Application of Epidemiology in Nursing Practice - University Report

This report delves into the application of epidemiology within nursing practice, critically reviewing a study on the epidemiology of polypharmacy in older adults. The study, employing a cohort design, investigated the risks associated with multiple drug use in this population, analyzing data through statistical models like logistic and Cox proportional regression. The findings highlighted the increased risk of chronic diseases and mortality among older adults on multiple medications. The report then translates these epidemiological insights into practical nursing implications, emphasizing the role of nurses in managing polypharmacy through patient education, medication management strategies, and the use of memory aids. It discusses the importance of healthcare approaches, including person-centered care and family involvement, to mitigate the adverse effects of polypharmacy. The report also acknowledges the study's limitations and proposes further research questions to enhance the understanding and management of multi-drug treatments in geriatric care.

Running head: APPLICATION OF EPIDEMOLOGY IN NURSING
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Application of Epidemiology in Nursing Practice
Name of the Student
Name of the University
Authors Note

APPLICATION OF EPIDEMOLOGY IN NURSING
APPLICATION OF EPIDEMIOLOGY IN NURSING PRACTISE
Epidemiology is the analysis and study of health determinants or patterns of health that
are responsible for causing disease in a particular population. The epidemiologists conducts the
study with a definite population and collects the data depending upon the study type and finally
analyzes and interpret the result (Gulis & Fujino, 2015). The major types of research includes
cause disease outbreak in a population, method of transmission of disease, monitoring the
condition and also finding the effect of the drugs in different populations. The epidemiology
study helps the healthcare professionals in many ways such as understanding the issue, planning
a proper strategy to cure the disease in the community or healthcare services and applying
correct prevention to control the situation and helping the community or a particular population
in resolving the condition (Frerot et al., 2018). The studies help in planning a method in nursing
research, evaluating the research literature, developing a structure for creating clinical decisions,
planning treatment for the patient or community who are at need and also it provides an
opportunity to enhance the nursing practice (Birmann et al., 2016). Polypharmacy or multi-drug
treatment is used in clinical centers to cure chronic diseases. It is usually prescribed to older
adults as they suffer from chronic diseases and needs complex care. However, the consumption
give rise to many chronic complications such as renal failure, diabetes, pain and even increases
the risk of mortality. The main purpose of the below paper is to critically review an article
named “The epidemiology of polypharmacy in older adults: register-based prospective cohort
study” and apply the knowledge gained from the article in nursing practice.
Study design of the article
The main objective of the article was to identify the effect of polypharmacy among the
older adults and the risks associated with using multiple drugs (Morin et al., 2018).

APPLICATION OF EPIDEMOLOGY IN NURSING
Polypharmacy is a combination of drugs which are often used in complex care among the older
adults and also in middle aged people. It increases the risk factors such as high death rate among
the older adults due to less immune capacity of the body and also due to complex drug-drug
interaction which the body fails to resist (Golchin et al., 2015). The study conducted with the
help of cohort study where the older adults above 65years were included as a participate for the
research. The cohort study or cohort sampling a method where the participates or the population
with same characteristics are included and cross-sectional intervals are performed. It is one of the
most common designs that are used in the epidemiological research (Setia, 2016). It also helps in
identifying the risk factors associated with the drugs. The study followed about 1.7 million
elderly adults who were under treatment which was recognized by from health care services. The
study aimed to identify the effect of multiple drugs at the beginning of the study and the
incidence of those drugs. The study design chosen is appropriate because it helps in identifying
the effects of drugs among the population with same characteristics. It also performed a
prospective longitudinal study among participates. The inclusion criteria of the study was the age
factor and the baseline was also same for all participates. The exclusion criteria that was
followed are participates with duplicate identity and other factor was older participates exposed
to multiple drug treatment for more than 5 and 10 years. The criteria was useful because the
greater period of exposure may lead to false result (Morin et al., 2018).
Analysis of the data and results obtained
The assessment of the result was done with the help of three characteristics such as the
date of allocation, the amount of drug that is distributed to each participates and the amount of
daily dose. The authors divided the population for measuring the characteristics of any individual
at the starting point. Other characteristics that were included are education and place of living

