Melissa Morris
Level III Project
Lit Review Medication Indications
Literature Review: Medication Indications
Title of Article
And Citation
Effects of including
medication indications on
prescription labels
(Burnside, Bardo, Bretz, &
Busbee, 2007).
LOE
7
Take Away Points and Quotations
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Burnside, N.L., Bardo,
J.A., Bretz, C.J., & Busbee,
L.A. (2007). Effects of
including medication
indications on prescription
labels. Journal of the
American Pharmacist
47(6). 756-758. LOE7.


Evaluation of a
medication education
program for elderly
hospital in-patients (Shen,
Karr, Chan, Khan, &
Duvall, 2006)
6
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

Shen, Q., Karr, M., Ko, A.,
Chan, D.K.Y., Khan, R., &
Duvall, D.
(2006).Evaluation of a
medication education
program for elderly
hospital in-patients.
Geriatric Nursing 27( 3).
184-192. LOE 6.

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“Pharmacists at the Erie Veterans Affairs Medical Center
(EVAMC) noticed that many patients did not know why
they were using their medications. Numerous patients
requested that the indication for medications be included
on the prescription label.”
“Fewer respondents (58%) at baseline perceived that
indications on the label would be useful, compared with
respondents after the survey (82%, P < 0.001; Table 1).
Similarly, fewer patients at baseline wanted the indication
on all of their prescriptions compared with post
implementation (P = 0.003; Table 1).”
“Having the indication entered by the prescriber on all
prescriptions has the potential to decrease ordering errors
by facilitating a second check as the indication is added.”
Limitations to the project included: no demographic data
collected, results relied on patient perceptions of drug
knowledge, and only medications with a single indication
were addressed.
Elderly patients are frequently admitted to hospitals due to
medication-related issues.
“Patient discharge information or patient transfer
information between hospitals, primary health care
providers (e.g., general practitioners), and specialists is
often limited.”
“The purpose of this study, therefore, was to assess the
impact of a nursing-staff-initiated in-hospital medication
education program (MEP) for elderly patients in terms of
increasing medication knowledge and adherence to a
medication regimen after discharge from the hospital.”
“An individual chart was printed for each participant
listing the following variables for each medication:
medication brand name, form and strength, dose and times
of administration, purpose and common side effects.”
Patients who were included in the education program were
visited 10 days after discharge by an RN or study
investigator.
“There was improvement in participants’ medication
knowledge following the education program in regard to
name of medication, dosage and times of medication
administration, and purpose of medication (P > .05 for all
Melissa Morris
Level III Project
Lit Review Medication Indications


Evaluation of a nursing
intervention project to
promote patient medication
education (Nurit, Bella,
Gila, & Revital, 2009).
6


