Patient education and consumer medicine information: a study of provision by Queensland rural and remote area Registered Nurses

The Educational Needs of Family of Patients Discharged from the Intensive Care Units: The Viewpoints of Nurses and the Patients' Families

Introduction

Thousands of patients are admitted to the intensive care units annually, which are stressful for patients and their families. The discharged patients and their families face different challenges in the caring process of the patients.

Objectives

This study aimed to determine the educational needs of the families of patients discharged directly home from the postintensive care units and to compare the views of families and nurses about these needs.

Method

This was a cross-sectional study. One hundred forty nurses and 140 family members of the patients discharged from intensive care units participated in the survey by convenience sampling method. A questionnaire of sociodemographic information and a researcher-made questionnaire on the educational needs of the family of patients discharged from the postintensive care units were used for data collection.

Results

The mean total score of the educational needs of the patients' families was 31.81 and 35.33 from views of families and nurses, respectively. Nurses significantly estimated the educational needs of families more than what they did (P < 0.001). The families and nurses reported the educational needs of self-care as well as nutrition and medicine at the highest level, respectively. Both groups reported the educational needs of defecation at the lowest level. Nurses estimated higher educational needs in all dimensions, except for the patient's mental health and family self-care than families (P < 0.001).

Conclusion

According to the present study, the educational needs were high from the views of nurses and families. Family need assessment is essential in designing and applying instructional interventions. Given the high level of family needs, implementing educational and practical interventions is necessary to enhance their skills.

A review of the medication pathway in rural Queensland, Australia

Objectives

It is well established that rural areas have compromised access to health services, including medication services. This paper reviews the practice developments for rural health professionals in relation to medication processes, with a focus on regulatory provisions in Queensland, Australia, and a view to identifying opportunities for enhanced pharmacy involvement.

Methods

Literature referring to ‘medication/medicine’, ‘rural/remote’, ‘Australia’ and ‘pharmacy/pharmacist/pharmaceutical’ was identified via EBSCOhost, Ovid, Informit, Pubmed, Embase and The Cochrane Library. Australian Government reports and conference proceedings were sourced from relevant websites. Legislative and policy documents reviewed include drugs and poisons legislation, the National Medicines Policy and the Australian Pharmaceutical Advisory Council guidelines.

Key findings

The following developments enhance access to medication services in rural Queensland: (1) endorsement of various non-medical prescribers, (2) authorisation of registered nurses, midwives, paramedics and Indigenous health workers to supply medications in sites without pharmacists, (3) skill-mixing of nursing staff in rural areas to ease medication administration tasks, (4) establishment of pharmacist-mediated medication review services, (5) electronic transfer of medical orders or prescriptions and (6) enhanced transfer of medication information between metropolitan and rural, and public and private facilities.

Conclusions

This review identified a divide between medication access and medication management services. Initiatives aiming to improve supply of (access to) medications focus on scopes of practice and endorsements for non-pharmacist rural healthcare providers. Medication management remains the domain of pharmacists, and is less well addressed by current initiatives. Pharmacists' involvement in rural communities could be enhanced through tele-pharmacy, outreach support and sessional support.

Medication supply and management in rural Queensland: views of key informants in health service provision

BACKGROUND

Rural settings challenge health care providers to provide optimal medication services in a manner that is timely and of high quality. Extending the roles of rural health care providers is often necessary to improve access to medication services; however, there appears to be a lack of pharmacy-based involvement and support within the medication system.

OBJECTIVES

This article explores medication supply and management issues in rural settings, based on the governance perspectives of key informants on regulatory aspects, policy, and professional practice. The specific objectives were to (1) identify the key issues and existing facilitators and (2) explore the potential roles of pharmacy to improve medication supply and management services.

METHODS

Semi-structured interviews were conducted with representatives within regulatory or professional organizations. The participants were key informants who held leadership and/or managerial roles within their respective organizations and were recruited to provide insights from a governance perspective before data collection in the community. An interview guide, informed by the literature, assisted the flow of interviews, exploring topics, such as key issues, existing initiatives, and potential pharmacy-based facilitators, in relation to medication supply and management in rural settings.

