Purpose: Read the article by Kovacevic et al. (2014). In this article, the authors described the use of the STOPP/START criteria to identify whether patients were over-prescribed or under-prescribed medications. For this assignment, you take the perspective of the home health nurse providing care for an individual living with a chronic disease of your choice (diabetes, hypertension, COPD, or depression).

Using the STOPP/START criteria, determine which medications your older adult patient should be prescribed, and what medications are to be avoided. As a nurse advocate, what would your role be if you discovered that your patient had contraindications to prescribed medications? What are the ethical issues related to this situation?
The paper will be 3-4 double-spaced pages excluding title page and references. References should be a minimum of three (3) peer-reviewed journals not included in your assigned readings. Webpages will not be considered as scholarly articles regardless of the source. The paper must be grammatically correct and use APA (6th ed.) style and formatting.
CO 2 ? Apply knowledge of pharmacology, pathophysiology, and nutrition as well as established evidence-based practice to the care of the older adult with common health alterations.
CO 3 ? Identify health education and safety needs of the older adult patients and their families, and provide education in conjunction with members of the health team.
CO 4 ? Use organizational and priority setting skills when providing care to older adult patients with common health alterations in selected settings.
CO 6 ? Adhere to ethical, legal, and professional standards while maintaining accountability and responsibility for the care provided to older adult patients.
Due Date: This paper assignment must be uploaded onto Sakai by 2355 on Sunday of Week 5.
Points Possible: 250 Points (25% of grade)
1. Describe the chronic disease that you chose. Provide information on the pathophysiology and psychosocial changes of the older adult living with this disease.
2. Based upon the chronic disease you chose and using evidence-based research to provide standard of care, outline the recommended prescriptions to manage this disease process.
3. Using the STOPP/START criteria, compare against the evidence-based research what medications older adults should be prescribed, and what medications older adults should not be prescribed. Discuss the rationale of why the older adult should or should not be prescribed these medications. Include the psychosocial and physiological variations seen in older adults.
4. Discuss what the role is of the nurse advocate when discovering that an older adult has been prescribed a medication contraindicated on the STOPP/START criteria.
5. Discuss any ethical issues that the nurse may need to manage when advocating for the older adult and prescribed medications.
NUR330E 2
6. Using your assigned class readings and a minimum of three additional peer-reviewed articles (published within the last 5 years) to support your discussion.
7. The paper must follow APA format: include title page, reference page, use 12-point Times New Roman font, and include in-text citations (use citations whenever paraphrasing, using statistics, or quoting from an article). Please refer to your APA manual as a guide for in-text citations and sample reference papers.
8. Students are permitted a maximum of two direct quotes. More than two direct quotes will result in a loss of marks.

Antimisiaris, D., & Cheek, D. J. (2014). Polypharmacy. In K. Mauk (Ed.), Gerontological nursing. Competencies for care (3rd ed., pp. 417-456). Burlington, MA: Jones & Bartlett Learning.

Cambria. (2013). STOPP START toolkit supporting medication review. Retrieved from http://www.cumbria.nhs.uk/ProfessionalZone/MedicinesManagement/Guidelines/StopstartToolkit2011.pdf

Kovacevic, V. S., Simisic, M., Rudinski, S. S., Culafic, M., Vucivevic, K., Prostran, M., & Miljkovic, B. (2014). Potentially inappropriate prescribing in older primary care patients. PLoS ONE, 9(4), e99536. doi: 10.1371/journal.pone.0095536

Mauk, K., Hanson, P., & Hain, D. (2014). Management of common illnesses, diseases, and healthy conditions. In K. Mauk (Ed.), Gerontological nursing. Competencies for care (3rd ed., pp. 417-456). Burlington, MA: Jones & Bartlett Learning.