NURS FPX 4905 Assessment 3 Technology and Professional Standards
Student Name
Capella University
NURS FPX 4905
Professor Name
Submission Date
Technology and Professional Standards
Quality of life, safety, and continuity of care can be greatly enhanced by technology and professional standards among individuals with a mental health disorder. Cognitive impairment may adversely impact medication adherence in adults with major depressive disorder (MDD) who also have dementia, since they may have difficulty regulating their medications and may miss taking their medication. A systematic review established that cognitive impairment had a significant impact on reduced medication adherence (Harris et al., 2025). This article presents a discussion on the role of registered nurses (RN) prepared to complete a BSN degree as one of the factors in enhancing adherence and outcomes among this group of patients, covering the following areas: process change, interdisciplinary teamwork, governmental recommendations, current and future technology, and the challenges in implementation.
Role in Process Change and Professional Standards
Evidence-based practice, quality improvement, and professional nursing standards enable the BSN-prepared RN to initiate the process of change. The experience at the Mayo Clinic of an RN working to curb medication barriers and simplify processes. The interdisciplinary group enables the RN to work with other disciplines to improve the treatment of adults with MDD and dementia through a collaborative approach. The Scope and Standards of Practice of the American Nurses Association identify quality improvement and leadership as some of the central areas of practice of the RN (American Nurses Association, 2021). In the capacity of a nursing student, I was part of the observation related to the existing medication reconciliation process and the records of patient medication adherence in the electronic health record (EHR) at Mayo Clinic.
In the interactions with the psychiatric nurse practitioner and the clinic RN, I discussed the issue of medication adherence. Nevertheless, as a licensed RN, I will be able to establish systematic adherence screening procedures and assist family caregivers of adults with dementia to be part of the adherence monitoring process. Research has determined that medication reconciliation and adherence monitoring activities are better coordinated, which results in improved medication safety and continuity of care for adult patients with MDD (Fatemi-Nejad et al., 2025). Additionally, Minnesota has given nurses the authority to assess, implement, evaluate, and coordinate care and take part in quality improvement programs by the Minnesota Nurse Practice Act (Minnesota Board of Nursing, 2024). Thus, the role of the BSN-prepared RN is crucial to improving medication adherence for adults with MDD and dementia.
Interprofessional Collaboration
Effective medication administration of older adults with MDD and dementia can be facilitated by interprofessional collaboration. The interprofessional team at Mayo Clinic comprised a psychiatric nurse practitioner, a registered nurse, a pharmacist, a care coordinator, a primary care provider, and family caregivers, who collaborated to facilitate medication safety and continuity of care. The psychiatric nurse practitioner prescribed and changed medications for the patient. The registered nurse assisted with the patient intake procedure, medication reconciliation, medication education, and medication adherence checks. An observational study suggested that collaboration between nurses, prescribers, pharmacists, and caregivers having proven a positive impact on medication adherence and adverse drug-related events in older adults who use multiple medications (Perron, 2024).
More opportunities for collaboration with patients on various psychotropic drugs could be established by expanding regular pharmacist consultations. This collaborative approach might also be enhanced by including family caregivers in medication education and follow-up visits. My practicum experience allowed me to support indirect collaboration with the psychiatric nurse practitioner by including medication adherence problems in the EHR, which would be reported to the nurse. Nevertheless, as a student nurse, I could not make independent decisions to use interprofessional interventions.
Assuming that I was a licensed RN who was working in this setting, I would refer to the primary care provider and advise the patient to make a referral to the pharmacist to assist with the polypharmacy. I would also arrange educational activities among caregivers on medication reconciliation meetings and join team case conferences to discuss medication adherence issues. I would also report the progress of the patient to other health care professionals. I would also ensure the advocacy of adherence support services, which are recommended by the evidence-based practice, to enhance medication adherence, safety, and outcomes among older adults with MDD and dementia.
Recommendations of Government and Accreditation Agencies
Suggestions of different governmental and accreditation agencies strengthen the safe medication handling of adult patients with MDD. The guidelines of the Joint Commission also valued the significance of appropriate medication reconciliation, as well as periodic review of suicide risk, to avoid medication errors and ensure patient safety in behavioral health care contexts (The Joint Commission, 2025). Both practices assist in diagnosing possible medication-related problems at a young age and result in effective treatment in MDD and dementia.
