Implementation of a Medication Management Evidence-Based Practice in a Public Sector Mental Health Treatment Setting

2.50
Hdl Handle:
http://hdl.handle.net/10755/304198
Category:
Abstract
Type:
Presentation
Title:
Implementation of a Medication Management Evidence-Based Practice in a Public Sector Mental Health Treatment Setting
Author(s):
El-Mallakh, Peggy; Howard, Patricia B.; Roque, Autumn P.; Rayens, Mary Kay
Lead Author STTI Affiliation:
Delta Psi
Author Details:
Peggy El-Mallakh, PhD, RN, peggy.el-mallakh@uky.edu; Patricia B. Howard, PhD, RN, FAAN; Autumn P. Roque, BSN; Mary Kay Rayens, PhD;
Abstract:

Poster presented on: Monday, July 22, 2013, Tuesday, July 23, 2013

Purpose: Present findings from an evidence-based practice implementation project on organizational support, barriers, and facilitators to implementation.  

Methods: This 3-year study used a mixed qualitative and quantitative design to test the feasibility of implementing a medication management EBP, the Medication Management Approaches in Psychiatry (MedMAP), in the treatment of schizophrenia in six Medicaid-financed community mental health clinics in a south-central state of the US. A 17-item Organizational Fidelity Scale was used to collect data on organizational support for MedMAP implementation at the participating clinical sites.    Qualitative data were obtained during in-depth interviews with 14 stakeholders in the MedMAP implementation study. Quantitative data analysis was conducted using means and standard deviations of organizational fidelity scores.  Qualitative data were analyzed using content analysis to identify relevant themes on barriers and facilitators of MedMAP implementation.

Results: Organizational support for MedMAP implementation was moderate. Support was highest for prescriber access to patient information and scheduling flexibility for urgent patient problems. Support was lowest for medication availability and identification of treatment-refractory patients. Facilitators to implementation included clinician awareness of the benefits of MedMAP in the provision of clinical care, communication between stakeholders, and feedback on fidelity ratings. Barriers to implementation included MedMAP requirements that were inconsistent with work flow, inadequate computer-based resources, organizational culture, payer source restrictions on reimbursement for several elements of MedMAP, and mandated restrictions from the state mental health regulatory agency related to medications included in the formulary.  

Conclusion: EBP implementation can be improved through nursing leadership at multiple levels within a service delivery organization, a paradigm shift in academic and clinical settings to support the use of EBPs, and development of innovative care delivery models. Nurses need to develop leadership, policy, patient advocacy, and information technology skills to promote optimal implementation of EBPs in their practice setting.

Keywords:
schizophrenia; evidence-based practice implementation; medication management
Repository Posting Date:
22-Oct-2013
Date of Publication:
22-Oct-2013
Conference Date:
2013
Conference Name:
24th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Prague, Czech Republic
Description:
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleImplementation of a Medication Management Evidence-Based Practice in a Public Sector Mental Health Treatment Settingen_GB
dc.contributor.authorEl-Mallakh, Peggyen_GB
dc.contributor.authorHoward, Patricia B.en_GB
dc.contributor.authorRoque, Autumn P.en_GB
dc.contributor.authorRayens, Mary Kayen_GB
dc.contributor.departmentDelta Psien_GB
dc.author.detailsPeggy El-Mallakh, PhD, RN, peggy.el-mallakh@uky.edu; Patricia B. Howard, PhD, RN, FAAN; Autumn P. Roque, BSN; Mary Kay Rayens, PhD;en_GB
dc.identifier.urihttp://hdl.handle.net/10755/304198-
dc.description.abstract<p>Poster presented on: Monday, July 22, 2013, Tuesday, July 23, 2013</p><b>Purpose: </b> Present findings from an evidence-based practice implementation project on organizational support, barriers, and facilitators to implementation.   <p><b>Methods: </b> This 3-year study used a mixed qualitative and quantitative design to test the feasibility of implementing a medication management EBP, the Medication Management Approaches in Psychiatry (MedMAP), in the treatment of schizophrenia in six Medicaid-financed community mental health clinics in a south-central state of the US. A 17-item Organizational Fidelity Scale was used to collect data on organizational support for MedMAP implementation at the participating clinical sites.    Qualitative data were obtained during in-depth interviews with 14 stakeholders in the MedMAP implementation study. Quantitative data analysis was conducted using means and standard deviations of organizational fidelity scores.  Qualitative data were analyzed using content analysis to identify relevant themes on barriers and facilitators of MedMAP implementation. <p><b>Results: </b> Organizational support for MedMAP implementation was moderate. Support was highest for prescriber access to patient information and scheduling flexibility for urgent patient problems. Support was lowest for medication availability and identification of treatment-refractory patients. Facilitators to implementation included clinician awareness of the benefits of MedMAP in the provision of clinical care, communication between stakeholders, and feedback on fidelity ratings. Barriers to implementation included MedMAP requirements that were inconsistent with work flow, inadequate computer-based resources, organizational culture, payer source restrictions on reimbursement for several elements of MedMAP, and mandated restrictions from the state mental health regulatory agency related to medications included in the formulary.   <p><b>Conclusion: </b> EBP implementation can be improved through nursing leadership at multiple levels within a service delivery organization, a paradigm shift in academic and clinical settings to support the use of EBPs, and development of innovative care delivery models. Nurses need to develop leadership, policy, patient advocacy, and information technology skills to promote optimal implementation of EBPs in their practice setting.en_GB
dc.subjectschizophreniaen_GB
dc.subjectevidence-based practice implementationen_GB
dc.subjectmedication managementen_GB
dc.date.available2013-10-22T20:31:01Z-
dc.date.issued2013-10-22-
dc.date.accessioned2013-10-22T20:31:01Z-
dc.conference.date2013en_GB
dc.conference.name24th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationPrague, Czech Republicen_GB
dc.description24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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