medication management goals and objectivesmedication management goals and objectives

endstream endobj 389 0 obj <> endobj 390 0 obj <> endobj 391 0 obj <>stream Handout 9 - Medication Therapy Management (MTM) and Part D What do MTM pharmacists do? Inform the patient and family about the Medication Management strategy. Respect for the patients and the family's' stress during evaluation and treatment, Willingness to seek supervision for all treatments, especially those which engender strong countertransference responses, Respect for the members of the treatment team and their differing roles. However, Nuttall and Rutt-Howard (2011) argued that for long term conditions, non-medical prescribers are able to make an independent prescribing decision. There is no evidence from controlled trials to indicate how long the patient with ADHD should be treated with medications. learn to evaluate psychiatric symptomatology in cancer patients and will become adept at distinguishing between symptoms arising directly from cancer or as the result of psychosocial adjustment to a devastating illness. It is a potent selective norepinephrine reuptake inhibitor. Boost their self-esteem. Understand what it is like to have a severe mental illness, what are the barriers, internal and external, to recovery, and how psychiatrists and institutions can be of assistance. Ability to treat patients with TRMDs using the mode of treatment most suitable to the particular situation. Methylphenidate and amphetamine are the two most commonly used stimulant medications for treatment of ADHD in adults (FDA-Approved Stimulant Medications for Adult ADHD). Step 1 - Identify a Champion and get Leadership Buy-in. Medication management is a strategy for engaging with patients and caregivers to create a complete and accurate medication list using the brown bag method. Advantages and risks of typical and atypical antipsychotic medications, in particular: learn to identify and treat tardive dyskinesia in its earliest stages. Read the target audience, learning objectives, and faculty disclosures. Slide 13: Step 1. The general clinics provide medication management and limited psychotherapy but can refer within the clinic for short and long term psychotherapy and neuropsychiatric testing. This eBook is designed to help you develop a new medication management program or improve an existing program. uuid:3bfb92e7-2a9b-5745-a0a7-80ed3c9c0d7e Pharmacotherapy 24 Month Residency - Effective 2018. Metacognitive therapy suggests stepping back from specific thoughts and instead understand ones own thinking style. Since nurses are the largest subgroup of healthcare professionals, their ability to make strides towards improved medication administration is undeniable. The following Goals and Objectives apply to all psychotherapeutic modalities. Residents will gain experience in liaising with community based (IBD support groups) and web-based resources. ), Suicidal or homicidal ideationsSubstance use or dependence, Extreme psychosocial stressors or recent traumatic events, Atypical presentation if presentation as brand-new symptoms this is not ADHD; even if not diagnosed as a child the symptoms must concur, Poor or no treatment effect after repeated medication adjustments. Avoid distraction. A Journal of Hospital Medicine study showed that "patients lacking timely PCP followup were 10 times more likely to be readmitted for the same condition within 30 days of hospital discharge and nearly seven times as likely to be readmitted for the same condition or receive other care.". Gain Age-Appropriate Self-Awareness 7. The following Goals and Objectives apply to all psychotherapeutic modalities. serve in the role as the primary psychiatrist, with attending backup, for 40 patients with chronic severe mental illness. ), Recognize and make therapeutic use of transference, Integrate biological and psychological aspects of a patient's history, Provide psychoeducation about psychiatric illness and the risks/benefits of commonly prescribed psychotropics, Understand how the meaning of a medication to a patient can have a significant impact on its efficacy and learn how to explore what medications mean to a patient, Use the placebo effect to more successfully prescribe medications, Demonstrate a basic understanding of diagnosis-specific psychotherapy and medication management, Have a basic understanding of medico-legal and psychotherapeutic issues in the context of one person prescribing medication and another person providing psychotherapy: confidentiality, informed consent, and collaboration, Use the concepts of transference and countertransference in prescribing medications in a therapeutic manner, Recognize the ways that prescribing mediation can enhance or hinder psychotherapy and ways that psychotherapy can enhance or hinder medication management, Identify the psychological aspects of non-adherence, Use structured cognitive-behavioral model including mood check, bridging to prior session, agenda setting, and review of homework, capsule summaries, and patient feedback, Use Dysfunctional Thought Records as a tool in therapy, Use Activity Scheduling as a tool in therapy, Identify common cognitive errors in thinking, Use behavioral techniques as a tool in therapy, Plan booster session's, follow-up, and self help sessions appropriately with patients when terminating active therapy, Assess regressive and adaptive shifts in ego functioning, Make interventions specifically in support of a patient's ego functions, including defensive operations, Deliberately take a non-interpretative stance in relation to a defensive operation in a patient, Recognize internal conflict and help a patient contain it without an emphasis on interpretation, Be directive: give advice set limits, and educate when appropriate with a patient. 