Question: Comment 1

"Medication reconciliation is a critical piece of care coordination for all individuals who use prescription medications. 82% of all adults in the U.S. take at least one medication (prescription or nonprescription, vitamin/mineral, herbal/natural supplement); 29% take five or more" (Kantor, et al, 2015). It is easy to imagine with more than 75% of adults taking medication in the United States, that the risk of interactions among prescription and over the counter drugs, along with herbbal supplements, is greatly increased. Pharmacies are getting better about cross-referencing all drugs when new prescriptions come in, but that is only as good as the information provided to them. For example, if a patient uses more than one pharmacy to get their meds filled, and the systems do not "talk to each other" electronically, or the patient takes supplements and herbs and does not notify the physician or pharmacist, there is no way the database will have the information in it.

Fortunately, there are tools available to patients and families to help with this process in case they omitted certain medications or supplements on their lists that the doctor has. There is virtual tool called "Drug Interaction Checker", which is a system that cross references the medications the patient is on with any potential dangerous interactions. The patient can enter the names of all medications and supplements into the database for review. If any interactions appeat, they can call the pharmacist or their prescribing doctor to clarify if the medication should be stopped, changed, or continued.

Comment 2

I agree. Spiritual care would definitely be an asset in this situation. Unfortunately, spiritual care is not front in center, at least in the organizations that I have been a part of. Also, when I worked inpatient and would ask patients if they would like to speak with a chaplain, they used to think something was seriously wrong with them. Some of the cited reasons for lack of spiritual care in hospitals were not having an agreed definition on what spirituality is, what the nurses' role is in addressing spirituality, the lack of time to meet a patient's spiritual need, and a lack of training nurses have in spirituality (Rushton, 2014).

Comment 3

I think this patient is definetly in need of teaching concerning her C-PAP machine for sleep apnea. Most patients seem to rebel at wearing the mask. So in the first few days especially the nurse could assess whether she is having trouble wearing all through the night. Non-compliant patients need the continued encouragement until they realize how important it is for the progress of their health. Myown husband for example had to be closely monitored for a year. He would rip it off in the middle of the night and unless I gentle put it back on him he didn't wear it. and then I didn't sleep. Make sure your mask is a good fit. The most common problems with CPAP occur when the mask does not fit properly. So education about the C-PAP is a must for her.