Introduction
It is hard to disagree that healthcare is improving, and there are many issues that have been solved recently. However, there is still an extended number of outcomes of nursing practice that require careful consideration and need to be addressed in the nearest future. Many of these problems are the result of other issues and errors, and eliminating the latter may help significantly improve healthcare outcomes. For example, there is a strong connection between polypharmacy and the increased risk of injurious falls in older adults, and this topic is the focus of this paper. Therefore, the main purpose of the following paragraphs is to create a clinical nursing theory in the form of Concept A | Proposition | Concept B. The steps are to identify the main concepts, explain how they can be measured in a research study, match the proposition in Jean Watson’s theory with this paper’s proposition, and draw relevant conclusions.
Summary of the Issue
As people grow older, they usually require more medications to manage their chronic conditions and prevent other health issues. At the same time, many older adults cannot control their medications properly and begin to take too many drugs that sometimes cannot be mixed with each other (Morin et al., 2019). What is more, as noticed by the National Institute of Aging (2021), it may be challenging for the elderly to control the dosage. Therefore, if a patient uses three or more medications at the same time to treat single or multiple conditions, they have polypharmacy (Hoel et al., 2021). Among the particular adverse consequences for patients, “polypharmacy is associated with resulting increased hospitalizations and higher costs of care for individuals and health care systems” (Hoel et al., 2021, p. 242). This condition is rather serious as it has a vast number of negative effects, including the higher risk of falls.
Creating a Clinical Nursing Theory
In order to create a clinical nursing theory, it is essential to focus on the following form: Concept A | Proposition | Concept B. This form generally consists of two nouns and a verb in the middle that serves as a connection between the two identified concepts. As mentioned above, polypharmacy is a severe issue that has many negative consequences (Dhalwani et al., 2017). One of them is the increased risk for falls and serious injuries in older patients. This outcome of nursing practice requires improvements as soon as possible. Overall, there are many research papers that explore this issue and the connection between the two problems, and eliminating or at least reducing falls as the consequence of polypharmacy is one of the main goals of healthcare workers.
Based on the information provided above, this paper’s clinical nursing theory is the following: nurses’ increased attention to and careful consideration of patients’ medications reduces the risk of their falls and injuries. This theory’s findings are based on previous research and current data regarding polypharmacy among the elderly and the falls that some of them experience after taking too many medications. Overall, this theory is rather important for the nursing profession and the improvement of nursing practice outcomes.
Identifying the Main Concepts
There are several main concepts that may be identified in the created clinical nursing theory. The first one is the level of polypharmacy that has increased among older patients in recent years. Second, it is the risk for falls and severe injuries that has also become higher and cannot be managed yet. These two concepts are related to each other, and if the former is reduced, the latter also decreases. Finally, the third concept is the positive impact of possible interventions that are mentioned in the paper. For example, increasing awareness among nurses and older patients and educating them about polypharmacy and its effects are crucial and effective steps.
Measuring the Identified Concepts in a Research Study
In order to make sure that there is actually a correlation between reduced polypharmacy and decreased risks for falls, it is possible to conduct specific studies with a number of participants. Generally, researchers take a specific number of participants living in the same area and being older than sixty-five or seventy. Then, they assess some measures of medication exposure and link them to falls and injuries. For instance, Ie et al. (2021) considered three important criteria. The first one is to assess polypharmacy by learning the total number of regularly used medications. The second measure is the “counts of potentially inappropriate medications derived from current prescription guidance tools” (Ie et al., 2021, p. 1). Finally, the third criteria is “medication burden indices based on pharmacologic mechanisms all derived from claims data” (Ie et al., 2021, p. 1). Studying these or other data and assessing the participants’ experiences related to the use of medications and consequent falls and injuries allows measuring the identified concepts.