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. %%EOF They are specific statements that have a set target that your teams need to reach. While endoscopic sinus surgery is effective for removing polyps and aerating sinuses, proper medical management remains necessary for reducing inflammation and limiting polyp recurrence. Knowledge of interactions between drugs used in mood disorders treatment, as well as interactions with drugs used for common medical disorders. Population Health Management and Data Analytics - Effective 2020 The initial phase (crash) of withdrawal syndrome occurs as the stimulant effects wear off. 2016-04-27T00:08:20Z Whichever way of dispensing the initial 5RS is the basic for individual to familiarize. There are numerous processes organizations can put in place and technologies that can be used to help reduce medication errors. Education of patients about anxiety disorders. OVERALL CLERKSHIP GOALS and OBJECTIVES At the end of the Primary Care Ambulatory Medicine Clerkship, the third and fourth-year medical student should have a well-developed foundation of skills, knowledge, and attitudes needed to provide for patients in office settings. If the medications themselves could be barcoded and scanned in before popping the medication in the medication cup, this would help the CM double check the five rights as well. ). It should cover common side effects (so patients aren't surprised if they occur) and what patients should do if they experience common or uncommon side effects. Nurses often excuse the behavior of colleagues when a medication error occurs, or nurses will pass the buck to a senior nurse to report the medication error (Haw, Stubbs and Dickens, 2014). 18 0 obj <> endobj 37 0 obj <>stream show concern and compassion with being either patronizing or overly-involved. On the other hand, I need to have that self-awareness of which patient is in the medication room and know how to talk, Staff work with the same residents day after day, and the CMs know what the residents take for medications every day. What roles does the nurse play in ensuring the implementation of quality and safety initiatives? Residents will have the opportunity to participate in ongoing QA/QI projects and present cases in M&M conferences. 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. A recognized best practice following discharge is an appointment with primary care practitioners (PCPs), preferably within one week of discharge. The general clinics provide medication management and limited psychotherapy but can refer within the clinic for short and long term psychotherapy and neuropsychiatric testing. 3. Unfortunately, statistics show that about half of all patients do not take their medications as prescribed. become familiar with means of preventing life-threatening complications of clozapine. endobj This system also streamlines the whole process of getting the prescription to pharmacy, dispensing and obtain refills. Learn to identify the resident's own vulnerabilities and sensitivities in this regard so that he/she cannot be blind-sided. Asking patients to follow up with their PCP is well and good, but actions speak louder than words. If you can see the customer do something (i.e.-complete a journal 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. By using this system it eliminates mistakes or errors due to illegibility, dosage and frequency as this system would alert the prescribers for attention. Residents will have a unique opportunity to gain an understanding of the concept of suffering and of compassion (suffering with). The primary goal of treatment is to minimize the impact of ADHD symptoms on patient function while maximizing the patient's ability to compensate or . Sustain a Tripod Grasp Control 4. Review goals for taking medications: dosage, timing, and instructions. The resident will learn to work with the families of patients undergoing complex treatments. Neurology - Effective 2018 . <> Increase awareness of anger expression patterns. Knowledge of complete and detailed neurological and psychiatric assessments needed for the evaluation of adults with cognitive disorders. Inform staff of the procedure for co-creating a medication list with a patient or family member. PGY-4 residents continue to work with psychotherapy patients electively. Residents participate in diagnostic evaluations, treatment recommendations, and ongoing management. Non-measurable goal Patient will be less isolated. Improve Medication Management and Health Outcomes With Clinical Pharmacist Support It's the HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). At the end of this rotation, residents will understand and display competence in the following: PGY-3 residents spend 6 months in this clinic. Knowledge of the multiple medical disorders that are co-morbid with and often precipitate psychiatric symptoms in older adults. 2016-04-26T17:08:21-07:00 Organizations should set a goal of zero medication errors and ADEs, including those associated with modifying patient regimens. 