Date of Award

Spring 5-27-2023

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Michelle Kabakibi

Second Advisor

Joseph Burkard

Abstract

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to identify and implement a patient education program on medication safety that can help reduce instances of polypharmacy among home-based elderly patients. This education program is pursued as an effective intervention in reducing polypharmacy in home-based older adults.

Background: Studies show that the majority of home-based older adults take at least one to five medications daily, increasing the risk of polypharmacy adverse medical outcomes. Effects of polypharmacy include medication non-adherence, increased risk of potentially inappropriate medication, drug-drug interactions, drug duplications, adverse drug reactions, and higher healthcare costs. Among home-based elderly patients, polypharmacy has a significant impact on their health outcomes. Although certain measures such as a reduction in the number of medications can be pursued, they may not be applicable at all times.

EBP Model/Frameworks: The evidence-based project is designed utilizing the Promoting Action on Research Implementation in Health Services (PARiHS) Framework. The three elements of the model, searching for evidence, identifying the context, and facilitating the implementation process will identify the impacts of the intervention.

Policy Interventions: Anonymous interviews were administered to older patients and their caregivers to identify issues related to drug-drug interactions and possible side effects. A follow-up interview was administered to determine the impacts of patient education on preventing polypharmacy and its side effects.

Evaluation/Results: The results demonstrated that as polypharmacy decreased, patient outcomes improved. Patients also reported an increase in their quality of life (QOL) over 6 months.

Implications for Practice: Patient-centered education on medication safety has the potential to reduce the impacts of polypharmacy in older adults. The evidenced-based project revealed that providing patients with proper information increases the safety of their medication administration by reducing medication errors and improving patient outcomes. Involving caregivers in the education program further leads to improved patient outcomes.

Conclusions: Future research can focus on the specific medication safety topics that can be provided in patient education at various stages of their care. Particularly, the impact of providing patient education opportunities at least twice or thrice a year.

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