Clarifying Connections: Practice, Evidence, and Changing Practice Paper

Clarifying Connections: Practice, Evidence, and Changing Practice Paper

Caregivers in inpatient and outpatient care settings face the daunting task of ensuring safety for patients with dementia due to the interplay between health conditions and environmental factors. According to Haikio et al. (2019), patients with dementia face multiple challenges, including deteriorating cognition, awareness, memory, and compromised ability to execute daily operations. In turn, such conditions increase their susceptibility to additional safety concerns such as disorientation, food safety issues, falls, and polypharmacy. Eventually, addressing these adverse ramifications depends on transforming patients’ health and modifying their immediate environment to eliminate safety concerns. Therefore, it is essential to understand the synergies between the practice problem, the existing evidence, and changing practices to guarantee safety for dementia patients.

Practice Problem

As noted earlier, dementia results in deterioration in memory, thinking, behavioral disorders, and compromised ability to participate or complete daily activities. Since it is primarily an age-related chronic and progressive condition, it leads to disability and dependency. Livingston et al. (2020) argue that dementia affects around 50 million people globally, leading to multiple ramifications, including lack of quality of care, mortality, morbidity, and increased economic cost. Further, Livingston et al. (2020) argue that global healthcare systems require around $1 trillion to combat dementia and its effects. The prevalence of additional safety concerns for patients with dementia exacerbates the situation by requiring healthcare professionals and organizations to embrace evidence-based practices and implement proven interventions to safeguard physical, emotional, psychological, economic, and social safety.

Evidence

Healthcare professionals are responsible for promoting patient safety by averting harm. Although the existing interventions for safeguarding safety for patients with dementia focus on improving their cognition and behavior, it is valid to argue that they are insufficient to guarantee safety and improve patients’ health. As a result, relying on external evidence is an essential strategy for delivering healthcare services that cut across various physical, emotional, psychological, economic, and social dimensions.

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Many scholarly studies propose quality improvement initiatives for safeguarding safety for vulnerable dementia patients. According to Haikio et al. (2019), it is possible to ensure physical safety for patients with dementia by maintaining a preventive presence, encouraging the use of protective aids, and monitoring by healthcare professionals. Zucchella et al. (2018) propose exercise and motor rehabilitation for bolstering physical safety and improving patients’ psychological status. Grobosch et al. (2020) underscore the importance of bolstering patients’ inner peace and emotional security by establishing meaningful relationships and orienting them to public spaces. Finally, Cheng et al. (2020) recommend psychoeducation, psychotherapy, counseling, and mindfulness-based care interventions to improve patients’ psychological awareness and strength. Other evidence-based care approaches for safeguarding patient safety include cognitive stimulation, training, rehabilitation, preventing loneliness, and providing care that upholds respect and human dignity.

Changing Practice

Undoubtedly, the need to safeguard safety for patients with dementia requires healthcare professionals to embrace a contingency plan that cuts across the physical, emotional, psychological, social, and economic domains. In this sense, it is vital to extend beyond the standard care services that focus on improving patients’ psychological, behavioral, and cognitive functions. Many scholarly studies propose the importance of incorporating social, economic, emotional, and even spiritual dimensions to the overall care services to guarantee patient safety. While dementia results in detrimental health effects, healthcare professionals face a daunting endeavor to guarantee patient safety due to high levels of susceptibility to safety concerns such as falls and polypharmacy. Therefore, it is essential to incorporate insights from literature to inform practices and guide decisions.

References

Cheng, S., Au, A., Losada, A., Thompson, L., & Gallagher-Thompson, D. (2019). Psychological interventions for dementia caregivers: What we have achieved, what we have learned. Current Psychiatry Reports, 21(7), 1-12. https://doi.org/10.1007/s11920-019-1045-9

Grobosch, S., Wolf, F., Juchems, S., & Kuske, S. (2020). Emotional safety of people living with dementia: A systematic review. Journal Of Mental Health, 1-22. https://doi.org/10.1080/09638237.2020.1739241

Häikiö, K., Sagbakken, M., & Rugkåsa, J. (2019). Dementia and patient safety in the community: A qualitative study of family carers’ protective practices and implications for services. BMC Health Services Research, 19(1), 1-13. https://doi.org/10.1186/s12913-019-4478-2

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., & Banerjee, S. et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), 413-446. https://doi.org/10.1016/s0140-6736(20)30367-6

Zucchella, C., Sinforiani, E., Tamburin, S., Federico, A., Mantovani, E., & Bernini, S. et al. (2018). The multidisciplinary approach to Alzheimer’s disease and dementia. A narrative review of non-pharmacological treatment. Frontiers In Neurology, 9, 1-22. https://doi.org/10.3389/fneur.2018.01058

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Discussion: Clarifying Connections: Practice Problem, Evidence, Changing Practice
Your literature review should be completed at this point in the module. Working from that assumption, you will use this Discussion to share your preliminary outcomes and analysis from your literature review with colleagues for their comment. You may choose to incorporate feedback from peers before submitting your Module Assignment on Day 7, although that is not required. The aim of this Discussion is to support you in providing the kind of analysis, evaluation, and synthesis of evidence to a group that would be involved in presenting a quality improvement initiative to stakeholders.

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To prepare:
• Review the Module 4 Learning Resources with guidance for analyzing and synthesizing evidence from your literature review.
• Complete your analysis of outcomes and synthesis of evidence to inform a practice change.
• Consider the linkage between your practice problem, evidence to address it, and the need for a practice change initiative.
• Assess the strength of this linkage and how to present it to colleagues.
With these thoughts in mind …
By Day 3 of Week 10
Post an explanation of the results of your literature review and the connection to your practice problem. Then, explain your synthesis of evidence on which to base a practice change and the need for a practice change initiative. Be specific and provide examples.