APPLICATION OF EPIDEMOLOGY IN NURSING
such as community or in health care homes. The division is for recognizing the correct effect
among any individual due to multiple drugs. Statistical analysis was done to identify the
characteristics. Statistical analysis is important because it provides proper information of the
data; it validates the data and also credits the usefulness of the data (Ali & Bhaskar, 2016).
Logical regression model was also done with the participant’s age, place of living; number of
diseases the older adults is involved and also with the death rate to identify the factors that are
associated with the multiple drug at the starting point. The result that obtained was odd ratio with
confidence intervals of 95%. The model is dependent upon two independent variable to identify
the problem, here in this case the effect of drug and the older person. The analyses were done
with correct method (Sperandei, 2014). The odd ratio indicates constant effect upon all the
participates which is logical in this case. The issues allied to the extraordinary risk of multidrug
were performed by Cox proportional regression model. This model helps in analysis of the effect
upon a particular time and the result obtained is 95%, which indicates that the survival time of
the patient (Brembilla et al., 2018). The Kaplan- Meier graph was plotted to identify the survival
time of the patient after treatment. The graph describes the survival time effectively and in useful
in medical research (Dudley, Wickham & Coombs, 2016).
The findings suggested that frequency rate of multiple drugs among individuals without
polypharmacy at starting position was 19.9 % by 100 person years which means number of
participates in the study and the time limit for which it depends upon the study. The effect of
multidrug is also high including occurring of diseases such as heart attack and renal impairment.
The finding also suggests and states that order persons who are consuming multiple drugs for a
prolonged period are more at a risk of death compared to individuals new to the treatment (Morin
et al., 2018).

APPLICATION OF EPIDEMOLOGY IN NURSING
Health Care Approach and Management
Poly pharmacy is a very common problem among the elderly person. Nurses play an
important role in managing the risks and chronic complications. The primary management can be
done by keeping a tract of all the medicines along with the optimal dose, reason for consumption.
The article focused upon the period of consumptions of multiple drugs and its effects over a
period among older adults, in that respect the result concluded that this effects increases the
death rate. The health care approach must focus upon reducing this burden of drugs along with
reducing the number of cases. The health care practitioners must manage this situation by
providing person centered care and patient education (Pieramico et al., 2014). Nurses must
educate the older person about the adverse effect of drugs, taking the medicines at proper time
and as directed provided emergency services to the drug associated problems. The nurse and the
health care practitioners can also provide suggestions for safe storage of drug as adverse effect
can also give rise to improper storage of drugs (Metin Akten, 2018).
Strategies for reducing polypharmacy effect
The health care practitioners can address and manage this situation by establishing a
memory aid facility especially for the older patients. The nurses can help the patient in advising
to consume correct medicines by providing services like colour-coded charts, voice recorded
messages and also family centered care. Importance can also be given in prescribing the less
number of medicines to the older adults in that case a regular dispensing report about the various
drugs can be adapted by the healthcare practitioners (Metin Akten, 2018).
View about observation

APPLICATION OF EPIDEMOLOGY IN NURSING
The observation clearly stated that the use of various drugs is harmful and leads to the
development of chronic disease and increases the mortality rate especially among the older
person. The older people are very much prone diseases due to lower immune capacity of the
body. The side effects of the drugs are also common among this community. The metabolic rate
of the body also diminishes in the body and the clearance rate is low due deposits the drugs into
the circulates and develops chronic diseases. The finding is appropriate in this case (Lavan &
Gallagher, 2016). The research questions that can be formed from this chosen article are-
1. What are the roles and responsibilities of a registered nurse in managing this
chronic impact of multi-drug among the older adults?
2. What knowledge does the nurse possess about different kinds of drugs?
3. What are the barriers or problems that can create problem in providing the care?
The findings are useful in planning treatment plan for the geriatric patient in the nursing
practice. The plan must include limited amount of drugs and more amounts of non-
pharmacological interventions to treat the patients (Pieramico et al., 2014). The dose and timing
of the drug must be well monitored to avoid complications. The study is helpful in nursing
practice to analyze the effect of multi drugs in older patient along with death rate. The nurses can
approach the patient and promote awareness about the effect of multi-drug by effective
communication and teaching. The family member can also be encouraged to participate in the
campaign problem to learn and drugs dosages, proper storage and right time of consumption. The
older persons are often found with cognitive impairment in that case nurses must provide
memory aid services like voice messages with the help of technologies. Dietary management can
also be given importance in order to reduce problems or building up immune capacity to
overcome the adverse effect or chronic diseases.

APPLICATION OF EPIDEMOLOGY IN NURSING
Limitation
The study is limited to a certain age group that is above 65 in Sweden; however, the
impact can also be studied in different age groups like onset of geriatric period. The time of
study was also limited and requires detailed explanation about the mechanism of the body failing
to adjust with the drug-drug interaction (Morin et al., 2018).
Conclusion
The above paper discussed about the concept of epidemiology and its impact in nursing
practice. It is a study that includes disease epidemic in a population, process of transmission of
disease, observing the condition and also verdict the effect of the drugs in different populations.
The paper also critically analyze an article based upon the epidemiology of multiple drug among
older adults. The finding suggests that the use of multiple drug lead high death rate among the
adults and causes chronic diseases. The paper also discusses about the application of this
findings in the nursing practice such as providing education to the patient along with family,
knowledge about the dosage of drugs and effects, providing technological services to address the
issue. Lastly, the paper focuses upon the limitations in learning that can be researched in future.

APPLICATION OF EPIDEMOLOGY IN NURSING
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APPLICATION OF EPIDEMOLOGY IN NURSING