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
Literature review
The project aims at promoting a health goal by ensuring old adults maintain health-related quality of life and well-being. The goal will be achieved by conducting a study that aims at promoting healthy prescription filling behaviors in the elderly to prevent Polypharmacy. The literature reviewed should be related to the following issues. The study will use the Scott Gray, et al. (2012) ten-step conceptual framework used to identify and discontinue potentially inappropriate drugs. The ten steps are:
Accurately ascertain all drug use
Identify patients at risk or those suffering
Estimate life expectancy
Define the overall goal
Verify current indication for the ongoing treatment
Determine need for disease-specific preventing medication
Determine the benefit-harm level of the medication
Review the relative utility of individual drugs
Identifying those drugs to be discontinued and seek patient consent
Device and implement a discontinuation drug plan and conduct a close monitoring of the patient
These ten steps play a significant role in identifying materials for the literature review. The literature review will be conducted following the rules. First, a thorough background reading of all materials related to the topic of study will be done. The reading will involve going through books, journals, past projects, and other relevant materials to determine their influence on the project topic. Second, the research team will derive search terms from project topic. The terms will be used to search for relevant journals, articles, and organizational reports. The search process will produce millions of related sources of information, but the researcher should select only sources that are more relevant and important to the research topic. Sources that focus on the relationship between the health care of the elderly and Polypharmacy will be selected for the literature review. The selected sources for the literature review will journal articles written within the last five years to capture current events. According to (Liverpool Hope University, 2012), journals act as the main source of information that most researchers rely on while conducting the literature review.
Data sources
After reviewing the literature and identifying the research gaps, the research team embarks on establishing data sources. Researchers acquire data from two primary sources, the primary and the secondary sources. The source identified should meet the research goals and answer all research questions. The project will rely on both sources of data to help close the research gaps and achieve expected outcomes. The secondary data will be collected from health care organizations’ records. On the other hand, the research will gather information from primary sources. Primary information will come from participants in the study who will include elderly adults, caregivers, and selected health care organizations.
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.
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.
