Description of the Health Organization
- The chosen healthcare organization is Atrium Health.
- They provide medical care and healthcare services of the highest quality.
- Their ethics are based on four core values.
- They specialize in cancer treatment and care, pediatric care, heart care, and organ transplants.
- Their other specialties are musculoskeletal pain management and treatment, burn treatment, and virtual care.
- The Innovation Engine allows the development and implementation of new ideas, knowledge, and suggestions.
These four core values are “caring, commitment, integrity and teamwork” (About Atrium Health, 2021, para. 4).
Description of the Problem
- The current problem is polypharmacy in older adults.
- It poses a number of risks to the quality of life of older adults.
- Adverse effects that are difficult to predict.
- The use of inappropriate medications.
- The stakeholders involved are physicians, nurses, academics, pharmacists, and patients.
- The risk associated with change implementation is the possible unattainability of positive clinical results.
Evidence-Based Idea for a Change in Practice
- Deprescribing is the chosen evidence-based idea.
- The decision is made based on the analysis of several studies.
- According to them, deprescribing is proven the best alternative to polypharmacy.
- Deprescribing through the implementation of a follow-up plan for patients.
- It will improve patient understanding of both medical policies.
- They will be able to make an effective and analyzed decision.
It should be mentioned that the theoretical basis for the idea was four academic papers. Aggregation and analysis of data as well as further decision-making based on the available information is a crucial process of evidence-based practice (Melnyk & Fineout-Overholt, 2018).
Plan for Knowledge Transfer
- Knowledge creation:
- Conducting a survey of medical professionals and elderly patients of Atrium Health on polypharmacy, deprescribing, and side effects.
- Contextually connecting gained knowledge with research findings.
- Knowledge dissemination:
- Research publication for academics.
- Mentoring physicians and nurses.
- Instructing pharmacists.
- Counseling patients.
- Knowledge adoption and implementation:
- Identification of the required resources.
- Evaluation of the resources that would be required.
- Adoption and implementation if the organization has sufficient resources and other specialists agree.
Contextually connecting gained knowledge with research findings means “finding and appraising the evidence and integrating its inferences with their expertise” (Hoffman et al., 2014, p. 1295).
Wake Forest School of Medicine and Wake Forest Innovations have the resources and facilities to interview medical professionals and elderly patients and further disseminate knowledge. Atrium Health notes that “Wake Forest School of Medicine is the academic core of the enterprise, including Wake Forest Innovations, which is advancing new medical technologies and biomedical discoveries” (About Atrium Health, 2021, para. 1).
According to Opperman et al. (2016), “the resources consumed for professional development activities need to be identified and quantified to be able to determine the worth of such activities” (p. 176).
Dissemination Strategy
- Chosen dissemination strategy follows the principle of shared decision making.
- Presenting project results to involved stakeholders and the local community.
- Medical professionals would receive feedback.
- It would allow healthcare workers to correct the deprescribing follow-up plan.
According to Kon et al. (2016), “shared decision making is a collaborative process that allows patients, or their surrogates, and clinicians to make healthcare decisions together, taking into account the best scientific evidence available, as well as the patient’s values, goals, and preferences” (p. 188).
Feedback is necessary because it improves shared decision-making between professionals and patients (Schroy et al., 2014).
Desired Outcomes
- Reducing the incidence of adverse drug effects.
- Reducing the use of inappropriate or unnecessary drugs.
- Strengthening positive connections between healthcare workers and patients.
- Raising awareness of the effects and properties of medications among the elderly.
A Summary of the Critical Appraisal
- Polypharmacy can be harmful to older people.
- Adverse effects and inappropriate use of drugs are potential risks.
- Studies show that deprescribing is a preferable alternative to polypharmacy.
- However, deprescribing is associated with the possibility of unattainable positive clinical outcomes.
What Have Been Learned
- Zero or negative outcomes of the intervention are still significant research findings.
- Outdated studies and those done using past theoretical frameworks and evaluation models can still be valuable.
- Associations are essential source of data in health research.
- Researchers should pay particular attention to the outcomes and effectiveness of interventions.
References
About Atrium Health. (2021). Web.
Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice. Wolters Kluwer.
Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. Web.
Kon, A. A., Davidson, J. E., Morrison, W., Danis, M., & White, D. B. (2016). Shared decision making in ICUs: An American College of Critical Care Medicine and American Thoracic Society policy statement. Critical Care Medicine, 44(1), 188–201. Web.
Opperman, C., Liebig, D., Bowling, J., & Johnson, C. S., & Harper, M. (2016). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32(4), 176–184. Web.
Schroy, P. C., Mylvaganam, S., & Davidson, P. (2014). Provider perspectives on the utility of a colorectal cancer screening decision aid for facilitating shared decision making. Health Expectations, 17(1), 27–35. Web.