Abstract
Drugs that have anti-cholinergic affects are known to have side effects such as urinary retention and constipation. In older people these drugs can also contribute to cognitive decline and loss of functional capacity leading to older patients being at risk of increased falls. Taking multiple medications with anti-cholinergic affects create a higher anti-cholinergic burden. Hilmer and Gnjidic (2022). Drugs that have anti-cholinergic affects block acetylcholine receptors (muscles do not receive neurotransmitter and therefore not functioning properly), Brown (2019). Some of these drugs are prescribed to have this effect but, in some patients’, this is an adverse effect. Although there are some drugs that are classed as anti-cholinergic drugs there are also drugs that have this effect which are not classed as anti-cholinergic such as anti-histamines, anti-depressants and anti-psychotics, Hilmer and Gnjidic (2022). This service improvement project will aim to introduce the anti-cholinergic burden scoring tool to a frailty unit for patients admitted with a fall with the aim of reducing the risk for patients who score highly being re admitted to hospital due to falls. Method This project will deliberate the development of change management using ADKAR (Awareness, Desire, Knowledge, Ability then Reinforce), Hiatt (2021) model of change management. By using this model, the author can prepare people for change, help people change and re-enforce the change allowing a successful service improvement. Results on completion of this project, the anti-cholinergic burden scoring tool will be successfully implemented onto the frailty unit and used by the medical team for patients admitted following a fall. By using ADKAR, Hiatt (2021) the author will be able to raise awareness, desire, build on knowledge and ability then reinforce the importance of reducing the risk of falls in older patients.