pEb$%_YrEff?7;/_*+WWYdu^DVD&eY]:{{Y~y\_'fi\YfeokMtR,RxR- 1vgj/Vayf7%+.s=>0lJlq! As a P1 student in SDSUs pharmacy program one of the activities required to prepare us for real world pharmacy practice would be to take part in a medication adherence simulation. Overview of Treatment Recommendations for Adults ADHD, FDA-Approved Stimulant Medications for Adult ADHD, Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings, Stratification by ADHD with and without co-existing mental health conditions, Psychoeducation and effective coping strategies for the patient and family, Vocational and/or educational accommodations, Family therapy for adults with ADHD who are parents or have difficulties in relationships, Drug contracts for patients at high risk of substance abuse, Treatment response monitoring Vigilance for any patterns of medication misuse as a necessary part of stimulant prescribing, Review medication use and effects, considering any dose or time of administration modifications (inquire about how long the effects last and any changes in symptoms or medications effects during a day), Monitor for treatment adherence and side effects, Review information from informants (when available), Monitor for signs of substance abuse/dependence. Do the facility employ process to assure nurses are checking the medication in order to avoid the administration of an incorrect drug or dosage? By implementing this, the CM can do the final check of administering the medications. Ability to educate patients and families regarding psychiatric and cognitive disorders in the older adult population. The general clinics provide medication management and limited psychotherapy but can refer within the clinic for short and long term psychotherapy and neuropsychiatric testing. Education of patients about anxiety disorders. educate and provide therapeutic interventions and care coordination to best meet client treatment . I have also read about methods of administration which some literature provides evidence of 5Rs and others give as much as 10RS. serve in the role as the primary psychiatrist, with attending backup, for 40 patients with chronic severe mental illness. the pharmacologic management of these disorders, and the complications attendant to the use of SSRI's TCA's, MAOI's, mood stabilizers, stimulants, and atypical antipsychotics, the treatment of refractory mood and anxiety disorders. I have discussed with my mentor {and all areas of weakness have been recognized as a great opportunity for improving my experience in medication administration. show concern and compassion with being either patronizing or overly-involved. As the nursing code of ethics states, nurses have the duty to protect the health and safety of those in their care (Winland-Brown, Lachman, O'Connor Swanson, 2015). Slide 13: Step 1. In these cases, the care manager can help people articulate goals.3,4 Goal-setting discussions are most successful when the individual trusts their care manager. The results of this analysis should be used to identify opportunities for improvement. The resident will learn to work with the families of patients undergoing complex treatments. Technologies are making it easier for organizations to schedule such follow-up appointments for patients, which will improve the likelihood of patients actually making it in to see their PCP in a timely manner. Goals and Objectives. Collaboration with referring clinicians/professionals and clinical psychologists. c. Check whether the medication is expired and note that on the Medication List form. learn to evaluate psychiatric symptomatology in medical patients and will become adept at distinguishing between symptoms arising directly from medical illness (e.g. By taking extra caution to administer medications correctly, this honorable obligation will always be within, As a student, one of my competency to achieved to become a professional nurse is medication administration. The following Goals and Objectives apply to all psychotherapeutic modalities. 4. To sign up for updates or to access your subscriberpreferences, please enter your email address below. 388 0 obj <> endobj This can start within a few hours to several days of stopping use of the stimulant, in addition to at least two of the following symptoms: Psychotic symptoms may emerge during the first one to two weeks, particularly if they were present during times of use. Organizations should assess their current approaches to patient education about medications and adherence and determine ways to strengthen how information is provided to patients. It is devised to use as an indicator of a person's current condition as well as to define how the course of treatment will go further. hVYo8+|lP. Client lacks understanding of disease process . stream Identify the preceding activity, specific location, and support needed for taking medication. But they also suggested that if a patient is presented with a condition in which they are competent to prescribe, then non-medical prescribers should be confident and competent to treat patient. Research conducted by Randolph and Scott-Cawiezell revealed trends in medication errors prior to and following the integration of MNAs. At the follow up visit, consider the following: About 60% of adults experience improvements in quality of life and symptom reduction in response to treatment. The clinic relies heavily on making use of other psychosocial rehabilitation