Adult Family Home Medication Log WAC 388-76-10475. Medication Administration for Adult Family Homes in Washington State

Medication Administration for Adult Family Homes in Washington State
AFH Centers
Practice Project Proposal
Problem Statement The Adult Family Homes (AFH) in Washington State was established by the Department of Social and Health Services (DSHS) and serve vulnerable populations especially the elderly. They also serve those with physical and developmental disabilities, mental illness, multiple diagnoses, complex medication in lists that require detailed dosing instructions, special needs, and those whose needs have not been adequately coordinated.. Currently, AFH providers are not required to have health care background or training for medication administrations, but they are trained and supervised by the nurse delegators. Medication practices need to be monitored closely at the AFHs where nurses are not always present like in hospitals to   prevent undesirable drug interaction, incorrect dosage, and therapeutic duplication and medication errors. In Washington State, there are strict laws on dispensing medication and there are AFH citations for repeated violations, which is essential to reduce the rates of medication administration errors. The Adult Family Home council is an organization that was established to ensure homes in Washington State are well supported and equipped with the necessary resources to accommodate increased needs in living facilities. Adult family homes reportedly have been regularly cited for failure to follow Washington Administrator Codes (WAC), Chapter 388-76 by the DSHS where there are inadequate tools to deal with codes1. In 2017 there were 634 reported citations for violating WAC 388-76-10475 (Medication Log). Proper medications administrations is necessary to improve the functioning and quality of life of the residents at adult family homes, improper management often results in serious and adverse consequences.  There is high frequency of the medication errors while health practitioners, policy makers and Adult Family Home staff members need to focus more on enhancing the quality of care to improve outcome1.The purpose of the DNP project is to investigate the medication administration errors in AFH and propose strategies to reduce such errors.  The AFH highlights the six rights of medication administration: right patient, medication, dose, time, route and documentation as well as reason and response.Objectives • Identify the origin and source of medication errors in the adult family homes. • Create simple and friendly tools to reduce transcription medication administration error citations1.1 Deliverables From the agency meeting, the need for a medication plan was evident. Thus the deliverable for the DNP porject is a care plan that includes guidelines for management of the medication process for the adults in the adult family home.Setting & PopulationThe population is the AFH providers in Washington State, who use the service provided by the AFHC and they focus on medication administration at these homes. The need for this project is necessitated by cases that have been presented concerning the errors made in the medication of patients and patrons in the adult care homes. The administration of medication is a fundamentally essential aspect that should be regulated and guided with the necessary rules and localized guidelines. Moreover, the project will undertake to look at the processes and procedures of various adult homes and seek to understanding how these procedures either contribute or reduce the instances and chances of errors in medicine administration. The management of adult family homes will be the primary respondent and target of the research. Furthermore, caregivers will shed light on the issue of administration of medicine in various facilities. The caregivers and management who interact with the medication procedures of the patient on a frequent basis will provide sufficient information concerning any errors in medicine administration, the type of errors, the reasons, and causes for any error and the best approached to curb them.3.2. Background and SignificanceThe number elderly in the community has been on the increase, especially in the past few years. Various authors have expressed the idea that for the fast time in the history of the United States of America, the population of the people above 65 years old has grown exceeding that of the younger population . The presence of a higher population of the elderly will present a challenge in the individual allocation of resources, which will reflect the need for adult homes . In some cases, the management of the elderly is complicated by the presence of chronic illnesses. As people get older, they tend to be more at risk of chronic diseases and increased chances of comorbidities . Prince et al., present the idea that about 23 percent of the total global burden of disease in attributable to chronic illnesses in older people. The leading contributors to disease burden in older people are cardiovascular diseases (30·3% of the total burden in people aged 60 years and older), malignant neoplasms (15·1%), chronic respiratory diseases (9·5%), musculoskeletal diseases (7·5%), and neurological and mental disorders (6·6%) . A substantial and increased proportion of morbidity and mortality due to chronic disease occurs in older people.2. Proposal Draft: Model/Framework & Evidence Table AddedThe Iowa Model The Iowa model is a seven-step approach that allows the incorporation of research and other types of evidence in the organizing of various activities. The Iowa Model can be best summarized by the following image, which shows the flow of the steps from the first, selection of a topic, to the last step which is evaluation. In the case of the current research, the Iowa model will be applied in the analysis of the issues around the administration of medication in adult family homes as follows. The first step would be the selection of the topic, which has already been done. The selected topic is “Investigation of Medication Administration for Adult Family Homes in Washington State AFH Centers.” The second step is the formation of a team that will assist in the gathering and retrieval of evidence. The team I will use will be led by myself and assisted by one or two research assistants. The team will be instrumental in the retrieval of evidence, which is the third step in the process. The fourth step is the grading of evidence followed by the development of an EBP standard. Additionally, I will develop an EBP standard around the errors identified and then implement it in the same organization. Finally, the new process will be evaluated for the success it may have achieved. The topic of this project, the AFH medication administration will require the use of the Iowa model, which allows for the use of evidence-based approaches to respond to adult family home medication administration errors. It provides an outline of how healthcare systems can make use of evidence-based techniques and methods in the creation of strategic plans necessary for responding to AFH medication errors. The Iowa model will provide for the extensive use of evidence-based approaches in responding to AFH medication errors. The model is favorable and applicable because it allows for a holistic approach to understanding and evaluating the problem. The model will offer an outline of how the health care system can make use of evidence-based methods and techniques in the creation of efficient and effective strategic plans for responding to AFH medication errors. The Iowa model will be a better approach in this case to find out critical facts on the underlying causal factors of medication error in AFH care facilities in Washington.Focused Evidence Appraisal The population and presence of the elderly is increasing in the community. While many people are interested in ensuring that the aged live comfortably and able to enjoy their later days, the presence of loneliness, social isolation, and poor social support increases chances of disease or illness3. In addition, alongside the increased populations of the elderly, there are associations of chronic illnesses that need specialized care3. Failure to handle the situation in time leads to the increased burden on the individual and regional economy5. The challenge of management of the aging is not a far-fetched idea. It becomes worse in the presence of health complications that threaten the lives of the elderly . The older person readily requires professional helper always that will allow him to live a peaceful life and one that is free of complications . Even with the presence of professionals, there are increased instances where the older person faces challenges such as the inability to co...