Research Proposal Paper Sample: Implementation Plan for Evidence-Based Practice

Patients with chronic non-cancer pain are prescribed medication to ease their suffering. Specifically, prescription opioid medications are preferred owing to their effectiveness in relaxing the body and relieving pain. Opioids are inclusive of semi-synthetic opiates like heroin which is derived from morphine and synthetic opiates such as propoxyphene. Inherently, if these medicines are taken in excess, they induce a feeling of complete relaxation. Notably, these medicines are prone to abuse and addiction. Since the patient is in constant pain, they may be tempted to overdose on the drug so that they are always in a steady state of relaxation. For this reason, opiate misuse is widely spread among patients with chronic non-cancer pain, and it is, therefore, paramount to implement programs to counter this problem as will be proposed. Of interest is the implementation of the Prescription Drug-Monitoring Programs (PDMP) in the primary care setting as a prevention measure to reduce the abuse of opiates.

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PDMPs for Evidence-Based Practice

PDMPs are those statewide databases that collect data from pharmacies. The data indicates the number of prescriptions of controlled substances that have been dispensed from these pharmacies to avoid their misuse and diversion (Bao, Pan, Taylor, Radakrishnan, Luo, Pincus, & Schackman, 2016). The pharmacies give reports on the medication data within the year including the dates when the medications were dispensed and the patient to whom it was prescribed. It is through these databases that fraudulent prescriptions and any diversion of the opiates can be identified (Finley, Garcia, Rosen, McGeary, Pugh, & Potter, 2017). Patients with chronic non-cancer pain seek medical attention from primary care physicians in the primary care setting. It means that the primary caregiver should be able to keep track of the number of drugs that are being received by the facility as well as the prescriptions to each patient. Currently, most primary care facilities are lacking in drug-monitoring systems where data such as these can be recorded and referenced as needed. It is, therefore, challenging to monitor any signs of wrongful prescriptions that often result in opiate misuse. The implementation of the PDMPs at this level would be ideal in combating the problem of illegal prescriptions inherently solving the problem of opiate misuse. It will be an opportunity to improve the practice of opiate prescription by monitoring the number of drugs that are given to patients.

Action Plan

Action Steps - What Will Be Done?

Responsibilities - Who Will Do It?

Timeline - By When? (Day/Month)

Resources - Resources available?

Resources needed but not immediately available?

Potential Facilitators and Barriers

Facilitators: What or who is already in place to support your practice change? How do you plan to maximize these facilitators?

Barriers: What are some barriers to the practice change that may impede progress? How do you plan to minimize these barriers? Communication Plan

Who needs to be involved?

What method of communication & how often?

Step 1:

Sensitization among the employees in the primary healthcare facility about the PDMPs

Information technology (IT) specialist and myself as the leader of the project 11/09/2018 Writing material and venue for training

IT specialist and computers which will be compatible with the PDMP software

A. 2 nurse practitioners and 2 physicians with background knowledge on PDMPs are available. These will help the IT specialist to demonstrate the use of the program upon its installation.

B. Unwillingness to embrace to technology for fear of losing jobs and the lack of basic knowledge on the use of computers. Individuals will be trained adequately and assured of their job security. The management of the healthcare facility and all the registered nurses (RNs).

Oral and written communication will be done on Mondays and Fridays during the staff meetings.

Step 2:

Installation of the PDMP database on all the computers at the facility

IT specialist and myself as the leader of the project 14/09/2018 5 computers that are compatible with the program software

5 more computers, program software, IT specialist

A. 2 nurse practitioners and 2 physicians with background knowledge on PDMPs are available. These will aid in the installation of the software.

B. Inadequate funds to purchase computers. The available computers will be utilized. The management of the healthcare facility and all the RNs.

Oral and written communication will be done on Mondays and Fridays during the staff meetings

Step 3:

Demonstration on the use of the program

IT specialist and myself as the leader of the project 17/09/2018 5 computers that are compatible with the program software and the videos for demonstration

5 more computers A. 2 nurse practitioners and 2 physicians with background knowledge on PDMPs are available. These will help the IT specialist to demonstrate the use of the program upon its installation.

B. Scheduling all the RNs and management to witness the demonstration. Demonstration will be done for a week to ensure all individuals are enlightened. Also, the educational videos will be not be deleted from the computers such that they are available for viewing at all times. The management of the healthcare facility and all the RNs.

Oral communication will be done on Mondays and Fridays during the staff meetings. Written communication will be pinned on the notice board for a week.

Step 4: Practical application of the program

IT specialist, trained RNs and management, myself as the leader of the project 19/09/2018 5 computers on which the PDMP software would have been installed.

5 more computers A. 2 nurse practitioners, 2 physicians, all the RNs, and the management. These groups will attempt to use the program.

B. Scheduling the RNs and the management to use the program. Practices will be done for a week to ensure all individuals can use the program confidently. The management of the healthcare facility and all the RNs.

Oral communication will be done on Mondays and Fridays during the staff meetings. Written communication will be pinned on the notice board for a week.

Step 5:

Feeding all the controlled substances into the program to begin its use and protecting the computers with passwords known to specific users

Trained RNs 28/09/2018 A. 5 computers installed with the PDMP software, list of controlled substances

B. 5 more computers A. Trained RNs to feed the list onto the program and the management as witnesses.

B. Some trained RNs may experience challenges in using the program. Follow-up trainings will be organized to streamline the process. Individuals will be encouraged to watch the educational videos. The management of the healthcare facility and the RNs.

Oral and written communication will be done on Mondays and Fridays during the staff meetings.

Similar Intervention

The practical use of PDMPs depends on the process of recruitment, utilization, and education. According to Clark, Eadie, Kreiner, & Strickler (2012), these practices ensure that the potential users comprehend the importance of these programs in all the activities that combat prescription drug abuse. In their article titled Prescription Drug Monitoring Programs: An Assessment of the Evidence for Best Practices, Clark, Eadie, Kreiner, and Strickler advice that the implementation plan begins with enabling the access to data by the appropriate users. Outreach and recruitment strategies should succeed this and culminate in strategizing on approaches that will increase the program's utilization. These procedures inform the current study which emphasizes that all the users must be able to use the program before they can disseminate their knowledge to other health caregivers.

Conclusion

Conclusively, the successful use of PDMPs is a practice that will reduce the chances of the misuse of opiates and other controlled substances. It is recommended that primary caregivers be equipped with the skills that are necessary to keep track of patients' prescriptions. PDMPs facilitate this activity. These skills can be perfected by conducting training sessions at the end of which the caregivers will begin using the program to monitor the prescription of all controlled substances.

References

Bao, Y., Pan, Y., Taylor, A., Radakrishnan, S., Luo, F., Pincus, H. A., & Schackman, B. R. (2016). Prescription Drug Monitoring Programs Are Associated With Sustained Reductions in Opioid Prescribing By Physicians. Health Affairs (Project Hope), 35(6), 1045-1051. http://doi.org/10.1377/hlthaff.2015.1673

Clark, T., Eadie, J., Kreiner, P., & Strickler, G. (2012). Prescription drug monitoring programs: an assessment of the evidence for best practices. The Prescription Drug Monitoring Program Center of Excellence.

Finley, E. P., Garcia, A., Rosen, K., McGeary, D., Pugh, M. J., & Potter, J. S. (2017). Evaluating the impact of prescription drug monitoring program implementation: a scoping review. BMC Health Services Research, 17, 420. http://doi.org/10.1186/s12913-017-2354-5