The Centers for Medicare and Medicaid Services (CMS) has placed emphasis on the following treatment practices. In particular, they proposed measuring adherence with antidepressants at both the acute and continuation stages of the treatment to enhance patient outcomes and reduce the likelihood of a relapse (Centers for Medicare & Medicaid Services, 2024). Measurement: Quality indicators promoted continuous performance improvement in nursing, fostered by the National Database of Nursing Quality Indicators (NDNQI) (Nelson-Brantley et al., 2026). Another possible quality indicator that enhances accountability in general and could positively affect continuity of care is adherence measurement. These government guidelines will probably ensure safer medication management of patients with MDD and dementia at Mayo Clinic, as shown above.
Current Technology Used at the Practicum Site
Mayo Clinic uses one enterprise-wide EHR as its primary technology to incorporate medication management in patient care. The system features electronic prescribing, medication reconciliation, clinical documentation, and secure communication features to help clinicians have an up-to-date list of medications the patient is taking and improve continuity of care. Patients can also access their own medication lists and engage in secure communication with their care team using a patient portal. Reconciliation is the best process towards the reduction of medication errors in care, as stressed by the researchers (Ahmed et al., 2025).
The issue with relying on an EHR in the present-day patient context, however, is that the system is reliant upon patients themselves providing information regarding medications during reconciliation, and with patients who have MDD and dementia, their cognitive ability may preclude this. Equally, elderly people do not use patient portals because of poor levels of digital literacy. The issue with the use of EHR today is that they rely on the patients providing correct information about their medication during self-disclosure. However, this might not be well done by patients with both MDD and dementia, due to their cognitive impairment. Similarly, patient portals are not frequently utilized by older adults, whether because they are low-digital literate or because a caregiver has less access to it instead. This implies that issues of medication compliance may be overlooked.
Technology Available and Recommended in the Literature
Recent articles indicate that medication adherence among adults with MDD and cognitive impairment will be improved with the use of technologies outside of the traditional EHR. The recommended technologies were smart medication dispensers (SMD), automatic medication reminders, remote adherence, and remote caregiver notification systems. Researchers claimed that adherence and the number of missed doses decreased in adults with cognitive impairment with the use of smart medication dispensers that contained a dose reminder, caregiver notification, and an adherence dashboard (Wainwright et al., 2026).
Other research studies advocated the use of medication dispensers with sensors to authenticate medication uptake and have a real-time dashboard of adherence so that clinical personnel can see it. Nurses could easily access the information about which patients were missing in-between doses, and interventions with caregivers could be planned earlier. By adopting this evidence-based technology from the Mayo Clinic, it would enhance medication monitoring, facilitate better communication between the giver and the caregiver, and improve the promptness of nursing intervention. This would, in turn, enhance medication compliance and response to treatment among adults with MDD and dementia.
Potential Implementation Issues
There will be certain obstacles in implementing a smart medication adherence technology into the practice of Mayo Clinic. The biggest concern will probably be financial barriers, since most smart medication systems are not included in the standard insurance packages; thus, not every patient will be able to use these systems. A single study identified a relationship between financial constraints and the reduction of antidepressant medication adherence, which is why adherence technologies that do not increase the financial burden are needed (Baryakova et al., 2023).
It would also require training of staff, caregivers, and patients to effectively use and respond to the system. Moreover, the technology will need to be integrated with the EHR and be secure and in compliance with the Health Insurance Portability and Accountability Act (HIPAA). Caregiver involvement might also be necessary, particularly in situations where medication adherence support is needed by the patient with dementia, and thus effective implementation will necessitate the involvement of a caregiver.
Practicum Hours
During my 20 practicum hours at the Mayo Clinic Behavioral Health Clinic, I spent 2 hours observing medication reconciliation during intake and follow-up appointments while reviewing the EHR medication reconciliation records. In addition, I managed to complete 2 hours shadowing psychiatric medication management sessions, having the opportunity to participate in discussions concerning adherence problems with the psychiatric nurse practitioner and RN. I was also present during another 2 hours of interdisciplinary interaction between the psychiatric nurse practitioner, RN, pharmacist, primary care provider, care coordinator, and family care partners. To establish the scope of the RN in terms of quality improvement initiatives, I was given 2 hours of study on the American Nurses Association Scope and Standards of Practice and Minnesota Nurse Practice Act. I also had 2 hours of an evaluation of the current EHR, e-prescribing, and medication reconciliation process, and the patient portal at Mayo Clinic.
