Effective Nursing Practices for Parkinson’s Medication

100 k

Total Downloads

1.82 m

Views

Downlaod PDF

Effective Nursing Practices for Parkinson’s Medication

Introduction

Parkinson’s Disease (PD) is a disorder of the nervous system. The disease is associated with the involuntary movement of the muscles, and hence it is considered as a severe disease that needs to be diagnosed earlier and its medication needs to be given at the right time (Hill et al., 2017). Nursing practices for the medication and cure of Parkinson’s disease needs to be improved and advanced as the disease itself is very vulnerable, if not treated and medicated timely and accurately (Shin, Habermann & Pretzer, 2015). Studies have been found that ignorance of nurses in medicines of Parkinson’s disease, lack of knowledge about the side effects and usage of medicines and insufficient health-care practices lead to unnecessary dysfunction and distress among the patients (Galna et al., 2015).

Therefore, the essay aims to highlight and reflect the clinical practices of Parkinson’s disease. To support the study, two articles have been selected namely “Impact of the Parkinson’s disease medication protocol program on nurses knowledge and management of Parkinson’s disease medicines in acute and aged care settings” by Chenoweth and et al. (2013) and “Medication errors in Parkinson’s disease in patients in the Basque country” by Lertxundi et al. (2017). Moreover, Rolfe et al., reflective model is also used for critically reflecting the essay. In addition to this, the essay critically analyses the study of nursing practices in light of the selected articles as well as learning areas from the study.

Specific Area for Improvement

My identified area of improvement is effective nursing practices for Parkinson’s Medication. I found this potential gap recently when I visited one of the rehabilitation seminars where I got to know that certain nursing practices are used for the rehabilitation and medication of Parkinson’s Disease (PD), such as “dopamine agonist” (DA) treatment for the “cognitive impairment”. Cognitive impairment is one the neuropsychiatric disease or a symptom associated with (PD) (Bot et al., 2016). However, I got to know that these medication and treatment methods are not much efficient because all the current practice guidelines highly prohibit the use of this practice for the treatment of patients with Parkinson’s disease. In this regard, a very significant study of Choi and Horner (2019) shows that treating PD patients with cognitive impairment worsens the conditions of the patients in terms of cognitive and psychiatric symptoms. On the other hand, the findings of Borovac (2016) shows that medications such as “dopamine agonists” (DA) impose critical risks for patients who possess the background of cardiovascular diseases. This lead to depression and hepatic insufficiency. I found that this particular learning need in my nursing practice has potentially limited my practice as a nurse as I observe inadequate clinical training and lack of knowledge in myself. Therefore, the area of knowledge that I need to improve and learn is various medication therapies and treatments for patients with Parkinson’s disease and its associated symptoms.

Critical Analysis

The article by Chenoweth et al. (2013), aims to highlight the medications and clinical practices for nurses to treat patients with Parkinson’s disease. The main finding of the article reflected that without targeted and adequate clinical education, nurse are unable to tackle and effectively manage the medications and treatment of the patients as they possess gaps of lack of insufficient knowledge. For supporting the findings of Chenoweth et al. (2013), Hernandez et al. (2019) reflects that nurses do not possess education about the management of Parkinson’s disease, however with proper training of nursing and clinical practices, their effectiveness can be increased. It has also been found that nurses tend to avoid the unnecessary and critical outcomes that are usually observed with the delay in medications. The article highlighted that nurses are unaware of the errors and omissions that they made in medications of patients as well as they do not know how to treat the patients of PD effectively and with safety measures (Martínez et al., 2015). For improving the deficit in clinical nursing practices for the safety and timely medication of patients with (PD), a well-developed program “Parkinson’s medical education program” (PDMPP) has been introduced to assist the nurses. The findings of Chenoweth and et al. (2013) are valid, ethically robust, trustworthy and reliable.

However, the article of Lertxundi et al. (2017) aims to evaluate the errors in the management of medication of Parkinson’s disease (PD). The main findings of the article highlighted that due to wrong medications, risk factors of prolonged stays in hospitals increase proportionally. Moreover, the findings of Cox, Louie and Sederholm (2018) supports the study of Lertxundi et al. (2017) by reflecting that due to the errors and omissions in clinical practices for timely medication of patients with (PD), they are supposed to stay in hospitals for more than two years due to the adverse effects of the incorrect medications. It is also found that the mortality rate of the patients with (PD) also increases due to the errors in medications. Furthermore, the article also highlighted the use of “anti-dopaminergic” drugs and treatment as the adverse treatment method and the cause of the increased mortality rate among the patients with (PD). Conversely, the article reflected to use “dopaminergic” drugs and treatment which are highly not recommended to use by various policies and clinical practices. Therefore, for reducing the errors and omissions in medications, it is critically important to promote clinical education and training of nurses (Cappell, 2017). The findings of Lertxundi et al. (2017), are accurate, valid, trustworthy and ethically robust in all aspects except for the treatment with “dopamine antagonists” (DA).

