Step I
The health promotion goal
The U.S. health care system’s goal is to maintain health-related quality of life and well-being by evaluating the emotional, physical, mental, and social functioning of an individual. The focus aims at determining the impact of the health status of a person the quality of life in additional to other measures such as causes of death, life expectancy, and population health (Healthy People 2020, 2016). The project aims at improving the health, function, and quality of life by promoting healthy prescription filling behaviors in the elderly adult to prevent Polypharmacy.
Proposed intervention to address the goal
Health care organizations record many hospital readmissions, numerous clinical complications, and deaths caused by lack of medical adherence by patients. However, health care information technologists have introduced a technology capable of identifying patients at risks of medication effect and those with poor adherence to medication. Experts in the health profession have developed and tried numerous interventions to help prevent Polypharmacy among older adults, but less has achieved expected outcomes. The project proposes an intervention that ensures health care professionals used technologically advanced measures of medication adherence to establish risk factors associated with the uptake of a specific type of medication by an elderly adult.
Importance of the project to the student’s future role as an advanced family nurse practitioner
Nursing students have a big role to play in transforming the health care sector in the future by putting skills and knowledge learned in class in practical use. The project will have a lot of impact on the nurse as a family nurse practitioner by ensuring the elderly people receive proper health care and never suffer from Polypharmacy. On the other hand, the project will involve the gathering of information about the causes and effects of Polypharmacy among old adults. The information collected will help the student gather more knowledge about Polypharmacy and determine additional barriers to old adult health; hence, develop strategies to overcome such barriers while in the practice of a family nurse practitioner. The outcome of the project will lead to the development of recommendations that the nurse student can implement while delivering care to the old and ensure they maintain health-related quality of life and promote in individual well-being.
Plan for identifying needed data and information to develop the project
The plan for identifying needed data and information to develop the project will follow five major steps.
Step 1: Determining existing data sources
The process involves identifying data sources that are already available. The available data will be collected from health care organizations and nursing homes taking care of the elderly
Step 2: Identifying gaps in the information and evaluating their influence in meeting the project goals
Research must have gaps that make it different from previously conducted studies. The project gaps will be achieved through a thorough literature review that will identify methods used by other researchers to collect data, their validity, and their critics. Information collected from the literature review will help to identify new methods of gathering information for the project. The proposed method must meet the project goals.
Step 3: Determining methods of collected new information
The method selected to collect data and information should represent every element of the study population. Additionally, the selected method should be able to achieve the project objectives and help answer all research questions.
Step 4: Evaluating the available resources to determine whether the planned method will be achieved and within the provided time frame
The resources available to carry out the project determine the workability of the proposed data collecting plan. The method identified should be capable of utilizing available resources and within the project’s given time frame.
Step 5: Determining requirements for privacy and ethics
The project will involve data collection that requires the project team to have permission and ethical rights to collect the information. All requirements for the participant’s privacy and application letters to the organization of study must be acquired before engaging in data collection.
Step II
Comprehensive review of literature and data sources
The following section provides a comprehensive review of the literature and data sources used to conduct the project. The objective of the project was to promote prescription filling behavior on elderly to prevent Polypharmacy. Debbie Kwan and Barbara Farrell conducted a study to investigate Polypharmacy by studying optimizing medication use in elderly patients. The study focused on risks for Polypharmacy associated with the elderly and adverse drug reactions. The authors claimed that age-related changes have a lot of impact on drug absorption rate in the body; hence, a need to optimize medication use among the aging population. Different case studies were investigated in the research. The research results revealed that Polypharmacy is a common problem among the elderly (Kwan and Farrell, 2014). There is an urgent need to develop interventions to prevent the issue in the future because of the large number of people reaching the age of 65 and above. The problem may be worse with a big population. The following project developed an intervention that promoted early detection of adherence and risks of medication in elderly using a computerized approach. The findings of Kwan and Farrell played a critical role in improving the outcome of the intervention by introducing standardized measures.
