Quality Use of Medicines Case study

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QUESTION
 
Apply advanced pharmacokinetic and pharmacodynamic principles to the safe use of
medications in vulnerable populations.
DESCRIPTION
In this assessment you will clinically apply the principles of Quality Use of Medicines (such as selecting management options wisely, choosing suitable medicines, and using medicines safely and effectively) to the following case study.
Analyse this case study from a QUM perspective and identify two [2] risk factors that will negatively impact Maja’s health outcomes. For each risk factor, identify two [2] QUM strategies you could introduce into Maja’s plan of care. Using contemporary scholarly literature, JUSTIFY how these strategies would improve Maja’s health outcome.
Assessment format
This is a case study; an introduction or conclusion are not required. Subheadings are acceptable, dot points kept to a minimum and if an appendix is used it must enhance content it does not replace the content. The paper must be written in 3rd person. Use 7th edition APA referencing style and format throughout the paper. There is an expectation you will support your case study with evidence based and contemporary references. The word count must be accurately stated at the end of the written piece. Word counts include everything except the reference list.
Case study:
Maja, a 69-year-old Serbian refugee speaks fluent Serbian and Russian, with some German and English. She was discharged from hospital four [4] days ago after undergoing surgical debridement for an infected right foot. Maja presents to the community health clinic for a dressing change. You are the community nurse assigned to this task. You have never met Maja previously.
You welcome Maja and ask for her discharge summary. She passes you an envelope and a clear plastic bag full of discharge medications. In heavily accented English she says, “Nurse in hospital tell me you know about these tablets.”
Discharge Summary
Past medical history includes hypertension, heart failure, diabetes, and pneumonia (2020). Maja is a known
patient of the hospital, mostly for missing her regular and necessary cardiology and endocrinology appointments.
Seven [7] days ago, Maja underwent a surgical debridement of an abscess in her right foot due to a gardening injury. While in hospital, the endocrinologist and cardiologist assessed her and adjusted some of her routine medications. Furosemide was increased from 20mg to 60mg mane and Metformin was increased from 1gm to 2 gm daily.
Discharge Medications
Metformin 2gm daily Gliclazide 40mg mane Paracetamol 1gm QID PRN Flucloxacillin 500mgs QID
Telmisartan 40mg nocte Metoprolol CR 190mg mane Furosemide 60mg mane
After reading this discharge summary you examine the medications in the plastic bag. You notice all the medication boxes are unopened.
You gently ask Maja why she hasn’t taken any of these medications. She responds, “In hospital they tell me, wait to talk to community nurse, she will tell you ‘bout the boxes.” Maja points to the medication boxes, “I have heart and sugar tablets at home. Big supply. I save these ones for later.” You show Maja the packet of Flucloxacillin and ask if she has these tablets at home. She responds, “I had operation, I don’t need tablets. Doctor told me foot is fixed now.”
Observations
Pulse 59bpm
BP 159/92mmHg Temperature 37.9C BSL 16 mmol
Respirations 19rpm SpO2 95%
Pain level 4/10
As you remove the old dressing you notice Maja has bilateral pitting oedema in her ankles. There is also a moderate amount of thick offensive exudate on the old dressing you have just removed.
End of case study
 
 

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