NURS90053 Health Education Plan for Mrs. Gamble - Case Study

Introduction

Adherence to prescribed medication and in the right dosage is crucial to positive health outcomes -- it can save emergency hospitalisations and also disease complications. However, recent research revealed that over 60% patients do not understand their prescribed medication regimen properly and hence, become non-compliant (Conway & Freedman, 2017). According to this research, the health care sector can save about $100-$300 billion in healthcare costs resulting from such medication non-compliance by patients. Perhaps, the only way to save these costs is through proper patient education, so that patients do not self-medicate or do not remain less informed about their medicines and doses. Unless they adhere to their prescribed treatment plan, recovery is difficult and further disease costs and complexities are inevitable. Nurses and healthcare professionals have the responsibility to educate patients about their disease, medicines, treatment program, self-management techniques, etc. (Bergh, et. al., 2015). The case of Mrs. Gamble is one such scenario where the patient is under-informed about her condition and takes medicines in wrong dosage. In her condition, this might turn fatal. Therefore, it has been assessed that she needs an appropriate health education plan to manage her health better. 

This document is a health education plan customised for Mrs. Gamble to help her be more aware of her disease and its proper management. It is not only intended to serve as a sample for Mrs. Gamble's atrial fibrillation management, but also inspire other clinicians to incorporate health education plans into their patient-care routine, which they usually neglect doing (Paterick, et. al., 2017).

Mrs. Gamble: Case Brief

According to the case study, Mrs. Gamble is a 78 year old widow, who was started on Warfarin therapy (Coumadin tablets) about three months ago, after she was found to be suffering from atrial fibrillation (AF). Atrial fibrillation is a condition where the heart beats irregularly, increasing chances of blood clots and stroke (Government of Western Australia, n. d.).  Her international normalized ratio or INR is tracked on a weekly basis. The INR is a standard method for assessing the risk of bleeding and blood clotting time (Shikdar & Bhattacharya, 2018). When a patient is on Coumadin, as is the case with Mrs. Gamble, the normal therapeutic INR range is between 2.0 and 3.0 (Cunha, 2018). INR levels below 2 suggest susceptibility to easy blood coagulation and that above 3 suggest excessive bleeding tendencies in the patient. 

Mrs. Gamble had a recent pneumonia attack and was admitted to the hospital for treatment. There, her INR was found below 2.0, at 1.5. This indicated a propensity towards blood clotting and consequent stroke. Naturally, the clinicians doubted her medication adherence and upon testing, she was found to be knowledge deficient about her condition and treatment plan. Her knowledge deficit areas were:

• She was unaware why she was still on Warfarin therapy.
• She could not differentiate between the various bottles of Warfarin having different dosages of Coumadin.
• She did not know how Warfarin worked and how it helped her condition.
• She did not know why Warfarin intake interfered with the consumption of some of her favourite foods like the broccoli and green leafy salads.