On the one hand, the study of Lertxundi et al. (2017) reflects that the prescriptions for the patients must include “antiparkinson drugs” from the classification system of “Anatomical Therapeutic Chemical” mainly from the group of N04B. On the other hand, the study of Chenoweth et al. (2013) reflects that the most effective treatment for the patients with (PD) is the combination of “carbidopa-levodopa”. According to Shamir et al. (2015), it helps in increasing the brain levels of dopamine that are deficit in patients with (PD). However, according to the “National Guideline Clearinghouse” (NGC, 2017), best practice for the medication of Parkinson’s disease is to enhance communication with the patients as their involvement empower them to make judgements about their health conditions and promote the feelings of optimism, which would psychologically help them to improve and overcome the Parkinson’s disease.

Cta 1 How “Dissertation Proposal” Can Help You!

Our top dissertation writing experts are waiting 24/7 to assist you with your university project, from critical literature reviews to a complete masters dissertation.

Find Out More

According to Lertxundi et al. (2017), “Dopaminergic” medications are rarely used for the medications of patients with (PD) which is further supported by Zhang and Chew (2016), reflecting that “dopamine agonists” (DA) have adverse effects on patients and decrease the efficacy of the treatment. Similarly, the findings of Lertxundi et al. (2017), reflects that “anticholinergics” therapies such as (N04A) are highly non-recommended by the specialists and are seldom used for patients taking antipsychotics. On the one hand, the findings of Chenoweth et al. (2013) reflects that inadequate clinical knowledge and training is the reason for inappropriate medications and nursing practices, which is supported by Deeken et al. (2017), by focusing on the need of effective nursing training and practices for Parkinson’s disease. On the other hand, the study of Chenoweth et al. (2013) reflects that one of the inappropriate practice of nurses is that they tend to avoid the severe results that arrive with the delay in medications due to lack of nursing practices, which is supported by the study of Siqueira and Oliveira (2016), according to which nurses are ignorant due the lack of knowledge and advanced nursing practices for managing the patients with Parkinson’s disease.

According to Lertxundi et al. (2017), one of the errors that nurses usually made is in the administration of drugs and medicines for Parkinson’s disease. They use to provide “antidopaminergic” drugs instead of “dopaminergic” drugs. The study further stated that due to the increase in errors of the medications, nurses largely risk the mortality rate of the patients and they have to stay in hospitals for longer durations. Hellqvist and Berterö (2015) supported it by stating that it was observed that nurses had given the wrong dose of “Levodopa” to the patient with Parkinson’s disease due to which the staying period of the patient in the hospital potentially increased. It is further supported by the study of Jerez et al. (2017), according to which in many cases, nurses give the medications and doses in incorrect timings that increases the risk factors of the patient. Moreover, the findings of Lertxundi et al. (2017) shows that 94% of the patients with Parkinson’s disease get the medications in incorrect timings along with 71% hospitals claimed that their staff is well-trained and they know very well about not to give the “anti-dopaminergic” drugs and treatment to patients and 80% of the physicians declared that “clozapine” and “quetiapine” are the two “antipsychotics” that least affect the patients with Parkinson’s disease. However, it is observed from the study of Chenoweth et al. (2013) that primary treatment for patients with Parkinson's disease is a popular drug therapy known as the “Levodopa”, which is the most effective and type of a “gold-standard” for managing the symptoms of Parkinson’s disease and the practice is very effective as it improves the physical functioning of body of the patients with (PD). In this regard, the findings of LeWit and Fahn (2016) are very similar according to which the treatment of patients with“Levodopa” is always the first choice among the practitioners because it is still considered as “gold-standard”. The study of Chenoweth et al. (2013) also provided that despite the severe side-effects of “Levodopa”, the studies and literature for assisting the junior nurses is surprisingly very limited. On the one hand, findings of Chenoweth et al. (2013) further stated that poor practices of nurses such as incorrect times of doses or in some cases omission of doses is mainly due to lack of expertise and knowledge. On the other hand, findings of Lertxundi et al. (2017), stated that many patients with Parkinson’s disease are at serious risks due to the inappropriate education and nursing practices of the staff as well as lack of knowledge about the medication and Parkinson disease. For supporting the perspectives of both the authors, Shin, Pohlig and Habermann (2016), reflected the complementary practices of nursing that are very effective and long-lasting. Therefore, the nurses need to examine the practices and approach critically that must be aligned with the patients with Parkinson’s disease for optimum results (Jones et al., 2016).

