Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Robert McWhirt

Abstract

The use of antipsychotic medications in older adults with dementia increases risk of

mortality; therefore, it is critical that nurses use nonpharmacological interventions in dementia care. The nurses' role is integral to implementation of treatment strategies to dementia patients and efforts to improve care in patients with dementia using a nonpharmacological approach are necessary. Therefore, guidelines outlining nonpharmacologic dementia care management will enable nurses to provide a wider spectrum of care to dementia patients. The purpose of this project was to make recommendations for the development and implementation of interdisciplinary practice guidelines to standardize care in the organizational setting. An integrative literature review was conducted using the Fineout-Overholt, Melnyk, Stillwell, and Williamson's analytical approach to reviewing evidence using 7 levels for evaluating the hierarchy of evidence. Inclusion criteria were limited to studies from January 2010 to October 2017 in English with full text. A total of 16 studies were reviewed and categorized according to 1 of the 7 hierarchical levels. Findings were summarized at each appropriate level and included systematic review or meta-analysis, randomized controlled trials, controlled trial without randomization, case-control or cohort studies, qualitative or descriptive studies and expert opinion or consensus. Non-pharmacological approaches including music therapy, cognitive-behavioral therapy, distraction, horticultural therapy, ear acupressure, and cognitive stimulation were all shown to be effective in dementia care. Social change based on this project targets improving nurses' knowledge of nonpharmacological interventions in dementia care.

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