Nurses’ attitudes and behaviors on patient medication education
Background: Medication education is vital for positive patient outcomes. However, there is limited information about optimal medication education by nurses during hospitalization and care transitions.
Objective: Examine nurses’ attitudes and behaviors regarding the provision of patient medication education. The secondary objectives were to determine if nurses’ medication education attitudes explain their behaviors, describe nurses’ confidence in patient medication knowledge and abilities, and identify challenges to and improvements for medication education.
Methods: A cross sectional survey was administered to nurses servicing internal medicine, cardiology, or medical-surgical patients.
Results: Twenty-four nurses completed the survey. Greater than 90% of nurses believed it is important to provide information on new medications and medical conditions, utilize resources, assess patient understanding and adherence, and use open ended question. Only 58% believed it is important to provide information on refill medications. Greater than 80% of nurses consistently provided information on new medications, assessed patient understanding, and utilized resources, but one-third or less used open-ended questions or provided information on refill medications. Most nurses spend 5-9 minutes per patient on medication education and their attitudes matched the following medication education behaviors: assessing adherence (0.57; p<0.01), providing information on new medications (0.52; p<0.05), using open-ended questions (0.51; p<0.01), and providing information on refill medications (0.39; p<0.05). Nurses had higher confidence that patients can understand and follow medication instructions, and identify names and purpose of their medications. Nurses had lower confidence that patients know what to expect from their medication or how to manage potential side effects. Communication, including language barriers and difficulty determining the patient’s understanding of the information, was the most common challenge for nurses and they suggested utilization of translator services and patient-friendly drug information resources as a way to improve.
Conclusion: Nurses have positive attitudes toward patient medication education. However, their attitudes do not fully explain their behaviors and many nurses are spending limited time with patients on medication education. Enhancements to medication education could include resources on communication and collaboration with pharmacists.
2. Hyrkas K, Wiggins M. A comparison of usual care, a patient-centred education intervention and motivational interviewing to improve medication adherence and readmissions of adults in an acute-care setting. J Nurs Manag. 2014;22(3):350-361. doi: 10.1111/jonm.12221
3. Frank-Bader M, Beltran K, Dojlidko D. Improving transplant discharge education using a structured teaching approach. Prog Transplant. 2011;21(4):332-339.
4. Koelling TM, Johnson ML, Cody RJ, Aaronson KD. Discharge education improves clinical outcomes in patients with chronic heart failure. Circulation. 2005;111(2):179-185. doi: 10.1161/01.CIR.0000151811.53450.B8
5. Kendall S, Deacon-Crouch M, Raymond K. Nurses' attitudes toward their role in patient discharge medication education and toward collaboration with hospital pharmacists: a staff development issue. J Nurses Staff Dev. 2007;23(4):173-179. doi: 10.1097/01.NND.0000281416.04731.3e
6. Auyeung V, Patel G, McRobbie D, Weinman J, Davies G. Information about medicines to cardiac in-patients: patient satisfaction alongside the role perceptions and practices of doctors, nurses and pharmacists. Patient Educ Couns. 2011;83(3):360-366. doi: 10.1016/j.pec.2011.04.028
7. Katz DA, Paez MW, Reisinger HS, Gillette MT, Weg MW, Titler MG, Nugent AS, Baker LJ, Holman JE, Ono SS. Implementation of smoking cessation guidelines in the emergency department: a qualitative study of staff perceptions. Addict Sci Clin Pract. 2014;9:1. doi: 10.1186/1940-0640-9-1
8. Desselle SP. Construction, implementation, and analysis of summated rated attitude scales. Am J Pharm Educ. 2005;69(5):97. doi: 10.5688/aj690597
9. Draugalis JR, Coons SJ, Plaza CM. Best practices for survey research reports: a synopsis for authors and reviewers. Am J Pharm Educ. 2008;72(1):11.
10. Pal A, Babbott S, Wilkinson ST. Can the targeted use of a discharge pharmacist significantly decrease 30-day readmissions? Hosp Pharm. 2013;48(5):380-388. doi: 10.1310/hpj4805-380
11. Komatsu H, Yagasaki K, Yoshimura K. Current nursing practice for patients on oral chemotherapy: a multicenter survey in Japan. BMC Res Notes. 2014;7:259. doi: 10.1186/1756-0500-7-259
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