Patients taking an excessive number of medications can have medication errors, falls, and other drug related problems. This condition has a variety of definitions that all use one name, polypharmacy. Polypharmacy affects not only the United States but the whole world. Patients commonly have this problem at age 65 or older. As patients age, they develop more diseases. Each disease requires a medication to treat symptoms. Patients at the end of life take a large number of medications which contribute to this problem. To help manage this problem with patients who are terminally ill, this scholarly project uses the Rosswurm and Larrabee evidence-based practice model as a stucture to put the project together. The theoretical model used as a guideline to help medical staff become accustomed to change is the Lewin’s Change Theory. This theory assists staff in implementing new changes. Data collection is performed using questionnaires to measure how well medical staff learn from the education given to them. The project uses a prescribing tool as a reference for medical staff to assess how many approriate medications each patient is taking. The number of medications prescribed to patients is also tracked by using chart audits. The purpose of these objectives is to demonstrate a decrease in the number of prescribed medications. There is collaboration between nurses and physicians in using the prescribing tool. A PowerPoint presentation was completed for education to deal with the barrier of using the prescribing tool incorrectly. The results for the project were improved understanding of the prescribing tool as demonstrated by the questionnaires. A decrease in unnecessary medications to terminally ill patients was noticed by chart audits. From 59 patients, 18 medications were discontinued when using the STOPP/START tool as screening criteria. A paired t-test was used to compare chart audit results. The p-value was 0.0148 showing the intervention was effective. Pre and posttest questionnaires with the medical staff involved demonstrated a 60% increase in overall learning with the STOPP/START tool. Conclusion: This scholarly project brought an awareness of the importance of medication review through the use of the STOPP/START tool. Staff had improved understanding on why medications could be discontinued with an evidence-based rationale. This scholarly project addressed the problem of polypharmacy in the hospice setting. Sustainability of this project in the selected job setting was not feasible related to personal opinion. Some staff did not have interest in using the STOPP/START tool while others did. The STOPP/START tool will remain at the job site as a resource for those interested in its use.
