Dissertation
A Quality Improvement Project to Address Medication Discrepancies Between Primary Care Providers and Prescribing Specialists for Intellectually and Developmentally Disabled Adults
(2018)
Abstract
Background: Adults with intellectual and developmental disabilities face many unique challenges when it comes to healthcare. There is a high rate of polypharmacy as well as specialty involvement to address the dynamic health needs of this underserved population.
Methods: This DNP project assessed the rate of medication discrepancies between primary care providers and prescribing specialists to determine if there is an increase in the re-hospitalization rate at 30-, 60-, 90-day intervals among those with an increased rate of medication discrepancies. Individuals in not-for-profit group homes in Western Massachusetts diagnosed with an intellectual or developmental disability with multiple prescribing providers were selected for the DNP project.
Results: Of the 33 eligible individuals, five were hospitalized during the course of the DNP project with an average of 27 prescribed medications, including routine medications and as needed medications. Sixty percent of the hospitalized individuals had medication discrepancies between their primary care provider medication list and specialist prescribed medications on their medical record. Among the three patients, there was a 4.8% medication discrepancy rate. Among the individuals that did not have any medication discrepancies, there was an increased number of nursing hours to provide oversight and increased number of prescribing providers using a connected EMR system.
Discussion: Improving PCP and prescribing specialty communication for adults with ID/DD is an imperative aspect of care for this vulnerable population. APRNs need to be aware of this existing gap in patient care to ensure patient safety.
Keywords
- Intellectual/Developmentally disabled adults,
- medication discrepancies,
- polypharmacy,
- specialty providers
Disciplines
Publication Date
Spring April 30, 2018
Degree
DNP-FNP
Field of study
Nursing
Department
Nursing
Advisors
Clare Lamontagne, PhD, RN
Citation Information
Kristi Watson. "A Quality Improvement Project to Address Medication Discrepancies Between Primary Care Providers and Prescribing Specialists for Intellectually and Developmentally Disabled Adults" (2018) Available at: http://works.bepress.com/kristi-watson/1/