PHARMACOLOGY PHARMACOLOGY
KNOWLEDGE RETENTION IN
PALLIATIVE CARE NURSES
Regina Kendall
Nurse Practitioner Candidate
GRPCT
Acknowledgements Acknowledgements
• Dr David Brumley
• Dr Greg Mewett
• Jan Milliken
• Jan Milliken
• Jade Odgers
• Bernadette Matthews Kim Smith
• Kim Smith
Background Background
• Grampian Regional Palliative Care Team (GRPCT)
• Training Plan development
• 5000 Attendee’s over four years E l ti
• Evaluation
• Aim of Study day:Aim of Study day:
– Improve pharmacology knowledge
– Assess knowledge retention of participantsg p p
Methodology Methodology
• Format
• Development of Questionnaire
• Anonymity
• Data Collection
Study Days Study Days
• Participants Di 1N
– Div 1Nurses
– Div 2 Nurses (Medication endorsed)
• 334 attendances
• Areas of practice
• Voluntary participation
Data Analysis Data Analysis
• Total attendances: 334
• Data excluded: 19
• Data for analysis: 315
• 6 week return: 36%
Findings Findings
Pass rates
• Pre test: 23%
• Post test: 97%
• 6 week post test: 96%p
Further Analysis Further Analysis
Sub analysis of four questions relating to:
– Nausea – Pain
– Anxiolytics
Questions Questions
Which anxiolytic agent has the shortest half life in hours?
hours?
A. Diazepam 14-200 hours 14-200 hours B. Lorazepam
8 24 hrs 8-24 hrs
C. Clonazepam 19 60 hours 19-60 hours D. Midazolam
2 3 hours 2-3 hours
Which anxiolytic agent has the shortest half life in hours?
half life in hours?
90 100
70 80 90
40 50
60 Diazepam
Lorazepam Clonazepam 20
30
40 Clonazepam
Midazolam
0 10
Pre Post 6 WK postp
Questions Questions
Which of the following drugs is not suitable for continuous s c infusion?
continuous s.c. infusion?
A Metoclopramide A. Metoclopramide B. Haloperidol
C P hl i
C. Prochlorperazine D. Cyclizine
Which of the following drugs is not suitable for continuous s c
suitable for continuous s.c.
infusion?
100
70 80 90
40 50
60 Metoclopramide
Haloperidol
Prochlorperazine
10 20 30
40 Prochlorperazine
Cyclizine
0 10
Pre Post 6 WK post
Questions Questions
Concerning haloperidol, which of the following statements is true?
A. s.c administration is more likely to lead to Parkinsonian side- effects than when given orally
effects than when given orally
B. Its long half-life means it can be given only once or twice daily
daily
C. The usual anti-emetic doses cause significant sedation D. Its use is contraindicated in renal failure
Concerning haloperidol, which of the following statements is true?
90
60 70 80
40 50 60
A B C 20
30
C D
0 10
Pre Post 6 Wk Post
Questions Questions
When changing a patient from twice-daily slow-
release morphine to a fentanyl patch, when should p y p , the last dose of SR morphine be given?
A Give last dose of SR morphine in the morning & apply A. Give last dose of SR morphine in the morning & apply
patch in evening
B. Give last dose of SR morphine at the same time as p applying patch
C. Apply patch in the morning then give last dose of SR morphine 12 hours later
morphine 12 hours later
D. Apply patch then give last dose of SR morphine 24 hours later
When changing a patient from twice-daily slow-release morphine to a fentanyl patch, slow release morphine to a fentanyl patch,
when should the last dose of SR morphine be given?
given?
100
70 80 90
40 50
60 A
B C
10 20 30
40 C
D
0 10
Pre Post 6 Wk Post
