Medication Education Collaboration Learning Activity

Submitter Information

Author: Gail Armstrong, ND, RN
Title: Assistant Professor
Institution: University of Colorado Denver College of Nursing
Email: gail.armstrong@ucdenver.edu

Competency Category(s)
Teamwork and Collaboration

Learner Level(s)
Graduate Students, New Graduates/Transition to Practice, Pre-Licensure ADN/Diploma, Pre-Licensure BSN, RN to BSN

Learner Setting(s)
Clinical Setting

Strategy Type
Case Studies

Learning Objectives

  • Describe own strengths, limitations, and values in functioning as member of a team.
  • Act with integrity, consistency and respect for differing views.
  • Appreciate importance of intra- and inter-professional collaboration.
  • Describe scopes of practice and roles of health care team members.
  • Function completely within own scope of practice as a member of the health care team.
  • Value the perspectives and expertise of all health team members.
  • Describe strategies for identifying and managing overlaps in team member roles and accountabilities.
  • Respect the centrality of the patient/family as core members of any health care team.
  • Respect the unique attributes that members bring to a team, including variations in professional orientations and accountabilities.
  • Analyze differences in communication style preferences among patients and families, nurses and other members of the health care team.
  • Communicate with team members adapting own style of communication to needs of the team and situation.
  • Value teamwork and the relationships upon which it is based.
  • Describe examples of the impact of team functioning on safety and quality of care.
  • Demonstrate commitment to team goals.

Strategy Overview

This learning activity is best suited for students who are in the senior level of a pre-licensure program, or are newly practicing graduates. The activity can also be easily adjusted for a graduate level student to complete more independently. This activity fits particularly well in a Public Health course or in Mental Health course. The students need to be operationally familiar with medication reconciliation and have utilized this process independently before this learning activity.
A commonly overlapping area of practice for pharmacists and nurses is the realm of medication education. Pharmacy curricula spend more time on specific facets of medication education, and there is much for nurses to learn from the pharmacy literature. This learning activity invites nurses or nursing students to engage in a focused interprofessional collaboration with a pharmacist or a pharmacy student in the area of medication administration.
Prior to clinical, I ask the students to read part of a chapter from Building a Successful Collaborative Pharmacy Practice: Guidelines and Tools. I ask the students to read pages 103 -122 from Chapter Two, which focuses on Services Covered by Pharmaceutical Collaborative Care. The entire citation is below:
Bennett, M. & Wedret, J.E. (2004). Building a successful collaborative pharmacy practice: guidelines and tools. Washington DC: American Pharmacists Association.
The first twenty pages of this chapter provide very specific strategies for what pharmacists label, “patient counseling,” and nursing calls “medication education.” There are 30 strategies offered to the reader, with substantive details provided for each strategy. The chapter also breaks these strategies down to three prime questions (What did the doctor tell you the medicine was for? How did the doctor tell you to take the medicine? and What did the doctor tell you to expect?) Additionally there are suggested approaches for working with special populations (geriatric, pediatric, cross cultural and physically impaired). The second part of the reading focuses on “Compliance Counseling.” There is background data about the costs of noncompliance, the clinical implications of noncompliance and analysis of some operative factors in the phenomenon of noncompliance. The reader is guided in how to assess nonadherence as well as strategies for developing patient-focused interventions for this problem. The clinician is provided specific strategies for enhancing adherence to pharmacotherapy, and modifications are proposed for special populations. Examples of interventions are provided for common chronic diseases (e.g. hypertension, and Type 2 diabetes).
Prior to the clinical assignment below, I review with students the main points of the reading. Some discussion questions that I ask in class (or online) are:
  • What did you learn from this reading?
  • Which content of the assigned reading felt specific for the scope of practice of pharmacists?
  • Identify 3 of the 30 Medication Education strategies that are most helpful to your nursing practice. How will you alter your nursing practice, based on these strategies?
  • Is there a different philosophical stance in how the patient is viewed that emerges from this reading, because of the assumed reading audience? Are there different approaches to patient education that you noted from this reading, specific to the scope of pharmacists?
  • Identify 5 areas of overlap from the reading in terms of how pharmacists and nurses provide medication education.
And then I give the students the following assignment for their clinical rotation.
Choose a patient or family whose medication regimen is complex. Most important in identifying the best patient for this activity is to find a patient whose medication list is complex and who seeks ongoing advice from a pharmacist. Write up each section of the activity into a cumulative paper.
  1. The first task is to complete a thorough medication reconciliation review with this patient/family. Be sure that the medication list with which you end up is inclusive, up to date and includes the necessary details for each medication (name of medication, indication for the medication, dosage, route, frequency, and any special instructions [e.g. take with food, take on an empty stomach]). Begin your paper with this medication list and then summarize the ease or difficulty in completing this correct medication list. Identify contributing factors to the patient’s clarity or lack of clarity about his/her medications.
  2. Assess your patient’s overall familiarity with his/her medications and his/her level of engagement in his/her own health processes. Identify contributing factors to these phenomena.
  3. Once you have a thorough medication list, assess the highest priority for this patient for medication education. Write out a plan for educating this patient over several visits and check that plan out with the patient. Include at least 5 strategies identified in the Bennett reading for this patient. Does the plan meet the patient’s self-identified needs around medication education? Are there issues for this patient around adherence to his/her medication regimen? Include some of the reading’s strategies around enhancing adherence. Revise your plan for medication education as recommended by the patient. You will submit both of these plans – be sure to clearly identify each version.
  4. Call the patient’s consulting pharmacist. Consult with the pharmacist about his/her perception of this patient’s needs for medication education. Ask for this health care team member’s strategies in working with this patient. What does the pharmacist assess as the patient’s highest priority in medication education? Revise your plan for medication education as recommended by the pharmacist. You will submit this third version – clearly identify each version.
  5. The last part of the write up is to reflect back on your original assessment, and consider the alterations you made along with the way with increased input and increased understanding. Did your priorities shift? What was the most influential factor in altering your original plan? How did your understanding of this patient shift with input from the patient and from the pharmacist? Reflect on what you learned from this collaborative exercise.

Submitted Materials

Additional Materials

Evaluation Description

Total possible points:100

Inclusive, thorough list of medications with analysis: 20 points

Assessment of patient’s familiarity with medication regimen: 20 points

Alteration of med education plan based on pt’s self-identified needs: 20 points

Collaboration with pharmacist: 20 points

Overall reflection on the exercise: 20 points