Nurit, P. Bella, B.C., Gila,
E., & Revital, Z. (2009).
Evaluation of a nursing
intervention project to
promote patient medication
education. Journal of
Clinical Nursing 18(17).
2530-2536. LOE 6
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categories).”
“Evaluation of this project showed that the MEP
significantly improved elderly patients’ knowledge about
their medication, even in those participants with a lower
MMSE score of 20-24.”
One purpose of this project was to examine whether an
MEP delivered by nursing staff was effective and
acceptable to patients. The results indicate that nurses are
in a unique position to carry out such a program, as they
are in constant communication with patients.
“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.”
This program was designed to promote and improve
patient education by nurses.
Nurses selected the high-risk drugs which would be
included in the study: beta blockers, digoxin, warfarin, and
sintrom.
“Specific leaflets on the designated drugs were created by
a multidisciplinary team comprised of nurses, clinical
pharmacists and physicians. Each leaflet included
information about the purpose of the drug, its usage,
medical follow-up, dietary recommendation, side effects,
what to do in case of forgetting to take the drug and when
to seek medical advice. Guidelines were formulated by the
research team instructing the nurses how to manage patient
medication education.”
Any patient who had one or more of the drugs chosen were
included; families of those patient who were unable to
communicate were given the education. Patients
discharging to long-term nursing facilities were not
included in the study.
Patients in this study had a generally good understanding
of medications, but were lacking in knowledge about
dietary restrictions and when to seek medical attention.
Not all of the nursing interventions in response to
identified gaps in patient understanding of medications
were documented properly in this study.
This study suggested that the role of nurses as medication
educators may need to be further emphasized to patients,
families, and the public.
Nurse-provided patient education should be a priority for
nursing administration and nursing continuing education.
Melissa Morris
Level III Project
Lit Review Medication Indications
Nurses’ attitudes toward
their role in patient
discharge medication
education and toward
collaboration with
hospital pharmacists: a
staff development issue
(Kendall, Deacon-Crouch,
Mid, & Raymond, 2007)
Kendall, S., DeaconCrouch, M., Mid, D., &
Raymond, K. (2007).
Nurses’ attitudes toward
their role in patient
discharge medication
education and toward
collaboration with hospital
pharmacists: a staff
development issue. Journal
For Nurses In Staff
Development 23(4), 173179. LOE 6.
Nurses’ Clinical
Reasoning: Processes
and Practices of
Medication Safety
(Dickson & Flynn, 2011).
Dickson, G.L., & Flynn, L.
(2011). Nurses’ clinical
reasoning: processes and
practices of medication
safety. Qualitative Health
Research 22(3), 3-16. LOE
6.
6
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6
Patient education is a legal, moral, and professional
responsibility of nurses.
The aims of this pilot study are twofold: explore the
attitudes of nurses regarding their role in educating patients
about their discharge medications and improving patient
compliance, adherence, or both; and explore nurses’
attitudes about pharmacists as collaborative partners in the
education of patients about their discharge medications.
28 nurses were asked to participate, but only 8 actively
participated in the interviews, and the majority of
responses showed a general resistance to research.
Nurses indicated barriers to giving patients information
including: patients not wanting the information, and
pharmacy not having copies of medication information.
The nurses expressed discomfort with giving any
medication information beyond what was provided on the
pharmacy handout.
Unfortunately, the results of this study mainly
demonstrated a need for professional development of these
study nurses.
The discussion stated the importance of developing nurses
to embrace and understand their role in patient education.
1. The article discusses nurses being the “frontline”
professionals of actual medication administration, and that
nurses are in a position to catch errors before reaching
patients.
2. Authors wanted to explore nurses’ thoughts and
interventions when they discovered something unexpected
with a medication or patient.
3. 50 medical surgical nurses from 10 hospitals were
interviewed using open-ended interview questions which
“focus[ed] on the events surrounding preparation and
administration of medications”.
4. The six categories of practice that were identified to help
provide safe medication administration were: “(a)
educating patients, (b) taking everything into
consideration, (c) advocating for patients with pharmacy,
(d) coordinating care with physicians, (e) conducting
independent medication reconciliation, and (f) verifying
with colleagues”.
5. The nurses identified challenges to safe medication
practices, including: “(a) coping with interruptions, (b)
interpreting physician orders, (c) documenting near misses,
and (d) encouraging open communication between
disciplines”.
Melissa Morris
Level III Project
Lit Review Medication Indications
6. “In the current study, nurses clearly demonstrated how
they used clinical reasoning to prevent potential errors
from reaching the patient. The major role nurses play in
preventing errors is yet to be acknowledged and valued by
many hospital administrators. Acknowledging and valuing
their roles in patient medication safety is ‘an idea whose
time has come.’ Additionally, the potential cost savings for
hospitals when nurses prevent medication errors is just
beginning to be addressed.”
Melissa Morris
Level III Project
Lit Review Medication Indications
References
Burnside, N.L., Bardo, J.A., Bretz, C.J., & Busbee, L.A. (2007). Effects of including medication
indications on prescription labels. Journal of the American Pharmacist 47(6),756-758.
LOE7.
Kendall, S., Deacon-Crouch, M., Mid, D., & Raymond, K. (2007). Nurses’ attitudes toward their
role in patient discharge medication education and toward collaboration with hospital
pharmacists: a staff development issue. Journal For Nurses In Staff Development 23(4),
173-179. LOE 6.
Nurit, P. Bella, B.C., Gila, E., & Revital, Z. (2009). Evaluation of a nursing intervention project
to promote patient medication education. Journal of Clinical Nursing 18(17), 2530-2536.
LOE 6.
Shen, Q., Karr, M., Ko, A., Chan, D.K.Y., Khan, R., & Duvall, D. (2006).Evaluation of a
medication education program for elderly hospital in-patients. Geriatric Nursing 27( 3),
184-192. LOE 6.
Dickson, G.L., & Flynn, L. (2011). Nurses’ clinical reasoning: processes and practices of
medication safety. Qualitative Health Research 22(3), 3-16. LOE 6.