NONCOMPLIANCE DEFINITION Behavior of person and/or caregiver that fails to coincide with a health-promoting or therapeutic plan agreed on by the person (and/or family and/or community) and health-care professional.In the presence of an agreed-on, health-promoting or therapeutic plan, person’s or caregiver’s behavior is fully or partially nonadherent and may lead to clinically ineffective or partially ineffective outcomes DEFINING CHARACTERISTICS • Behavior indicative of failure to progress • Complications or evidence of exacerbation of signs and symptoms • Failure to keep appointments and adhere to treatment regimen • Objective indications (e.g., laboratory tests, physiologic markers) RELATED FACTORS Health system Individual • Access to, convenience of care • Cultural/spiritual values • Client–provider relationships • Developmental and personal • Individual health coverage abilities • Provider communication skills, • Health beliefs credibility; continuity; teaching skills; reimbursement • Knowledge of regimen • Motivational forces Healthcare plan Network • Complexity, intensity • Involvement of members in • Cost, ﬁnancial ﬂexibility, and health plan duration of plan • Social value regarding plan ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.) • Behavior • Knowledge • Beliefs/values • Roles/responsibilities • Coping • Self-perception • Emotional status EXPECTED OUTCOMES The patient will • Identify factors that inﬂuence noncompliance.Assessment information may help select appropriate interventions.Perform: Provide an environment that is nonjudgmental.Does he need to be stop taking the pill or can he stay on the pill while we try for a baby? Q: Lotrel 10/20 is a blood pressure medicine, can you take Toprol XL also, because it too lowers the blood pressure? Q: I'm taking Vytorin and was wondering if it's ok to take a diet smart multivitamin/dietary supplement with EGCG ? Q: I get diarrhea about the same time every day, pm. If I went back on nexium is there any long term side effects? A: Robitussin and Penicillin may be used together with no problems.I am convinced that one of my new medicines is causing it. A: It would be unlikely Nexium will cause long term side-effects. You'll need a doctors diagnosis to differentiate between the flu and pneumonia.
Updates of OBRA guidelines have liberalized some dosing restrictions, but documentation of necessity and periodic trials of medication withdrawal are still emphasized.Anxiety and insomnia are common problems in the institutionalized elderly.If behavioral measures are not successful, antidepressant medications with shorter half-lives may avoid drug accumulation, which can lead to excessive sedation, cognitive impairment and an increased risk for falls.• Demonstrate level of compliance that maintains safety. • Use support systems to modify noncompliant behaviors.SUGGESTED NOC OUTCOMES Acceptance: Health Status; Adherence Behavior; Compliance Behav- ior; Symptom control; Treatment Behavior INTERVENTIONS AND RATIONALES Determine: Assess patient’s perception of health problem, treatment regimen and history of compliance, obstacles to compliance, ﬁnancial 237 resources, ethnicity, and religious inﬂuences.Improving the quality of care for nursing home residents has been a major concern for years.