Mentored Quality Improvement Strategies to Enhance Deprescribing During COVID-19: A Case Series of Three Nursing Homes.

Abstract

Background In post-acute and long-term care (PALTC) facilities, challenges exist to optimizing medication management. During the COVID-19 pandemic, nursing homes (NHs) sought ways to streamline medication administration and deprescribe medications. Objective This quality improvement (QI) initiative aimed to implement medication-related projects in three NHs. Methods Each NH was assigned a nurse practitioner (NP) QI mentor who led the facilities through the QI efforts using validated tools during the COVID-19 pandemic. Each facility selected their medication-related topic of interest. The QI efforts were implemented by the NH staff including the director of nursing, providers, and consultant pharmacists. Results Two facilities focused on general medication deprescribing, and the third facility focused specifically on antipsychotic deprescribing. Successful deprescribing interventions occurred in all three facilities; however, they did not achieve all QI goals. Conclusion Successful deprescribing can occur using mentored implementation of QI tools. However, it is imperative to have key stakeholders within NHs who are supportive and engaged in the deprescribing process, such as facility staff (leadership and front-line staff), facility providers, consultant pharmacists, and residents/families.