Critical Reflection

By considering the various articles and educational resources, including policies, I get to know a lot of effective nursing practices that I can embed in my nursing practice to overcome the knowledge gaps that I mentioned earlier. On the one hand, the first thing that I learned is that ‘communication’ medium is one of the most important element of effective nursing practices (Williams, 2017). Initially, I lacked communication with the patients that created potential gaps and barriers for the patients also. Although, from onwards, I would make sure to facilitate patients with Parkinson's disease with more care and communications. On the other hand, the main challenge that I was facing earlier was the inadequate knowledge of various effective therapies and medications for the treatment of patients with Parkinson’s disease (PD) therefore, the second thing that I learned is that the therapy of “Levodopa” is the key to treat and medicate the patients. The practice is quite difficult to embed (Bhidayasiri et al., 2016); however, with little much clinical nursing training, I would embed this medication practice in my nursing practices. As per the study of Gupta et al. (2019), “Levodopa” medication is very effective practices, therefore I would flexibly enhance my nursing practices by embedding this practice. Moreover, I have also examined that another important nursing practice regarding Parkinson's disease is the provision of timely and appropriate medication to the patients (Poewe et al., 2017) which I lacked in my nursing practices also.

Cta 2 How “Dissertation Proposal” Can Help You!

Our top dissertation writing experts are waiting 24/7 to assist you with your university project, from critical literature reviews to a complete masters dissertation.

Find Out More

Conclusion

The conclusion that can be drawn from the study of the essay is that effective nursing practices are essential for managing patients with Parkinson’s disease. This is due to the reason that lack of knowledge of medicines results in adverse effects. Therefore, proper clinical nursing training and programs are recommended for nurses for better and optimum results. Communication with patients is yet another significant clinical practice until now and can easily be embedded with the nursing practices. Another significant nursing practice is the proper and timely medication to patients with Parkinson’s disease. In this regard, the best medication practice is the “Levodopa” due to its effectiveness and “gold-standard”. Nurses can easily implement this medication as one of the reliable nursing practices with proper clinical trainings. However, it is equally important for nurses to read the articles, books and relevant educational research to get more insights into the medications and nursing practices for Parkinson’s disease. Moreover, from the analysis of articles, it was observed that different training activities are conducted to remove the potential gaps in the knowledge of nurses regarding Parkinson’s disease and thereby effectively support the nurses with best nursing practices. With the implementation of these effective practices, it is possible to get rid of complications that are observed in Parkinson's disease.

 

References

Bhidayasiri, R., Boonpang, K., Jitkritsadakul, O., Calne, S.M., Henriksen, T., Trump, S., Chaiwong, S., Susang, P., Boonrod, N., Sringean, J. & van Laar, T., (2016). Understanding the role of the Parkinson's disease nurse specialist in the delivery of apomorphine therapy. Parkinsonism & related disorders, 33, pp.S49-S55.

Borovac, J. A. (2016). Focus: The Aging Brain: Side effects of a dopamine agonist therapy for Parkinson’s disease: a mini-review of clinical pharmacology. The Yale journal of biology and medicine, 89(1), 37.

Bot, B.M., Suver, C., Neto, E.C., Kellen, M., Klein, A., Bare, C., Doerr, M., Pratap, A., Wilbanks, J., Dorsey, E.R. & Friend, S.H., 2016. The mPower study, Parkinson disease mobile data collected using ResearchKit. Scientific data, 3, p.160011.

Cappell, M.S., (2017). Principles and practice of hospital medicine. McGraw-Hill Education Medical.

Chenoweth, L., Sheriff, J., McAnally, L. & Tait, F., (2013). Impact of the Parkinson's disease medication protocol program on nurses' knowledge and management of Parkinson's disease medicines in acute and aged care settings. Nurse education today, 33(5), pp.458-464.

Choi, J., & Horner, K. A. (2019). Dopamine Agonists. In StatPearls [Internet]. StatPearls Publishing.

Cox, N., Louie, J., & Sederholm, B. (2018). Inappropriate Medication Use in Hospitalized Patients Diagnosed with Parkinson’s Disease. Pharmacy, 6(3), 100.

de Siqueira Tosin, M. H., & de Oliveira, B. G. R. B. (2016). The Role of Nurses in Parkinson's Disease. In Challenges in Parkinson's Disease. IntechOpen.