In 2 hours, I reviewed the literature on smart medication dispensers and the remote monitoring technologies that are applied to support medication adherence and compared it to the existing practice. The other 2 hours of my practicum was spent in a literature review of the recommendations given by The Joint Commission, CMS, and the NDNQI regarding medication safety and quality improvement initiatives. 2 hours of my time were used assessing challenges with implementation, including cost, training, integration of technology, and caregiver buy in. During the last 4 hours, I thought about the experience and combined new evidence with clinical observations, and developed evidence-based interventions that will be used to enhance adherence and patient outcomes among adult patients with MDD and dementia.
Conclusion
Professional standards and technology can enhance medication adherence among dementia and MDD patients. The BSN-prepared RN can enhance the process by utilizing leadership, interdisciplinary collaboration, and evidence-based practice. Best practices set by government and accrediting bodies improve proper and safe usage of drugs. Smart adherence can also be improved to improve patient monitoring and timely nursing intervention. As much as implementation of smart adherence technologies might be challenging, proper planning, educating staff, and participation of family caregivers can make it a successful intervention in the Mayo Clinic behavioral health clinic. This method will improve medication adherence, patient safety, and clinical outcomes by integrating both professional standards and state-of-the-art technology.
References
Ahmed, S. A., Aziz, A., & Sethi, S. M. (2025). Improving medication reconciliation compliance in a tertiary care hospital of a developing country: A quality improvement initiative using the PDSA cycle. BMJ Open Quality, 14(4), e003487. https://doi.org/10.1136/bmjoq-2025-003487
American Nurses Association. (2021). Nursing scope of practice. In American Nurses Association. https://www.nursingworld.org/practice-policy/scope-of-practice/
Baryakova, T. H., Pogostin, B. H., Langer, R., & McHugh, K. J. (2023). Overcoming barriers to patient adherence: The case for developing innovative drug delivery systems. Nature reviews drug discovery, 22(22), 1–23. https://doi.org/10.1038/s41573-023-00670-0
Centers for Medicare & Medicaid Services. (2024). 2024 National impact assessment of the centers for medicare & medicaid services (CMS) quality measures report. https://www.cms.gov/files/document/2024-national-impact-assessment-report.pdf
Fatemi-Nejad, M., Mehrpooya, M., Ahmadimoghaddam, D., Shirmohammadi, K., Zamanirafe, M., Sharifikia, M., & Eshraghi, A. (2025). Improving medication safety with proactive reconciliation in acute coronary syndrome patients: A randomized trial. Exploratory research in clinical and social pharmacy, 18(2), 100577–100577. https://doi.org/10.1016/j.rcsop.2025.100577
Harris, D., Mandarino, M. J., Gregg, A. P., & Freedberg, A. (2025). Medication adherence: Challenges and strategies for older adults. Mental health clinician, 15(2), 40–42. https://doi.org/10.9740/mhc.2025.04.040
Minnesota Department of Health. (2025). Nursing practice standards: Scope of nursing practice decision-making framework. https://www.health.state.mn.us/people/childrenyouth/schoolhealth/nps/standards.html
Nelson-Brantley, H., Pascale, A., Losty, L. S., & Warshawsky, N. E. (2026). The national database of nursing quality indicators: Delivering on a promise. The Journal of nursing administration, 56(5), 233. https://doi.org/10.1097/NNA.0000000000001718
Perron, A. E. (2024). Towards a prescription for change: Interprofessional management of polypharmacy and deprescribing. Current geriatrics reports, 13(3). https://doi.org/10.1007/s13670-024-00420-z
The Joint Commission. (2025). National patient safety goals® e ective January 2026 for the behavioral health care and human services program goal 1 goal 3 introduction to Reconciling medication information. https://digitalassets.jointcommission.org/api/public/content/495eaf1731824b748fe5a3384da1da99?v=5e625246
Wainwright, J. E., Bennett, A., Randhawa, G., Pappas, Y., Singh, H., & Cook, E. J. (2026). Assessing the impact of automated devices for enhancing health and reducing medication errors in older adults with long-term health conditions (adhere): A study protocol for a randomised controlled trial. BMJ Open, 16(1), e104359. https://doi.org/10.1136/bmjopen-2025-104359