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. Disease management (including pain management) Palliative. Multiple Sclerosis brain involvement) or as the result of psychosocial adjustment to a devastating illness. 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. For example: Initech's goal was to increase annual profits. To improve medication adherence, and reap the benefits that come with it, organizations should strive to improve their medication management program. Ability to understand and use neuropsychological data, various imaging, and laboratory data to arrive at the correct diagnosis and treatment plan for each individual. NIDA pursues this objective through research and development of non-opioid pain medications, abuse-deterrent formulations of existing medications, and user-friendly overdose reversal drug formulations (e.g., intranasal naloxone). This would alert the nurse that all the residents were getting their medication at the same time, which is impossible. At the end of this rotation, residents will display the following: PGY-3 residents spend 12 months in child and adolescent psychiatry clinics. 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. Here are three worthwhile medication management goals to set for your organization. Engage with their treatment. Goals and Objectives: Provide quality behavioral health and basic medical services including, but not limited to: therapeutic interventions; mental status exams; intervention and management; coordination of patient's medication regime. 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). willingness to seek supervision for psychotherapeutic and pharmacologic assessments and interventions. A treatment plan will include the patient or client's personal information, the diagnosis (or diagnoses, as is often the case with mental illness), a general outline of the treatment prescribed, and space to measure outcomes as the client progresses through treatment. endobj Medication management work doesn't stop after patients are discharged. Changing ones own patterns or style of thinking could have a broad impact on how one manages their life. PSYCHOTHERAPY LEARNING OBJECTIVES FOR SPECIFIC PSYCHOTHERAPEUTIC MODALITIES, COMBINED PSYCHOPHARMACOLOGY AND PSYCHOTHERAPY. Setting goals in a treatment plan helps patients: Feel motivated. introduction a, treatment plan goals amp objectives, sample goals and objectives for supporting a culture of, how to write a treatment plan for mental health healthy, writing measurable objectives . Remind patients to bring all their medications to their appointments. Using the Medication List form, go through the prescription medications one by one: a. 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). P P D W s O O " q q q $ P ' ' q q 4. Document the client's typical daily routine. 2016-04-26T17:08:21-07:00 Residents will create rapport with and patients with histories of addiction and will develop skills at eliciting comprehensive histories from patients with addictive behaviors. The overall goal of the program is to develop psychiatrists competent to practice independently in each of the competency areas detailed below. Medication-Use Safety and Policy - Effective 2019. Walk Independently 9. Residents will become aware of the range of services for patients with addictive behaviors including inpatient and outpatient substance use programs, self-help groups, and other available resources. Familiarity with the literature related to their effectiveness, including newly emerging evidence. Sample Process for Medication Management Strategy [PDF, 133 KB]. The General Adult Psychiatry Clinics provide diagnostic evaluation and treatment for a range of psychiatric disorders in adults, including bipolar and unipolar affective disorders, anxiety disorders, adjustment disorders, attentional disorders, personality disorders, and some psychotic disorders. Residents will communicate with multidisciplinary treatment teams effectively and will incorporate feedback from them. The Anxiety Disorders Clinic provides consultation and treatment on treatment-refractory cases that are often referred from the Department, Hospital, and community. Ability to form an alliance with patients with TRMDs and their families, in order to collect information, establish a diagnosis, provide education and implement a treatment plan. Pediatric - Effective 2016. A PCP can serve as another source of education, further stressing the importance of adherence and answering questions patients may have about their new regimen now that they have been on it for a few days. 3. Treatment plans also help therapists and behavioral health staff with documentation. Interestingly, the utilization of computerized order entry does not prevent the prescriber from ordering an incorrect medication dose or the wrong drug (Lapane, Waring, Dube, & Schneider, 2011). Many patients have come to UCMC for tertiary treatment of complex multimorbidities. Education must speak to the importance of following a regimen and the risks of failing to do so. Patients should drink at least 2-3 liters of water per day during stimulant withdrawal. Techniques used in the evaluation and treatment of adults comorbid presentations of anxiety disorders and other major psychiatric disorders (mood, alcohol/substance abuse, and dependence, etc.). 3. 