Feedback

Review the feedback on the change proposal professional presentation and make required adjustments to the presentation. Present your evidence-based intervention and change proposal to an interprofessional audience of leaders and stakeholders. Be prepared to answer questions and accept feedback.

After presenting your capstone project change proposal, write a 250–350-word summary of the presentation. Include a description of the changes that were suggested by your preceptor before your presentation and how you incorporated that feedback. Describe how this interprofessional collaboration improved the effectiveness of your presentation. Include a description of the feedback and questions from your audience after your presentation, and how this experience will affect your professional practice in the future.

APA style required, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

NRS 493

06/07/2022

Capstone Project Change: Adverse Drug Reactions among Older Adults

 

 

 

Background/Problem

ADEs results to 1.3 million emergency visits annually

Older adults (65 + years) at higher risk of ADEs

ADEs causes include wrong prescription, cognitive and sensory impairment etc.

ADEs have many negative repercussions on the healthcare system and patients. They increase financial costs in health due to increased LOS and patient readmissions. Also, ADEs result to reduced patient safety.

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Intervention

Two methods were proposed: electronic medication and educational training for healthcare practitioners

The best approach between the two is electronic medication

Therefore, the change project focuses on introducing electronic medication to deal with ADEs

N.B: Educational training for healthcare practitioners and patients on prescriptions and medications can also reduce Adverse Drug Events. However, the most suitable method is electronic medication.

Electronic medication- automatically documents the administration of medication into certified EHR technology using electronic tracking sensors

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Evidence-Based Literature

Search Strategy

Articles to support intervention were searched on Google Scholar and PubMed

All articles published within five years

Key search word was electronic medication and Adverse Drug Events

Articles published within five years have current information on electronic medication. The Boolean operator (and) was used to limit the number of results

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Evidence-Based Literature

 

Findings

Electronic medication can reduce time nurses spend with patients (Gregory et al., 2021)

Electronic medication is a better intervention in reducing ADEs (Li et al., 2019)

Patients are more optimistic about e-prescribing (Lau et al., 2018)

Electronic medication improves patient safety (Wang et al., 2019) and workflow (Kinlay et al., 2021)

The study by Li et al., (2019) compared different interventions including education and training. On the other hand, Gregory et al., (2021) recommends for more research because electronic medication reduce the time nurses spend with their patients. Electronic medication enhances collaboration between healthcare practitioners in improving patient outcomes.

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Change Objectives

Enhance workflow at hospital facilities (Kinlay et al., 2021)

Improve patient safety (Wang et al., 2019)

Lower healthcare costs

Improve clinical practice and reduce medication errors (Bugnon et al., 2021)

The change objectives are derived from the literature findings on the selected intervention (electronic medication). These objectives will address the current problems experienced hospital facilities due to high number of ADEs. They include advanced workflow, improved patient safety, and reduced healthcare expenditures.

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Resources Needed

 

Tools to facilitate electronic medication include: digital displays, audiovisual reminders real-time monitors and recording tools (Checchi et al., 2014)

Trained personnel who can efficiently these tools to undertake electronic medication

Electronic Health Record (EHR) database

The five Electronic Medication Practice (EMP) characteristics include recording dosing events and storing a record of adherence, audiovisual reminders to cue dosing, digital displays, real-time monitoring, and providing patients with adherence performance feedback (Checchi et al., 2014). A successful electronic medication system must incorporate these characteristics.

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Expected Outcomes

 

 

Reduced readmissions at the facility

 

 

Reduced Length of Hospital Stay (LOS) for targeted patient population

 

 

Reduced operational costs/treatment expenditures

 

 

Increased patient safety/low infection risks

 

 

Reduced number of ambulatory visits to hospitals

 

 

Evaluating Electronic Medication Effectiveness

Reviewing patients’ opinions on the intervention through interviews

Assessing healthcare expenditures after implementing the change and compare them to previous expenditures (quasi-experiments)

Analysis of the budgetary needs to sustain the intervention

Assessing infection rate, ambulatory visits and LOS using hospital records

The evaluation of the intervention will be outcome-based. Evaluation data will be obtained through interviews with the patients and healthcare practitioners, hospital documents and quasi experiments. The aim will be to determine whether the change objectives of promoting patient safety, workflow, advancing clinical practice and a reduction of healthcare costs are met.

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References

Bugnon, B., Geissbuhler, A., Bischoff, T., Bonnabry, P., & von Plessen, C. (2021). Improving primary care medication processes by using shared electronic medication plans in Switzerland: Lessons learned from a participatory action research study. JMIR Formative Research, 5(1). https://doi.org/10.2196/22319

Checchi, K. D., Huybrechts, K. F., Avorn, J., & Kesselheim, A. S. (2014). Electronic medication packaging devices and medication adherence. JAMA, 312(12), 1237. https://doi.org/10.1001/jama.2014.10059

Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive Care Nurses’ experiences with the new electronic medication administration record. Nursing Open, 9(3), 1895–1901. https://doi.org/10.1002/nop2.939

Kinlay, M., Ho, L. M., Zheng, W. Y., Burke, R., Juraskova, I., Moles, R., & Baysari, M. (2021). Electronic Medication Management Systems: Analysis of enhancements to reduce errors and improve workflow. Applied Clinical Informatics, 12(05), 1049–1060. https://doi.org/10.1055/s-0041-1739196

 

 

 

References

Lau, G., Ho, J., Lin, S., Yeoh, K., Wan, T., & Hodgkinson, M. (2018). Patient and clinician perspectives of an integrated electronic medication prescribing and dispensing system: A qualitative study at a multisite Australian Hospital Network. Health Information Management Journal, 48(1), 12–23. https://doi.org/10.1177/1833358317720601

Li, R., Zaidi, S. T., Chen, T., & Castelino, R. (2019). Effectiveness of interventions to improve adverse drug reaction reporting by healthcare professionals over the last decade: A systematic review. Pharmacoepidemiology and Drug Safety, 29(1), 1–8. https://doi.org/10.1002/pds.4906

Wang, H., Meng, L., Song, J., Yang, J., Li, J., & Qiu, F. (2018). Electronic medication reconciliation in hospitals: A systematic review and meta-analysis. European Journal of Hospital Pharmacy, 25(5), 245–250. https://doi.org/10.1136/ejhpharm-2017-001441

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