Applying Jean Watson’s Theory of Human Caring
Various research questions and problems require funding, and the issue explored in this paper is not an exception. In order to present the research question correctly, it has to be guided by a theoretical model. Jean Watson’s theory of human caring is chosen for this paper because this theoretical model is defined by positive energy and is mutually rewarding to both nurses and patients (Redlands Community Hospital, n.d.). Watson’s theory is built upon ten Caritas processes that all together lead to an improved healthcare environment and better outcomes (Redlands Community Hospital, n.d.). It is possible to integrate one of these factors into the clinical nursing theory of this paper.
The sixth factor of Jean Watson’s caring theory can be applied since the clinical nursing theory of this research is that nurses who pay more attention to and carefully consider their patients’ medications lower the likelihood of their falls and injuries. The chosen Caritas process is to “deepen scientific problem-solving methods for caring decision making” (Redlands Community Hospital, n.d.). Therefore, the new proposition reads as follows: deepening scientific problem-solving methods for caring decision-making allows to address polypharmacy and risk for falls in older patients.
General Discoveries and Their Impact on the Nursing Profession
During the research, it was possible to make some essential discoveries and determine their impact on the nursing profession. Overall, as noticed by the Nursing License Lab (2021), nursing theories “attempt to explain, describe or predict specific issues in clinical nursing practice” (para. 2), as well as “a foundation for sound decision-making in nursing” (para. 6). Therefore, clinical nursing theories themselves, as well as the ideas and discoveries they offer, are an integral part of the healthcare improvement process.
To be more precise, the main discoveries of this particular paper include the following ideas. There is actually a strong connection between polypharmacy and the risk for falls; this issue does not receive enough attention from medics; and it is possible to address the latter by eliminating the former (Dhalwani et a., 2017). It is hard to disagree that these discoveries have extremely significant effects on the nursing field. First, nurses who are aware of these facts can pay closer attention to the medications their patients use (National Institute of Aging, 2021). Second, nurses may develop specific recommendations for their older clients and educate them and their relatives about the increased risk for falls (Morin et al., 2019). These steps are likely to have a positive effect on the main issue and improve nursing practice outcomes. Finally, there are several questions that arise from this theory and require further consideration. One of them is the following: What are some other preventative measures that can reduce the levels of polypharmacy and falls in the nearest future?
Conclusion
To draw a conclusion, one may say that the identified issue is extremely severe and requires further research and careful consideration. Overall, it is possible to prevent polypharmacy and risk for falls in older patients if nurses address the former and pay close attention to the medications taken by their clients. The middle-range nursing theory outlined in this paper explains the necessity of addressing the problem and proves that there is a strong connection between polypharmacy and falls that lead to injuries. When the level of the former increases, the same happens with the level of the latter. Creating a nursing theory and supporting it with proper research and another middle-range theory may help identify new questions and have a significant impact on the nursing profession itself.
References
Dhalwani, N. N., Fahami, R., Sathanapally, H., Seidu, S., Davies, M. J., & Khunti, K. (2017). Association between polypharmacy and falls in older adults: A longitudinal study from England. BMJ Open, 7(10).
Hoel, R. W., Giddings Connolly, R. M., & Takahashi, P. Y. (2021, January 1). Polypharmacy management in older patients. Mayo Clinic Proceeding, 96(1), 242-256.
Ie, K., Chou, E., Boyce, R. D., Albert, S. M. (2021). Fall risk-increasing drugs, polypharmacy, and falls among low-income community-dwelling older adults. Innovation in Aging, 5(1), 1-9.
Morin, L., Larrañaga, A. C., Welmer, A. K., Rizzuto, D., Wastesson, J. W., & Johnell, K. (2019). Polypharmacy and injurious falls in older adults: A nationwide nested case-control study. Clinical Epidemiology, 11, 483-493.
National Institute of Aging. (2021). The dangers of polypharmacy and the case for deprescribing in older adults. NIA. Web.
Nursing License Lab. (2021). Introduction to nursing theories. Web.
Redlands Community Hospital. (n.d.). Jean Watson’s theory of human caring. Web.
