Dissertation
Medication Management Among Persons Who Have Experienced Chronic Homelessness
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background: Medication non-adherence is a well-documented issue among persons experiencing homelessness (Hird et al., 2024). The gold standard intervention for addressing homelessness are Permanent Supportive Housing (PSH) initiatives. While these initiatives improve long-term housing stability, similar barriers to medication adherence are observed in this population, indicating a need for further intervention (Aubry et al., 2020). Medication management programs (MMPs) are an evidence-based intervention to improve medication adherence which reduces disease complications, decreases mortality, and improves quality of life (Cadel et al., 2023; Ganguli et al., 2016). Purpose: The purpose of this project was to implement a standardized medication management program across two PSH initiatives to improve the quality of services offered onsite and improve medication adherence. Methods: A three-tiered MMP was developed, along with an organizational policy outlining the roles and responsibilities of staff members offering services onsite and electronic documentation logs to track participant s medication adherence. Additional project interventions included tenant signed service agreements, a partnership with a local pharmacy, and educational materials for staff members. Over the 17-week implementation period, 14 PSH tenants and 25 PSH staff members participated in the program. The Model for Improvement (Institute for Healthcare Improvement, n.d.) was utilized to ensure timely assessment of the need for change and evaluate change effectiveness throughout the implementation period.Findings: Documentation related to medication adherence increased from 38% to 86% at site A and 0% to 87% at site B. Staff satisfaction with the education they were provided regarding their role in offering medication management services increased from 21% to 89%. Additionally, staff role clarity improved from 64% to 89%. The number of tenants who reported MMP services met their needs increased from 55% to 100%. Onsite providers also reported a positive impact of the project on their clinical decision making. Discussion: This project extrapolated evidence of the effectiveness of MMPs to a PSH setting. Furthermore, it demonstrates the positive impact of nurses in reducing barriers to health in a community setting.
Details
- Title: Subtitle
- Medication Management Among Persons Who Have Experienced Chronic Homelessness
- Creators
- Samantha Rosonke - University of Iowa
- Contributors
- Tess Judge-Ellis (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Family Nurse Practitioner
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Samantha Rosonke
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841034902771
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