How to use the template to complete this assignment:
- Open the template and save on your computer. Rename the PowerPoint file with your First and Last Names.
- Refer to the Exemplar Capstone Poster Example.
- Using your MSN Capstone Project Proposal Form complete the sections on the PowerPoint:
- Abstract – In this section provide an abstract of your proposal. This is only a proposal and is not a project to be implemented. Only provide the information you have actually completed on your MSN Capstone Project Proposal Form.
- Background Information – In this section provide the background information on the problem. Why is this project important?
- PICOt Question – In this section provide your PICOt question from Week 5 section on the MSN Capstone Project Proposal Form.
- Literature Review – In this section provide a review of the literature. What were the themes?
- Evidence-Based Intervention – In this section describe the evidence-based intervention. What will be done?
- Outcome Measures – In this section provide your outcome measures (3) and definition. What do you plan to measure to demonstrate success.
- References – In this section provide no more than two (2) top references you used in the literature review to support your proposal.
- Please use the template to complete this assignment. Attached is also an exemplar as a guide. This has to be based on the project last attachment (the one about asthmatic children). This project will be like a resume of the other one attached.
NP Adherence to Practice Protocol:
Management of Persistent Pain in Older Adults
George Peraza-Smith, APRN, DNP, FAANP1; DNP Chair2, GNP, DNP, FAANP
1South University, 2Case Western Reserve University
Even though persistent pain is highest among
older adults, they have been insufficiently
represented in clinical trials and studies on the
management of persistent pain. Agism has had
a negative impact on the adequate assessment
and management of pain in older adults.
Evidence has emerged indicating serious risk for
cardiovascular, gastrointestinal and renal
dysfunction with consistent use of NSAIDs and
COX-2 analgesics. Other evidence supports the
efficacious use of opioid analgesic in the
treatment of moderate-to-severe persistent pain
in older adults. Updated guidelines recommend
more reliance on opioid analgesia.. This
proposal aim is to implement an evidence-based
practice protocol on the pharmacological
management of persistent pain in older adults.
An estimated 25% to 50% of older adults living
in the community and up to 80% of those in
nursing homes experience significant pain at
least some of the time. Undertreated persistent
pain in older adults has been linked to
depression, anxiety, cognitive impairment,
delirium, sleep disturbances, functional decline
and increased healthcare utilization and cost.
This project will implement a best practice so
that each older adult in a clinic will be assessed
and treated more effectively.
Persistent pain is a personal emotional and physical
Untreated or Inadequate Pain Management
• Persistent pain is under-recognized and under-treated
in older adults in many settings.
• Those with dementia have a greater risk for
inappropriate and inadequate pain treatment.
Pain Assessment with Older Adults
• Many older adults under-report their pain so as not to
be a burden.
• Numeric Rating Scale (1-10) has been shown
ineffective with older adults.
•IPT has high validity and reliability.
Opioid Use with Older Adults
• Guidelines support for persistent pain.
• Prescribing practice of opioids in older adults is mixed.
1.GSA. (2009). Pharmacological management of
persistent pain in older persons. Pain
Medicine, 10(6), 1062-1083.
2. Flaherty, E. (2021). Pain assessment for older
adults. ConsultGeri, 7.
Population (P): NP providers who make rounds in a 50-
bed skilled nursing facility
Intervention (I): Implementation of an evidenced-Based
Protocol on the management of persistent pain in adults
50 years and older
Comparison (C): Current practice of no protocol
Outcomes (O): 20% improvement in self-report pain
relief, 90% compliance rate of providers with protocol,
50% reduction on the use of NSAID with adults 50 years
time (t): 60-days
Implementation of a best practice protocol from
the American Geriatrics Society on the
pharmacological management of persistent pain
in older adults.
• Standardized pain assessment tool
• Initial treatment – Acetaminophen
• NSIDs and COX-2 used rarely
• For pain scores at moderate or greater, opioid
therapy is considered.
© 2021 South University. All rights reserved.
Outcome 1 – Iowa Pain Thermometer (IPT) self
report on pain intensity related to a thermometer.
Outcome 2 – NP compliance rate with
Outcome 3 – Filled NSAIDs per day compared
to prior to implementation of protocol.