services in the Chicagoland area. Familiarity with the literature related to their effectiveness, including newly emerging evidence. Patients should drink at least 2-3 liters of water per day during stimulant withdrawal. uuid:9fefe832-e4df-8949-ba01-4aae37089cab willingness to seek supervision for psychotherapeutic and pharmacologic assessments and interventions. or psychomotor retardation (e.g., slowed reflexes, moving as if one feels they are weighted down, moving like one is in slow motion, etc. The time that nurses spend in clarifications had greatly reduced and this allows nurses to focus more on patients care. Simple list that is used by practice staff who engage with the patient and/or family member during preparation and is then used for medication reconciliation. Understands OTC and Rx medications related to menstruation and how to use. However, DOH (2006) specified that supplementary prescribing also provides a perfect structure for newly qualified. Knowledge of complete and detailed neurological and psychiatric assessments needed for the evaluation of adults with cognitive disorders. Knowledge regarding the various imaging and laboratory tests that are needed to assess cognitive disorders and their stages. Changing ones own patterns or style of thinking could have a broad impact on how one manages their life. The Mental Health and Mental Disorders objectives also aim to . Organizations should then implement changes and monitor and measure whether these changes are having the effects desired that will help prevent such a medication error from occurring again. Comorbid conditions such as mood and anxiety disorders are also highly treatable. Whether through a call, email, or use of an automated system that provides instructions, condition- and medication-specific questions, and/or information from their clinician(s), such proactive follow up can help identify regimen adherence issues early and keep patients on a road to recovery. Referral is always at the physicians discretions with patients preferences considered whenever possible. Knowledge of the various treatments used in TRMDs, strategies for choosing a new treatment based on the previous treatment history and presentation of the patient. Organizations should set a goal to ensure there is a follow-up plan in place for all patients and consider this an essential component of the discharge process. Residents will communicate with multidisciplinary cancer treatment teams effectively and will incorporate feedback from them. 3. 3 Medication Management Goals to Set for Your Organization, HEDIS is a registered trademark of the National Committee for Quality Assurance. Metacognitive therapy is as a type of therapy that involves changing how people think rather than what they are thinking about. Essential Functions and duties of position included: Provide Medication Therapy Management Review to patients (COA-Care for . The clinics collaborate with primary care providers in the evaluation and treatment of medical problems which may intersect with psychiatric presentations, such as sleep disorders, some cortical and subcortical dementias which are comorbid with affective disorders, and the common renal, thyroid, hematologic and hepatic consequences of medications commonly used in psychiatric practice. Ability to deal effectively with the concerns of students who are worried about any consequences of long-term medication management but have a clear clinical indication for prolonged pharmacologic treatment. This multidisciplinary team meets weekly in case-based discussions and didactic sessions. Besides resident physicians and the attending, the clinic is staffed by a clinical nurse practitioner. Exercise is an important part of a healthy lifestyle, and should be recommended for both health and possible ADHD benefits. https://www.ahrq.gov/patient-safety/reports/engage/interventions/medmanage.html. If patients are significantly distressed or agitated, presenting a danger to themselves or others, short-term use of benzodiazepines (diazepam 5 to 10mg QID PRN) and antipsychotics (olanzapine 2.5-5mg BD PRN) for control of irritability and agitation can be helpful, particularly in the inpatient setting. Ability to understand and use neuropsychological data, various imaging, and laboratory data to arrive at the correct diagnosis and treatment plan for each individual. No matter which goal you choose, you'll want to consider the pros and cons of each treatment approach. Be familiar with the various diagnostic conditions seen during childhood and adolescence including ADHD, Conduct Disorder, Anxiety Disorders, Substance Abuse Disorders, and Learning Disabilities, Understand the difference in symptomatology between children, adolescent, and adults, Understand the occurrence of commonalities in children and adolescents, Develop competency and appropriately prescribe and manage stimulant medication for ADHD including Ritalin, Dexedrine, and Adderal, Develop competency and appropriately prescribe and manage non-stimulant medication for ADHD including Wellbutrin, Clonidine, and Strattera, Develop competency and appropriately prescribe and manage SSRI medications for depression and anxiety, Be aware of the various structured diagnostic tests (CBCL, Conners, CDI, etc. Using the Medication List form, go through the prescription medications one by one: a. I have managed to disperse quite a few times but occasionally get muddled with the whole process by doing little errors and the pace at which I administer needs to be faster due to factor of time and the amount of patient lined up for medication. Checklist for staff to provide a quick reference for the steps to creating a medication list with a patient or family member. The primary goal of treatment is to minimize the impact of ADHD symptoms on patient function while maximizing the patients ability to compensate or cope with any remaining difficulties. The resident will understand and provide the psychiatric care of patients with complex medical and psychiatric co-morbidities. Content last reviewed December 2017. 