HLT490 Topic 3 Proposed Solution, Implementation, and Evaluation Sample Paper

HLT490 Topic 3 Proposed Solution, Implementation, and Evaluation Sample Paper

HLT490 Topic 3 Proposed Solution, Implementation, and Evaluation Sample Paper

The following proposed solution seeks to address and reduce the number of adverse drug events (ADEs) in elderly patients that promotes medication reconciliation and healthcare literacy for patients and healthcare providers. This collaborative interdisciplinary program will consist of an educational component focused on teaching healthcare practitioners evidence-based practices related to medication reconciliation and identifying and communicating with elderly patients at risk for low healthcare literacy. Once we have had an opportunity to complete the educational component of the new proposed program, a new process will be implemented and occur upon a patient’s admission to the hospital, that will require nurses to educate their patients on the importance of medication reconciliation, and contact primary care physicians via fax to ensure records are completes, while encouraging patients to use a central pharmacy for all of their prescription needs.HLT490 Topic 3 Proposed Solution, Implementation, and Evaluation Sample Paper

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Preparing an Implementation Plan

The first step towards the implementation of this proposed plan is the introduction of the method that will be utilized to obtain the approval and secure the support from the organization’s leadership. This is to ensure that the research is conducted in an ethical manner because the proposed plan does intend to use and evaluate human subjects in the pilot program and track medical data, health literacy, patient outcomes and patient satisfaction. The proposed plan will be presented to the institutional review board (IRB) of the institution or governing body that is responsible for reviewing and approving research protocols. Liberale & Kovach (2017) report that the role of the IRB committee is to “protect the ethical rights and welfare of human subjects from research risks through the initial and continuing review of research protocols , adverse events, amendments, and other issues.” It will equally important to introduce the proposed plan in a formal presentation to the fellow staff members that will be participating in the research program.

Adverse drug events (ADEs) in elderly patients who suffer from multiple medical conditions can be complicated by limited or lack of health literacy, thereby increasing the likelihood of a negative patient outcome. The current policy requires healthcare professionals to review patient medications but does not require them to educate their patients in medication reconciliation and does not hold them accountable for identifying healthcare deficient patients while assuming the responsibility for educating them to ensure that they fully understand and comprehend all communication related to their condition. In order to establish a baseline for comparison all patients participating in the study will have to meet specific inclusion criteria as follows: must be 65 years or older, have experienced one or more ADE in the last five years, and have been identified as having limited or no health literacy at time of admission. In addition, healthcare providers participating in the study will also have to take several continuing education courses on medication reconciliation and health literacy and agree to follow all new policies and procedures as outlined in the research protocol.

The new process will require nurses to review all relevant information related to all of the patient’s medications upon admission, followed up by an initial assessment of the patient’s understanding of the medication that is being prescribed and patient’s current health literacy. Once this has been established the nurses will discuss and educate patients’ on the importance of medication reconciliation and answer any questions related to their patient’s healthcare in terns that they can understand. The interaction between the nurse and the patient will be documented through informed consent to participate in the study and a signed form stating that the nurse discussed the topic of medication reconciliation and provided educational healthcare support.

The rationale for selecting this proposed solution is that providing education to healthcare providers on the topic of medication reconciliation and increasing health literacy in patients can possibly help reduce preventable adverse drug events that can lead to negative patient outcomes and increase the delivery of quality healthcare. In addition, this research study does not involve any invasive medical procedures so there is no physical risk to the patient, however there is a big opportunity to help save lives. Furthermore, the cost of implementing this proposed plan will be minimal in comparison to many other studies being conducted in the interest of helping to reduce ADEs.

One study reported a problem of inappropriate medication in elderly patients complicated by the use of several pharmacies (Yasein, et al., 2012). With the proper intervention elderly patients can be educated about their medicines and provided a comprehensive plan to follow while being encouraged and educated on the importance of the utilization of one pharmacy for all of their medication needs. Research has also shown that between the years 2000 and 2011the Institute for Safe Medication Practices (ISMP) Medication Safety Self Assessment for Hospitals observed that by implementing safety strategies that increased awareness helped in decreasing negative patient outcomes, supported and increased the engagement of patients in safety (Cohen & Smetzer, 2018). Healthcare professionals must properly engaged their patients in their healthcare by proactively offering education so that they are able to make informed decisions and follow medication and health protocols in an effort to reduce ADEs and increase positive patient outcomes.