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. Knowledge of the psychopharmacologic interventions used in the treatment of cognitive disorders in older adults. Learn about the range of medication options for patients with severe mental illness, and what medications are likely to be most effective in diminishing particular symptoms. Yvonne, your post was extremely intriguing to me as a community health department is not an environment I have had the privilege of experiencing. Clinical Guidelines for Withdrawal Management and Treatment of Drug Dependence in Closed Settings. Telephone: (301) 427-1364. Copyright 2023 American Academy of Family Physicians. Copyright 2023 IPL.org All rights reserved. Respect for, and communication with referring physicians, therapists, and caregivers to optimize treatment. Goals: . %PDF-1.4 % 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. 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. By definition, all medication errors are preventable. Measurable, time-limited goal Patient will initiate 2 or more social contacts per week for the next 4 weeks. The clinic includes a medication management clinic, a support group, and several psychotherapy groups geared to people at different stages of recovery. About half of all people in the United States will be diagnosed with a mental disorder at some point in their lifetime. Adherence with a regimen that includes an incorrectly prescribed medication, such as a mistake about the type of drug, dosage, refill frequency, can also cause great harm to a patient. endstream endobj startxref 5600 Fishers Lane evaluate individuals treated on other services for issues of decisional capacity. 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. Medication Management and Occupational Therapy. PGY-2 residents spend six months in the continuing care clinic. Overview of Treatment Recommendations for Adults ADHD outlines a general approach to treating ADHD in adults. This multidisciplinary team meets weekly in case-based discussions and didactic sessions. Conductsupportive psychotherapy for select patients who are currently going undergoing crises, going through transitions, or otherwise are appropriate for these services. xZ6)("JdE"(c :6Nt$JEEJpa>:Q"Qe]IW%Ue955'JO'MB|? i=6|H8W What follows are descriptions for each of the treatment goals: define target symptoms and then choose an appropriate intervention (e.g. For most people, the ultimate long-term goal of treatment is to overcome depression symptoms and achieve a state of remission (an end to serious, noticeable symptoms). Treatment plan is a specifically tailored plan which is used as a powerful tool for the planning and management of a person's health condition. pEb$%_YrEff?7;/_*+WWYdu^DVD&eY]:{{Y~y\_'fi\YfeokMtR,RxR- 1vgj/Vayf7%+.s=>0lJlq! You and your mental health provider will work together to define your long-term objectives from treatment. Feel a sense of accomplishment. It is suggested that all adults with a new ADHD diagnosis, uncontrolled symptoms or any change in medication should be seen within 30 days and monthly there after until the symptoms and function improve. Residents will communicate with multidisciplinary cancer treatment teams effectively and will incorporate feedback from them. Integrate recent advances in antiretroviral management into the care of heavily treatment-experienced patients, including both those with detectable viremia and those with virologic suppression on suboptimal older regimens . Residents will learn to evaluate, diagnose, and manage patients with a range of addictive behaviors, implement evidence-based treatment approaches to addictive behaviors, and address common comorbidities. Identify when countertransference issues or unfair patient demands are interfering with the resident's ability to provide appropriate clinical care. According to National Center for Health Statistics Data Brief No. The Behavioral and Substance Addiction Clinic at the University of Chicago evaluates and treats individuals with alcohol and drug problems (including marijuana, cocaine, opiates) as well as those with behavioral addictions gambling, sex, stealing, spending and internet addictions. b.Ask the patient what the medication is for and document why the patient takes it. Six months after the introduction of medication aides, error rates were as follows: RN (2.75%), LPN (7.25%) and medication aides (6.06%) with a mean error rate of 6.6% Randolph & Scott-Calwiezell (2010) as cited in Budden (2011). Here are three worthwhile medication management goals to set for your organization. Can manage menstruation "prep" and awareness, as in, has tampons or pads in her backpack most of the time, so as not to get caught off guard. PGY-3 residents spend twelve months in the General Clinics. These medications should be prescribed for a maximum of seven to 10 days. Eat Independently 8. Curative. Target Date: 10/1/2014. SHORT-TERM GOALS 1. Goal: Increase and practice ability to manage anger Walk away from situations that trigger strong emotions (100%) Be free of tantrums/explosive episodes Learn two positive anger management skills Learn three ways to communicate verbally when angry Be able to express anger in a productive manner without destroying property or personal belongings While providing education cannot ensure a patient will adhere to a regimen, organizations should do all they can to help make adherence easier.

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