RESULTS

Issues identified that hindered the provision of optimal medication supply and management services in the rural areas centered on workforce, interprofessional communication, role structures, and funding opportunities. Legislative and electronic developments and support mechanisms aim to facilitate medication processes in rural areas. Potential initiatives to further enhance medication services and processes could explore extended roles for pharmacists and pharmacy support staff, as well as alternative service delivery models to enhance pharmacy workforce capacity.

CONCLUSIONS

The study provided an overview of key issues with medication supply and management and highlighted the potential for increased pharmacy involvement to improve and support medication services in rural areas. The governance views of these key informants could be used to inform policy and practice related to rural medication services.

Evaluation of a nursing intervention project to promote patient medication education

AIM AND OBJECTIVE

The purpose of this study was to evaluate patients' knowledge regarding their medication regime following a nursing interventional project in patient medication education.

DESIGN

Evaluation.

BACKGROUND

Educating patients during their hospital stay regarding their medical treatment is an issue which the medical staff deals with on a daily basis. The hospitalisation period is a known critical point in the provision of influential information to the patient and related family members, probably because the hospitalised patient and family members have unique learning needs that cannot be postponed.

METHODS

The study was conducted in three internal medicine wards in a large university tertiary hospital in Jerusalem, Israel. The intervention project used structured written materials and verbal patient education related to highly potent drugs. The study evaluated patients' knowledge regarding their medication as the main interventional outcome. In addition, the rate of patients receiving verbal and written education, rate of patient intention to take the medication and adequacy of nursing interventions according to the patients' educational needs were also assessed. Data collection was carried out by a short structured tool that examined patient knowledge. With this tool, the nurse interviewed the patients and recorded the patient's response and her recommended intervention.

RESULTS

Two hundred and fifty-one patients participated in the study. Most of the patients (71-93%) reported that they had received instructions from nurses. The majority of the patients demonstrated a high level of knowledge regarding their medications and planned on taking their medications on a regular basis. Lack of knowledge was observed mostly on issues related to dietary recommendations. In these cases, the nurses' intervention was not always documented and did not necessarily match the problem identified.

CONCLUSIONS

The findings show that patients, who received medication education, demonstrated satisfactory level of knowledge and intended to take their medication. Patients' knowledge feedback enables the nurse to assess her intervention.

RELEVANCE TO CLINICAL PRACTICE

Patient medication education in the hospital is a challenging task. This article suggests an applicable tool to assure that patients receive appropriate medication education, while assessing the effectiveness of this education. This tool also enables the nurses to modify their intervention according to patient response.

The asthma/COPD nurses' experience of educating patients with chronic obstructive pulmonary disease in primary health care

The number of patients with chronic obstructive pulmonary disease (COPD) is increasing. These patients need nursing care, including education in self-care, which has a positive effect on their physical and psychoemotional well-being. The aim of this study was to describe the experiences of asthma/COPD nurses' in primary health care (PHC) of educating patients with COPD. A descriptive, qualitative study was conducted, with interviews of 12 asthma/COPD nurses. The data were analysed using qualitative content analysis. The findings are presented in two themes: Theme 1, receiving support results in a feeling of security, which enables the development of patient education; and Theme 2, a lack of support results in a feeling of insecurity, which makes it difficult to develop patient education. The asthma/COPD nurses were individual orientated with individualization of care, but the patient's mood, the varying support of those around and the nurses' varying degrees of security affected the education. The conclusion is that the asthma/COPD nurses' experience of patient education fluctuated between insecurity and security. The nurses' feeling of insecurity in their patient education can be strengthened through support from colleagues and by increased knowledge in promoting the learning of others. Collaborative teamwork with a well-functioning asthma/COPD clinic in PHC can facilitate and improve patient services; these initiatives can enable the asthma/COPD nurses to reach their full potential.