Supporting Parkinson's disease medication safety for nurses in the acute care setting through an educational intervention study.

INTRODUCTION: Patient medication safety in the acute care setting is a foundational action provided by nurses and healthcare providers for safe patient care. Hospitalization of patients with Parkinson's disease (PD) can be dangerous due to the unique and variable medication regimen required. Patients with PD often have their medication administered inappropriately in the acute care setting (e.g., holding a PD medication in preparation for surgery, not administering the medication on the patient's home schedule, and delaying administration). The research question posed in this study was the following: does a PD medication educational intervention in the clinical setting enhance knowledge, comfort, and competence of practicing nurses in the care of patients with PD regarding their medication safety? DESIGN: A mixed methods study design was used for this 5-month, two-part study with a sample of practicing RNs at three different hospitals. Part one of the study assessed nurses' initial knowledge of PD and PD medication safety and included an educational intervention. Part two of the study occurred 3 months later and evaluated if knowledge from the educational intervention was retained. METHODS: The study was conducted in two parts and included a pre-test, educational intervention, post-test, and follow-up test 3 months later. The educational intervention consisted of a 15-minute video of two PD advanced practice nurses being interviewed regarding the general care of a patient with PD. The pre-test, post-test, and follow-up test were identical and consisted of six questions regarding knowledge, comfort, and self-perceived competency. Participants were additionally asked three open-ended questions at follow-up to gain insight on the effectiveness of the educational intervention. RESULTS: A total sample of 252 RNs participated in this study. Statistically significant improvements in knowledge, comfort, and self-perceived competency were observed in the post-test scores compared to pre-test scores. These statistically significant improvements were retained after 3 months, despite a 42.9% decrease in the number of responders (n = 252 vs. n = 144). Additionally, compared to the post-test, there were no statistically significant declines in knowledge, comfort, or competency in the follow-up test. Qualitative findings indicated that the training regarding PD medications was retained and found to be valuable, even if it was seldom applied in practice. CONCLUSION: A review of the literature and this study both support the need for increased education for practicing nurses as it relates to PD and PD medication safety. Healthcare systems, organizations, and associations that support continuing education for nurses create a stronger workforce. Education has been found to keep nurses up to date on the latest advances in care and treatment while also providing exposure to other areas of nursing beyond their clinical settings. CLINICAL RELEVANCE: Promoting better patient outcomes through safe medication administration is a hallmark of nursing care excellence. This study found that supporting the use of an educational intervention of PD medication safety for nurses improved RN levels of knowledge, comfort, and competency up to 3 months later. As the population of those with PD increases, healthcare systems, and nurses must now, more than ever, be poised to care for these individuals. This is a critical point in PD patient care since persons with PD are hospitalized 1.5 times more than their peers without PD.

Parkinson's Disease Medication Administration During a Care Transition: The Impact of Interprofessional Team Simulation on Student Competency, Comfort, and Knowledge.

AIM: This study investigated the impact of an interprofessional mock code on students' comfort and competency related to Parkinson's disease (PD) medication administration during care transitions. BACKGROUD: Patients with PD are at increased risk for medication errors during hospitalization. Individualization of PD medication creates vulnerability during care transitions. METHOD: Four interprofessional groups took part in this study: baccalaureate degree senior nursing students (n = 113), master's level nurse anesthesia students (n = 35), doctor of osteopathic medicine fourth-year students (n = 32), and doctor of clinical psychology fourth-year students (n = 22). Groups participated in an unfolding case study simulation involving a mock code with a focus on the omission of time-sensitive PD medication. Pre- and postsimulation test results were compared. RESULTS: Findings indicated an increased understanding among three of the four groups relating to medication timing during care transitions. CONCLUSION: All groups improved with respect to perceived comfort and competency.

Medication Safety of Patients With Parkinson's Disease During Care Transitions: Educating Nursing Students.

The purpose of this study was to increase awareness and educate undergraduate nursing students and clinical faculty regarding the importance of missed or omitted Parkinson's disease medications during care transitions. To improve quality and safety among this vulnerable population, an innovative, simulated unfolding case study focusing on incomplete medication reconciliation and omission of time-sensitive medications was conducted. Second-degree BSN students (n = 94) and clinical faculty (n = 7) participated in the study. Pretest/posttest results were compared. Findings indicated increased understanding among students and faculty regarding the impact of medication reconciliation and the timely administration of Parkinson's disease medication.

Transitional Care Experience in Home Health: Exposing Students to Care Transitions Through Scenarios and Simulation.

Chronically ill older adults are at risk for avoidable adverse events especially during care transitions, the transfer to one care setting or one level of care to another. Because of the expected increase in the older adult population, increased demand for transitional care is anticipated. Despite the consistent call for expanded competencies in care transitions, nursing education has not incorporated these concepts into nursing curricula. To fill this gap, Villanova University developed patient care scenarios and simulations incorporating standardized patients to demonstrate the needs, risks, and potential complications associated with transitioning patients from acute care to home.

A preliminary study of right hemisphere cognitive deficits and impaired social judgments among young people with Asperger syndrome.

Seven children and young adults with definite signs of Asperger syndrome were administered a battery of tests designed to test: intelligence; left and right cerebral hemisphere functioning; ability to discriminate eye gaze; and social judgment. The subjects revealed a non significant tendency to have a higher verbal IQ than visual IQ; and their right hemisphere functioning seemed impaired. They were also poorer at discriminating eye gaze and revealed difficulties in making hypothetical social judgments. The data are considered with reference to Rourke's (1988) work on non-verbal learning disabilities together with the ideas of Tantam (1992) on the "social gaze response" and Baron-Cohen's (1993) Eye-Detection Detector model. The possible links between social judgment and theory of mind (Frith, 1991) are briefly explored.