On the other hand, Loffler, Drewelow et al. (2014) conducted a study to optimize Polypharmacy among elderly hospitalized patients with chronic diseases. The study randomized controlled Polite-RCT trial to determine the effectiveness of an intervention aimed at reducing the number of prescribed long-term drugs among the target population. The intervention made use of different stakeholders including patient-centered medication review team and pharmacist-based professional team. A face-to-face communication with hospitalized patients to collect information about their prescribed medication and potential impacts was utilized during the study. The study targeted old patients suffering from chronic diseases aged 65 and above and having more than five prescribed long-term medications. The study outcome revealed that inappropriate medical prescription among elderly people has negative outcomes on their health. Researchers called for health care organizations to promote acceptable filling behaviors by enhancing patient autonomy and patient-centeredness (Loffler, Drewelow et al., 2014). The research revealed some barriers to data collection because researchers used patients as the source of information to conduct an intervention. The project utilized computerized assessment process to detect patient’s adherence to medication.
Evidence of synthesis and analysis of literature
The table below shows 3 selected journals and articles that will be utilized during the literature review.
Overview of a theoretical framework
The project used the Scott et al. ten-step conceptual framework. Figure 1 represents the overview of the theoretical framework.
Figure 1: The proposed conceptual framework
Interventions based on literature review
People face numerous health-related issues that influence their health care related and well-being. Among the most affected population is the old adult. Older adults record the highest growth rate among all other age groups with the country having a population of approximately 37 million old adults. Additionally, older adults stand higher chances of developing chronic diseases (Woodruff, 2010). Older adults have the highest rate of medicinal consumption in the United States contributed by increasing cases of chronic conditions among this age group. Older adults face numerous health problems forcing health professionals to prescribe different types of drugs. Unlike the young population, elderly adults face different and problematic reactions to medications. Polypharmacy affects the health-related quality of life and well-being of the elderly people; hence, need to develop measures to overcome the problem. Adverse reactions towards drugs are experienced more in older adults that in younger people. According to Woodruff (2010), approximately 35 percent of older adults face adverse effects every year, with 29 percent of these reactions calling for a hospital admission. In many cases, the negative effect of one drug goes unnoticed making the physician prescribe another drug to the patient to cure the same health problem. Moreover, old adults face a major challenge in managing multi-drug regimes considerations brought about by functional limitations, cognitive impairments, using multiple health care providers, transportation and financial barriers (Marcum & Gellad, 2012). A review of the literature leads to these interventions:
Validating risk assessment tools and interdisciplinary models of care to address the issues of Polypharmacy among elderly people
The project to report its outcomes to the relevant bodies for evaluation to ensure recommendations are replicated in the clinical practice.
References
Cooper, J. A., et al. (2015). Interventions to improve the appropriate use of polypharmacy in
older people: a Cochrane systematic review. BMJ Open, 5, 1-12
Healthy People 2020. (2016, February 26). Health-Related Quality of Life and Well-Being.
HealthyPeople2020.gov. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Health-Related-Quality-of-Life-and-Well-Being
Kwan, D. and Farrell, B. (2014). Polypharmacy: optimizing medication use in elderly patients,
CGS Journal of CME, 1(4), 21-27
Liverpool Hope University. (2012, September). Doing literature search: a step by step guide.
Loffler, C., Drewelow, E. et al. (2014). Optimizing Polypharmacy among elderly hospital
patients with chronic diseases-Study protocol of the cluster randomized controlled POLITE-RCT trial. Implementation Science, 9(151).
Marcum, Z. A., & Gellad, W. F. (2012). Medication Adherence to Multi-Drug Regimens. Clinics
in Geriatric Medicine, 28(2), 287–300.
Scott, I. A., Gray, L. C., Martin, J. H., Pillans, P. I., and Mitchell, C. A. (2012). Deciding when
Wang, K. A, Camargo M, and Veluswamy, R. R. (2013). Evidence-based strategies to reduce
polypharmacy: A review. OA Elderly Medicine, 1(1):6.
Woodruff, K. (2010). Preventing Polypharmacy in older adults. American Nurse Today, 5(10),
1-8.