The proposed plan is set to be implemented on January 1, 2018 and continue collecting data over the course of three years. The first phase of the program will include the selection of the nursing units that will participate in this pilot study. The nurses will signed an informed consent and must voluntarily agree to commit themselves to the additional responsibilities, duties and obligations as outlined in the research study. The nurses will then be required to completed a comprehensive course on medication reconciliation and health literacy and pass an assessment on the material covered in order to ensure proficiency. Once this educational phase of the program has been completed the plan will move to the next phase and determine the eligibility of the patients who will participate through the administration of a questionnaire that is presented upon admission to the hospital, identifying the patients who have already experienced an ADE, are at high risk for an ADE or have limited or no health literacy. After the patients have been selected, a patient consent to participate in the study will be obtained as part of the research protocol and the patient will be informed of their rights. As part of the intake process the nurse must review the patient’s medication, the new policy dictates that after this has been established the nurse will educate the patient on the importance of medication reconciliation and clarify any misunderstandings or misconceptions that were identified when then initial paperwork was completed. There will be a dedicated nurse case manager that will be placed and in charge of coordinating the schedule for educating the staff, they will be responsible for ensuring the all documents are signed and that data is collected according to the guidelines listed in the research protocol, oversee the implementation process and assist in the analysis and interpretation of data.

The resources that will be required for the implementation of this program begin with the funding needed for the proposed plan, if federal funding in unavailable then private funding will have to be secured for the necessary resources. The monetary reimbursement for this program will cover the cost of educating the staff, the printing and production of educational materials for both staff and patients that may include but not limited to pamphlets, handouts, and posters. Additional printed materials will include assessments for health literacy, questionnaires that will help determine eligibility, informed consents, surveys before and after in order to assess the patients’ knowledge and understanding when the baseline is taken and after the implementation of the intervention and other related printed research materials. It will also cover the cost of the use of any technology related to the gathering, collecting and analyzing of data before, during and after the research has been completed. Finally, the program will require a committee of people who are dedicated and committed to initiate, overseeing and evaluating the need for change in the proposed plan, as well as a dedicated nurse case manager that will be responsible for the daily operations related to the implementation and success of the program.

Evaluation Plan

An evaluation plan is necessary in order to assess the effectiveness of the proposed solution implemented and for this program there will be several different facets that will help to measure the success of this intervention. The first evaluation will allow researchers to analyze the results of the comparison of the initial assessment of the healthcare literacy questionnaire completed at the beginning of the program versus the score achieved at the completion of the proposed intervention. The second evaluation will keep tracks of ADEs that occur in these patients after the educational program in medication reconciliation and health literacy that is presented to the patients upon their admission to the hospital. The third evaluation will track patients’ readmission or use of inappropriate medication as a result of a follow up initiated through a telephonic survey conducted by the nurse case manger responsible for the program. The fourth measurement involves a written survey completed by the patient before and after, that will measure the patients’ perception of the delivery of care before and after the initiative towards patient awareness and education was initiated. The projected outcomes for this proposed plan are expected to be positive, however, success will determined by the increase in patient health literacy scores, overall decrease in ADEs as well as patient readmissions and an increase of a positive patient perception as it relates to the delivery of quality patient care. There are several variables that will need to be considered when analyzing and interpreting the results collected from the proposed intervention. The first variable that will need to be assessed is the age of the patients in the study, older patients will have a more difficult time processing and retaining new information as a result of the their age. This variation in age may affect the overall expected outcome for this specific assessment of the program. Another variable that will be assessed is the education and continuing education of nursing staff occurring over the course of the research study. It is important that the program promotes patient safety and engagement through the professional development of the healthcare providers responsible for taking care, treating and educating these elderly patients. The next variable that will be assessed through the analysis and interpretation of these results is comparison in the number of ADEs as a result of practitioner error versus patient error. ADEs are a preventable negative clinical patient outcome and discovering the nature of why it continues to happen even after the implementation of the proposed intervention will help researchers adjust, change and expand the research program to address the issues and concerns that are still creating medication errors. The interim evaluation will take place every three months to assess the effectiveness in the implementation of the program and to a number of data points that can be analyzed and interpreted after the completion of the project. A final evaluation and interpretation of all results will be presented to the committee that was appointed to be responsible for overseeing this research study, including all of the key stakeholders involved throughout this process.

References

Centers for Disease Prevention and Control. (2011). Developing an Effective Evaluation Plan: setting the course for the effective program evaluation. Retrieved from: https://www.cdc.gov/obesity/downloads/cdc-evaluation-workbook-508.pdf

Liberale, A. P., & Kovach, J. V. (2017). Reducing the Time for IRB Reviews: A Case Study.

Journal of Research Administration, 48(2), 37-50. Retrieved from: https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=128078158&site=eds-live&scope=site. HLT490 Topic 3 Proposed Solution, Implementation, and Evaluation Sample Paper