Conduct a collaboration interview with two or three key leaders in your practice setting to determine the measures for your practice problem and associated challenges impacting measurement for your practice problem (include confidentiality, anonymity, access issues, etc.). Perform an existing evidence review on your practice problem and search for evidence that demonstrates how your practice problem is measured across the country.
Post a description of the measures identified from the interviews, the challenges to obtaining the data that were discussed, and a summary of how this quality indicator is measured in the literature. Discuss any gaps in the data that were identified and additional sources that might be needed to obtain this data. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from practice and data that is available. Practice Experience Essay Paper
Practice Experience: Applying Measurement Tools to a Practice Problem
The practice problem in the setting is the unnecessary and inappropriate use and prescription of antipsychotics among older adults. Inappropriate prescription of antipsychotics among older adults with multiple co-morbidities is very high and it is often done for indications that are not FDA approved (Kirkham et al., 2017). Collaboration interviews were performed with the head of the clinical services and two mental health nurses working within the mental health unit. The interviews were performed in order to identify measures for the use of antipsychotics.
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From the interviews, the measures identified included: the severity of the mental health disorders and the adverse health effects of the antipsychotic agents. First, the severity of the underlying psychiatric problem influences the constant use of antipsychotics among patients with mental disorders. Secondly, administering high doses of antipsychotic medications elevates the risk of adverse side effects for the patients, including death. From the interview, it emerged that the most common side effects of antipsychotics were impaired cognition, insulin resistance, sedation, cardiovascular events, and extrapyramidal symptoms (EPS). The two nurses emphasized the need to tailor antipsychotic agents to the special needs of every patient and hence provide individualized treatment. The head of the clinical services underscored the need to provided individualized treatment.
Evidence indicates that inappropriate prescription of antipsychotics leads to adverse events like sedation, extra-pyramidal symptoms, increased risk of stroke and other cardiovascular events, cognitive impairment, orthostatic hypotension, and premature death (Fulone & Lopes, 2017). Therefore, the adverse health effect of antipsychotics is a measure used to identify inappropriate use of antipsychotics. Practice Experience Essay Paper
The identified gap is that the mental health unit does not comprehensively use medication reviews to evaluate, review, and follow-up drug therapy for each individual patient. Therefore, there is a need to implement a structured and systematic medication review procedure for older adults, and are being administered with antipsychotics (Lenander et al., 2017).
References
Fulone, I & Lopes, L. (2017). Potentially inappropriate prescriptions for elderly people taking antidepressant: comparative tools. BMC Geriatr, 17(278). https://doi.org/10.1186/s12877-017-0674-2
Kirkham, J., Sherman, C., Velkers, C., Maxwell, C., Gill, S., Rochon, P., & Seitz, D. (2017). Antipsychotic Use in Dementia. Canadian journal of psychiatry. Revue Canadienne de Psychiatrie, 62(3), 170–181. https://doi.org/10.1177/0706743716673321.
Lenander, C., Midlöv, P., Viberg, N., Chalmers, J., Rogers, K., & Bondesson, Å. (2017). Use of Antipsychotic Drugs by Elderly Primary Care Patients and the Effects of Medication Reviews: A Cross-Sectional Study in Sweden. Drugs – real-world outcomes, 4(3), 159–165. https://doi.org/10.1007/s40801-017-0111-z.
Practice Experience Essay Paper