of services that will be provided. With this respect, when
3

Mr. Fazio is provided with adequate information, then it enables to raise or enhance the
participation. On the other hand, when he is not properly informed, then they will not observe the
changes that take place in their body after they are provided with medications (Wagner, Quick
and Ross-Degnan, 2014).
Effective communication: This is another strategy that enables to develop trust and
confidence with the mind of patient. There are different type of problems that are faced at the age
of 75. However, it becomes helpful to know the issues faced by them when there are effective
communication (Dartnell, Heaney and Zuo, 2015). Patient tent to develop trust and confidence
within their mind for nurses and they will enhance their involvement for the meditations that are
being provided to them.
Don't stop information: The type of medication provided will be able to improve the
health related issues that are faced by patient. However, when patient have the faith that the
meditation will surly help them to overcome the problem, then the rate of improvement will be
high. In this context, there should be frequent information that should be conveyed to so that they
will be able to understand the benefit of each medication provided to them (Tran and Bero,
2015). This the involvement of Mr. Fazio will be high and he will share the problems that are
faced by him and this way better treatment can be delivered by nurses for the type of problems
faced by this particular patient.
4

REFERENCES
Books and Journals
Ballard, C. D., Peterson, G. M., & Beggs, S. A. (2013). Off‐label use of medicines in paediatric
inpatients at an Australian teaching hospital. Journal of paediatrics and child health. 49(1).
pp.38-42.
Dartnell, J., Heaney, A., & Zuo, Y. (2015). NPS MedicineWise: a national approach to
improving the quality of use of medicines. J Bras Econ Saúde. 7(suppl 1). pp.3-5.
Davis, J. (2014). Quality use of medicines. Australian Nursing and Midwifery Journal, 21(8),
p.26.
Mostafavi, S. H., Salek, S., & Walker, S. (2015), August. An Evaluation of the Quality of
Regulatory Review Process for Marketing Pharmaceutical Products in Iran and Its Impact
on Patient’s Access to Medicines. In Toulon-Verona Conference" Excellence in Services".
Onder, G., Bonassi, S., & Trifirò, G. (2014). High prevalence of poor quality drug prescribing in
older individuals: a nationwide report from the Italian Medicines Agency (AIFA). The
Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 69(4).
pp.430-437.
Patounas, M., Lau, E. T., & Nissen, L. M. (2016). Exploring accredited pharmacists’ work
processes during Home Medicines Reviews.
Sluggett, J. K., Caughey, G. E., & Gilbert, A. L. (2014). Use of secondary stroke prevention
medicines in Australia: national trends, 2003-2009. Med J Aust. 201(1). pp.54-57.
Tran, D. N., & Bero, L. A. (2015). Barriers and facilitators to the quality use of essential
medicines for maternal health in low–resource countries: An Ishikawa framework. Journal
of global health. 5(1).
Wagner, A. K., Quick, J. D., & Ross-Degnan, D. (2014). Quality use of medicines within
universal health coverage: challenges and opportunities. BMC health services research.
14(1). pp.357.
5