Outcomes of Therapeutic Touch in Patient Care, Capstone Project Example

Addressing the needs of older adults often includes the development of new approaches and strategies which are instrumental in their course of care and treatment. For many older adults, much potential exists with the concept of therapeutic touch, which has become increasingly common in offering patients a greater sense of relief and healing for a given diagnosis. Holistic approaches to healing have become more popular in recent years, and demonstrate the capacity of nurses to offer these approaches to patients as viable alternatives to traditional methods. Older adults require different forms of treatment, and should be offered therapeutic touch when appropriate.

Importance of Project

Therapeutic touch and its influence on the wellbeing of older adults is an important hands on method of reducing pain and negative forms of energy which plague many patients. This approach also provides a level of physical contact to provide a sense of healing for one or more parts of the body (Sayre-Adams et.al, 2001). This practice is essential in treating older adults because it enables them to obtain a greater sense of relief from pain in a natural setting without a dependence upon pain medication or other medicinal interventions. It is anticipated that older adults will experience an effective level of relief as a result of this form of treatment. It is important for nurses to expand their skills and knowledge of therapeutic touch and to apply this knowledge to patients who require a means of alleviating different forms of pain.

Impact on care of Older Adults

Therapeutic touch is likely to have a significant impact on the care and wellbeing of older adults who experience pain in different forms. This impact also demonstrates that it is important to provide older adults suffering from pain with a variety of alternatives to improve their overall wellbeing, rather than to merely “solve” the problem with prescription pain medication, which is often highly addictive and may pose more harm than good to patients. Therefore, therapeutic touch may provide additional support for patients who otherwise might not have any real pain relief.

Gaps in Research and Practice

Therapeutic touch is generally described in stages, using energy vibes and physical contact to promote a sense of healing (O’Mathuna et.al, 2002). Although more nurses have begun to incorporate this method into their own practice settings, it remains relatively new in many hospitals and healthcare clinics (O’Mathuna et.al, 2002). Therefore, a number of gaps in research and practice for nurses remain, and must be explored in order to make definitive decisions regarding this practice and its overall impact on older adults experiencing pain in different forms.

Population: Nursing Home Residents Using Pain Medication

There are a relatively significant number of residents in nursing homes who are prescribed various types of medications to alleviate pain. Many of these medications possess addictive tendencies, which may further complicate and compromise a patient’s wellbeing. In addition, some patients might not require a strong pain medication to experience relief, as some cases might be mild and less severe. As a result, it is important to recognize the value of other alternatives to alleviate pain in nursing home residents. Since pain varies from one person to the next in terms of severity and type, it is important to consider other alternatives rather than pain medication to alleviate this pain accordingly.

Aging Theory

In many cases, pain is a consequence of aging, as the body’s natural method of breaking down impacts various organs and systems (Gagliese, 2009). It is believed that “Given the increased vulnerability associated with aging, it is reasonable to expect that pain would differ with age in important, clinically relevant ways” (Gagliese, 2009, p. 344). This coincides with a discussion of the different approaches which are required to address aging and its complications in a manner that is most effective for patients requiring treatments for a variety of conditions, including pain management. Since it is believed that there is a strong correlation between aging and pain in many patients as the body’s natural decline impacts organs, systems, muscles, and bones in different ways (Gagliese, 2009).

Resources to be used

Integrating therapeutic touch as an alternative for older adults requires an effective understanding of the resources that are required to maximize this programmatic benefit to this group. For example, nurses must be provided with the appropriate level of training and education to perform therapeutic touch, which involves the time and effort that is necessary to perform these functions. It is also expected that this level of training will require a predetermined amount of time on an ongoing basis to train new employees in this area. Other resources used may include separate meeting rooms or spaces to perform therapeutic touch on patients.

Budget & Timeframe

The proposed timeframe for a program of this nature is expected to require several training sessions over a period of two to four weeks, and upon completion, nurses and other providers will receive a certificate that they have completed the required training and are prepared to perform therapeutic touch activities on their patients. The costs associated with this training will include the following elements: 1) Salary and fringe benefits for instructors; 2) Materials and supplies, including food and drink for training sessions; 3) Books, DVDs, or other supplemental educational materials; and 4) Meeting space. Each of these costs must factor into the requirements of the proposed project and the essential components that will lead to programmatic success in this endeavor.

Work Plan

The proposed project requires a greater understanding of the different areas of therapeutic touch which are important in establishing an effective work plan for implementation. As a result, it is expected that a project of this nature will require a planning mechanism to ensure that nurse training is properly executed in a manner that will promote knowledge and success with this new approach. The work plan must include the required training and education that are necessary to qualify nurses to perform these functions in the appropriate manner. In addition, the rollout of this intervention will be performed on a gradual basis and will address problems as they arise so that all required adjustments are made in a timely manner. It is important to develop and to stick to the work plan as closely as possible to ensure that this approach is conducted in an organized manner with consideration of its potential outcomes.