3. 347, August 2019, about 1 in 5 American and Canadian adults took 5 or . Knowledge of the techniques used in the evaluation of adults with treatment-resistant mood disorders (TRMDs), including evaluation of previous pharmacologic, somatic, and psychotherapeutic treatments. 400 0 obj <>/Filter/FlateDecode/ID[<38AE6961186DAC41A255D329ADBB4926>]/Index[388 29]/Info 387 0 R/Length 73/Prev 426904/Root 389 0 R/Size 417/Type/XRef/W[1 2 1]>>stream Residents will have the opportunity to work with patients who are dying and to develop skills dealing with end of life issues. Care managers can listen for cues that indicate a readiness to set goals such as Metacognitive therapy suggests stepping back from specific thoughts and instead understand ones own thinking style. This way it makes it difficult for the CM to sign off all the medications at once for the residents when setting them up. Amphetamine withdrawal is largely psychological, but may be difficult to manage, particularly for friends and family members, due to mood swings. About half of all people in the United States will be diagnosed with a mental disorder at some point in their lifetime. During assessment and diagnosis process, consider referral to a psychiatrist or mental/behavioral health professionals in the following several presentations and co-conditions: During treatment and monitoring, consider referral to a psychiatrist in the following situations: Most adult patients with ADHD can benefit from education about ADHD, skill building trainings and adjuvant psychotherapy. hbbd``b`@ H !f$t7Hr*HP=L ? Secondly, the way the resident receives his medications should consist of the CM stating what each of the medications are so the resident is aware what he is taking. Step 5 - Evaluate and refine. The resident will learn to work with patients with advanced medical illness and be sensitive to their physical limitations. Weight Loss Goals Goal: Decrease body weight by 10 percent from baseline. These medications should be prescribed for a maximum of seven to 10 days. gain an increased knowledge of the psychopharmacologic considerations in a medically ill population and learn to work with the neuropsychiatric side effects of complex medical and psychiatric treatments. The aid can be handed out as a pocket card or posted at workstations. The resident will be observed in many patient interactions by the attending and will receive feedback on those observations including issues of rapport, adherence, patient education and formulation of a treatment plan shared with the patient. GENERAL OBJECTIVES endobj Boost their self-esteem. %PDF-1.4 % medication, supportive therapy, cognitive behavioral therapy, environmental intervention). PSYCHOTHERAPY LEARNING OBJECTIVES FOR SPECIFIC PSYCHOTHERAPEUTIC MODALITIES, COMBINED PSYCHOPHARMACOLOGY AND PSYCHOTHERAPY. Patients are generally stable and the goal is to help them manage setbacks, prevent hospitalization, and progress towards recovery. Department of Psychiatry and Behavioral Neuroscience, the ability to complete a thorough general psychiatric diagnostic assessment, the ability to formulate a case, integrating biological, psychological, and social issues, the ability to generate and carry out a plan of care, including pharmacological, psychological and social interventions, the ability to identify issues and patterns better approached by psychotherapy than by medication. Establish a clear treatment framework (e.g., a treatment contract) with explicit agreements about the following: Goals of treatment sessions (e.g., symptom reduction, personal growth, improvement in functioning) When, where, and with what frequency sessions will be held A plan for crises Before the introduction of medication aides, error rates were as follows: RN (11.55%) and LPN (10.12%) with a mean error rate of 10.4%. An inpatient setting may be necessary if the patient has significant psychotic symptoms, in which case a referral to mental health services is appropriate. Knowledge of the techniques and interview styles used in the evaluation of older adults with sensitivity to cognitive disorders what are common in this population. Copyright 2023 IPL.org All rights reserved. the various presentations of depression, bipolar disorder, anxiety disorders, and adjustment disorders and other disorders mentioned above, and how to differentiate among them. Engage with their treatment. Willingness to explain and discuss findings to patients, caregivers, and their families. Provide tips for clinicians on strategies to overcome common barriers to medication filling and adherence. Learn to identify the resident's own vulnerabilities and sensitivities in this regard so that he/she cannot be blind-sided. As it relates to the patient medication programme this curriculum