Deeken, D. J., Wakefield, D., Kite, C., Linebaugh, J., Mitchell, B., Parkinson, D., & Misra, M. (2017). Development, Validation, and Implementation of a Clinic Nurse Staffing Guideline. Journal of Nursing Administration, 47(10), 515-521.

Galna, B., Lord, S., Burn, D.J. & Rochester, L., (2015). Progression of gait dysfunction in incident Parkinson's disease: impact of medication and phenotype. Movement Disorders, 30(3), pp.359-367.

Gupta, H. V., Lyons, K. E., Wachter, N., & Pahwa, R. (2019). Long Term Response to Levodopa in Parkinson’s Disease. Journal of Parkinson's disease, (Preprint), 1-5.

Hellqvist, C. & Berterö, C., (2015). Support supplied by Parkinson's disease specialist nurses to Parkinson's disease patients and their spouses. Applied Nursing Research, 28(2), pp.86-91.

Hernandez-Baltazar, D., Nadella, R., Zavala Flores, L. M., Rosas-Jarquin, C. D. J., Rovirosa-Hernandez, M. D. J., & Villanueva-Olivo, A. (2019). Four main therapeutic keys for Parkinson’s disease: A mini review. Iranian Journal of Basic Medical Sciences, 22(7), 716-721.

Hill‐Burns, E.M., Debelius, J.W., Morton, J.T., Wissemann, W.T., Lewis, M.R., Wallen, Z.D., Peddada, S.D., Factor, S.A., Molho, E., Zabetian, C.P. & Knight, R., (2017). Parkinson's disease and Parkinson's disease medications have distinct signatures of the gut microbiome. Movement Disorders, 32(5), pp.739-749.

Jerez-Roig, J., Ferreira, L.M.D.B.M., de Araujo, J.R.T. & Lima, K.C., (2017). Functional decline in nursing home residents: A prognostic study. PloS one, 12(5), p.e0177353.

Jones, B., Hopkins, G., Wherry, S.A., Lueck, C.J., Das, C.P. & Dugdale, P., (2016). Evaluation of a regional Australian nurse-led Parkinson's service using the context, input, process, and product evaluation model. Clinical Nurse Specialist, 30(5), pp.264-270.

Lertxundi, U., Isla, A., Solinís, M.Á., Domingo-Echaburu, S., Hernandez, R., Peral-Aguirregoitia, J., Medrano, J. & García-Moncó, J.C., (2017). Medication errors in Parkinson's disease inpatients in the Basque Country. Parkinsonism & related disorders, 36, pp.57-62.

LeWitt, P. A., & Fahn, S. (2016). Levodopa therapy for Parkinson disease: a look backward and forward. Neurology, 86(14 Supplement 1), S3-S12.

Martínez-González, N.A., Rosemann, T., Tandjung, R. & Djalali, S., (2015). The effect of physician-nurse substitution in primary care in chronic diseases: a systematic review. Swiss medical weekly, 145(0506).

Poewe, W., Seppi, K., Tanner, C.M., Halliday, G.M., Brundin, P., Volkmann, J., Schrag, A.E. & Lang, A.E., (2017). Parkinson disease. Nature reviews Disease primers, 3, p.17013.

Shamir, R.R., Dolber, T., Noecker, A.M., Walter, B.L. & McIntyre, C.C., (2015). Machine learning approach to optimizing combined stimulation and medication therapies for Parkinson's disease. Brain stimulation, 8(6), pp.1025-1032.

Shin, J. Y., Pohlig, R. T., & Habermann, B. (2016). Use of complementary health approaches in individuals with Parkinson's disease. Journal of gerontological nursing, 43(2), 46-54.

Shin, J.Y., Habermann, B. & Pretzer-Aboff, I., (2015). Challenges and strategies of medication adherence in Parkinson's disease: A qualitative study. Geriatric Nursing, 36(3), pp.192-196.

Williams, N. A. (2017). The National Guideline Clearinghouse. Journal of Electronic Resources in Medical Libraries, 14(2), 82-92.

Zhang, J., & Chew-Seng Tan, L. (2016). Revisiting the medical management of Parkinson’s disease: levodopa versus dopamine agonist. Current neuropharmacology, 14(4), 356-363.

Cta 3 How “Dissertation Proposal” Can Help You!

Our top dissertation writing experts are waiting 24/7 to assist you with your university project, from critical literature reviews to a complete masters dissertation.

Find Out More

Ace Your Grades
Without Overspending

Why pay more for the same quality? Choose our cheap assignment writing services today and witness the difference yourself. Click now to get started!

  • 24/7 Customer Support
  • Team of Academic Experts
  • Guaranteed Results