Behavioral Objectives

From a behavioral perspective, nurses who employ therapeutic touch in their daily routine are likely to enhance the lives of their patients, which leads to a greater sense of wellbeing and satisfaction for patients and their caregivers. This is an important opportunity to evaluate the different approaches that are essential to the discovery of therapeutic touch as a positive alternative method to improve the lives of older adults. This leads to a greater level of satisfaction for nurses and other caregivers when their patients experience pain relief via natural and non-chemical means.

Timeline

After the initial training process, which is expected to require two to four weeks, rollout of this technique on patients will be gradual yet steady over a period of months. This will ensure that patients are provided with the promised benefits of therapeutic touch in as many cases as possible, while also evaluating the method itself and how to improve its use in the nursing home environment. Therefore, an evaluation of the method may require an additional period of time to ensure that patient needs are being met with therapeutic touch in a timely manner. Therefore, evaluations must be ongoing and consistent with the objectives of the program as a whole.

Specific Activities

The activities to be considered for a therapeutic touch program for older adults must include a testing mechanism to ensure that this approach will be effective for this population group in as many cases as possible. Therefore, training and education, testing, and full implementation are steps of the process that must be completed to ensure that patient needs and pain alleviation is met with this method. In order to accomplish these different tasks, scheduling must take place that will accommodate these needs accordingly.

Evaluation Plan

Evaluating the success of therapeutic touch on older patients with pain is generally based upon their reactions to this pain and whether or not the method alleviates this pain as it occurs in different forms. Therapeutic touch as an effective means of improving pain management must also consider existing research to accommodate this practice, which to date possess mixed perspectives (Aghabati et.al, 2010). In evaluating a prior study involving cancer patients, it was determined that “TT is a modality that is non-invasive, readily learned, and can provide a non-pharmacological intervention for the selected pain and fatigue of the these patients. TT can be applied in many different settings such as home or day care, and requires no specialized equipment. This non-pharmacological intervention warrants further nursing researches especially in vulnerable populations (such as neonates and the frail elderly), for whom invasive therapies are problematic” (Aghabati et.al, 2010, p. 380). Therefore, it is essential to determine how to best move forward with this approach in nursing home settings where therapeutic touch might provide effective benefits to alleviate pain a variety of patients.

Implementation Strategy

Implementing a program of this nature also requires a greater understanding of the different elements which contribute to successful outcomes for older adults. This is accomplished through a programmatic intervention which is based upon overcoming barriers in believing that pain might be alleviated without the use of medications. In many ways, this requires an adjustment of philosophy regarding pain management, using new approaches that are less expensive and less harmful from a chemical perspective. These elements are critical in shaping a program to support the pain management needs of older adults facing pain from a variety of causes.

Barrier and Facilitators to Implementation

Implementing a program of this nature is likely to experience a number of important barriers, which must be overcome to ensure that patient healing is a top priority. Attitudes regarding alternative medicine and its approaches are perhaps the most significant barrier, as many clinicians remain opposed to these methods because they do not believe that they will lead to successful outcomes. Under these conditions, it is important to address prior research findings regarding the value of these methods and how they might support an improved quality of life and wellbeing for patients facing critical challenges in the area of pain management. The programmatic structure must also overcome any barriers to accessing the required resources that are necessary to implement the program and to ensure that it achieves the desired objectives in alleviating pain in older adults.

Evaluation: Structure

The programmatic structure must utilize existing resources wisely and should also consider other factors which are important in order to achieve the desired results. An evaluation of the chosen structure must be conducted to ensure that efficiency and effectiveness are maximized at all times to achieve optimal performance. This is also essential in order to determine the best possible approaches to the structure, including an assessment of existing participants and if additional participants (i.e. trained nurses) and/or educational instructors are required to ensure that the program is successful.

Function

After implementation, the program must function as a stand-alone entity, and must focus on the different approaches that are required to ensure that success is achieved. It is expected that the function of this program will grow over time, based upon the results of the intervention and how it impacts pain in the designated older adult population. Once these opportunities are identified and resources are secured, it is expected that additional frameworks will be considered to ensure that patients will benefit from the intervention and its potential for success within this population group.

Outcome

It is expected that therapeutic touch as an active alternative for pain management will provide patients with the tools and resources that are necessary to support their pain management needs. In older adults, it is important to maximize the quality of their lives through a variety of techniques, and by supporting non-medicinal approaches to patient care, it is believed that their lives will improve over time and their pain will be overcome.

References

Aghabati, N., Mohammadi, E., and Esmaiel, Z.P. (2010). The effect of therapeutic touch on pain and fatigue of cancer patients undergoing chemotherapy. eCAM, 7(3): 375-381.

Gagliese, L. (2009). Pain and aging: the emergence of a new subfield of pain research. The Journal of Pain, 10(4): 343-353.

O’Mathuna, D.P., Pryjmachuk, S., Spencer, W., Stanwick, M., and Matthiesen, S. (2002). A critical evaluation of the theory and practice of therapeutic touch. Nursing Philosophy, 3: 163-176.

Sayre-Adams, J., Wright, S.G., Biley, F.C. & Richardson, M. (2001). The Theory and Practice of Therapeutic Touch. Amsterdam: Elsevier Health Sciences.