Date of Award
Evidence-Based Project Report
Doctor of Nursing Practice (DNP)
Jeffrey A. Coto
With older adults making up about 14.5% of the U.S. population, polypharmacy may be an unintended consequence of adhering to clinical practice guidelines (Kim & Luck Parish, 2017). Effective polypharmacy interventions are needed in the primary care setting to increase prescribing safety and lower the risk of adverse drug events among older adults. The application of the Beers criteria, in conjunction with a brown bag medication reconciliation event, was initiated as focused interventions for a private primary practice without electronic health records. Outcomes included medication reduction, identification of possible inappropriate medication, decrease of medication dosages, and identification of duplicate medication. The sample population included 34 patients whom were 65 years and older and prescribed five or more medications. The evidenced based Stetler model was utilized for project implementation for a progressive approach within a primary care setting. The theoretical framework was guided by Paterson and Zderad’s Humanistic Nursing Theory. A paired samples t-test was used to analyze the number of medications Pre- and Post- implementation of the Beers criteria and findings showed statistical significance in the reduction of medication of (t(33) = 1.787, p < .05). A single-sample t-test was used to analyze the identification of possible inappropriate medications, number of discontinued medications, decrease in medication dosages and duplicate medications. There was statistical significance found with the identification of possible inappropriate medications (t(33) = 4.68, p < .05). Results demonstrated that there is statistical evidence to encourage application of the Beers criteria for safe prescribing in older adults. Although the brown bag medication reconciliation event did not yield statistical significance, utilizing medication reconciliation at every patient visit is standard of care.
Garza, Kristen, "Application of Beers Criteria and a Brown Bag Event to Increase Prescribing Safety in Older Adults" (2019). Evidence-Based Practice Project Reports. 119.