aims to develop students role in accountability and be inform nurses of the proper use of medication administration to patients. Patients awaiting lung, liver, heart, and kidney transplant make up the initial patient population, but the clinic population includes many patients who are post-transplant. I have noticed some errors that needs to back up all the time. Multiple Sclerosis brain involvement) or as the result of psychosocial adjustment to a devastating illness. However, Nuttall and Rutt-Howard (2011) argued that for long term conditions, non-medical prescribers are able to make an independent prescribing decision. Here are three worthwhile medication management goals to set for your organization. With that said, another goal should be to reduce the number of medication errors month over month, quarter over quarter, year over year, always keeping that zero goal as motivation for improvement. By definition, all medication errors are preventable. It lacks the abuse potential of stimulants and is not a controlled Schedule II drug. The resident will learn to work with the families of patients undergoing cancer treatment. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. The resident will be able to: Establish and maintain a treatment frame (e . <> { Ql{Ont~UTgc/B/}rp6O^c:v+Fh, Microsoft Word - T019_ProgramGoalsObjectives_MAT.doc. Residents will demonstrate knowledge of evidence-based treatment approaches to addictive behaviors. The resident will Conduct supportive psychotherapy for select patients who are currently going undergoing crises, going through transitions, or otherwise are appropriate for these services. While achieving this goal may seem unrealistic, any goal other than zero would suggest a willingness to accept some medication errors. Remind patients to bring all their medications to their appointments. Acrobat PDFMaker 15 for Word Identify when countertransference issues or unfair patient demands are interfering with the resident's ability to provide appropriate clinical care. When patients fail to get regular exercise, it could be an indication that ADHD is affecting their organizational skills. The goal of this activity is to put ourselves in the patients shoes to get an idea about how patients adhere to their regimens in the real world. Medication Management and Occupational Therapy. One of the most critical steps organizations should take is to perform a comprehensive root cause analysis every time a medication error and ADE occurs (another worthwhile goal). competency to stand trial, suitability for conditional release following a successful insanity plea, psychological damages in civil cases, etc. hb```f``2g`K@9$V0894 e&a6LdIMm*0e6aJ *d$p0-- (C|*SbCYB #CM f:F+;Z?h~H2X D @ l $; Hs 8LEr05uJ`s;&O9Aq/?g`3 _ Knowledge of the multiple medical, neurological and psychiatric disorders that underlie cognitive complaints in adults. identify and treat extrapyramidal syndromes. Information card that can be provided to patients along with an appointment reminder before the appointment. Medication Management Implementation Quick Start Guide: The Quick Start Guide provides clinicians and practice staff with five simple steps for implementing the medication management strategy in the office setting. PGY-3 residents spend twelve months in the General Clinics. the types of psychotherapy, and their indications, which are effective in managing the problems seen in a general psychiatry clinic. The follow-up appointment is vital for several reasons from a medication perspective. An ability to engage, collect information, evaluate, diagnose and establish a treatment plan for geriatric patients who present with dementia, neuropsychiatric and psychiatric symptoms. Checklist: Creating a Medication List [PDF, 94 KB]. At the end of the twelve-month rotation, the resident will have acquired: The resident will be conversant with standards for metabolic screenings, assessment of movement disorders, Depression and Anxiety written inventories, and other standards of care, and will incorporate these measurements into patients' medical records. Provide a holding environment, Recognize and specifically describe affects, Tolerate direct expressions of hostility, affection, sexuality and other powerful emotions, Identify problems in collaborating with the treatment/therapist, Recognize obstacles to change and an understanding of possible ways to address them, Maintain focus in treatment when appropriate, Assess readiness for and manage termination from treatment, Assess the patient's readiness for specific interventions, Assess the patient's response to specific interventions, Identify aspects of an ongoing case in terms of theories of drive and defense, internalized object relationships, and consideration of the patient's self-experience, Link present to past as demonstrated by understanding the patient's present pattern of thought, feeling, action and relationship in terms of his or her past personal experience, Identify and elicit automatic thoughts and cognitive errors in thinking, and develop and implement a treatment plan employing CBT strategies and techniques, Establish and maintain a professional relationship, Understand and protect the patient from unnecessary intrusions into privacy and confidentiality. 2006 ) specified that supplementary prescribing also provides a perfect structure for qualified... 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