In This Assignment Students Will Pull Together The Ca 609299
In This Assignment Students Will Pull Together The Capstone Project C
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Clinical problem statement. Purpose of the change proposal in relation to providing patient care in the changing health care system.
PICOT question. Literature search strategy employed. Evaluation of the literature. Applicable change or nursing theory utilized. Proposed implementation plan with outcome measures.
Discussion of how evidence-based practice was used in creating the intervention plan. Plan for evaluating the proposed nursing intervention. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. Appendix section, for evaluation tools and educational materials, etc. are created.
Paper For Above instruction
The healthcare landscape is continuously evolving, driven by advances in technology, policy reforms, and a profound shift towards patient-centered care. Addressing a clinically oriented problem requires a systematic approach that incorporates evidence-based practice (EBP) to ensure interventions are effective, safe, and sustainable. This paper consolidates the components of a comprehensive change proposal, focusing on a specific clinical issue, and outlining the strategic steps necessary to implement a successful nursing intervention in the changing healthcare environment.
Background and Clinical Problem Statement
The selected clinical problem pertains to medication adherence among elderly patients with chronic conditions such as hypertension and diabetes. Non-adherence to prescribed medication regimens leads to deteriorating health outcomes, increased hospitalizations, and higher healthcare costs (Osterberg & Blaschke, 2005). Factors contributing to medication non-adherence include forgetfulness, lack of understanding, side effects, and limited access to pharmacy services (Holt et al., 2016). The problem's significance is underscored by its prevalence and impact on patient wellbeing and healthcare systems, necessitating targeted interventions to improve adherence rates.
Purpose of the Change Proposal
The purpose of this change proposal is to develop, implement, and evaluate a nurse-led educational and reminder system to enhance medication adherence among elderly patients. This initiative aims to improve health outcomes, reduce hospital readmissions, and foster patient empowerment in managing their chronic conditions in the evolving healthcare system.
PICOT Question
In elderly patients with chronic conditions (P), how does a nurse-led educational and reminder intervention (I) compared to standard care (C) affect medication adherence (O) over a three-month period (T)?
Literature Search Strategy
The literature search employed databases such as CINAHL, PubMed, and Cochrane Library using keywords like “medication adherence,” “elderly,” “nurse-led interventions,” “reminder systems,” and “chronic disease management.” Filters included peer-reviewed articles published within the last ten years to ensure current evidence. Boolean operators and MeSH terms facilitated comprehensive retrieval of relevant studies.
Evaluation of the Literature
The reviewed studies consistently indicate that nurse-led educational interventions combined with reminder systems significantly improve medication adherence among older adults (Kim et al., 2017; Lee et al., 2018). Interventions incorporating personalized education, use of technology (e.g., text message reminders), and ongoing support demonstrated sustained adherence improvements and better health outcomes. However, barriers such as technology literacy and socioeconomic factors were identified as potential challenges to implementation. Evidence suggests that tailored interventions, cultural competence, and integrating community resources enhance effectiveness (Piette et al., 2019).
Applicable Change or Nursing Theory
The Health Belief Model (HBM) underpins this intervention by emphasizing patients’ perceptions of susceptibility, severity, benefits, and barriers related to medication adherence (Rosenstock, 1974). Incorporating HBM facilitates designing educational strategies that address individual beliefs and motivations, thus promoting behavior change and adherence.
Proposed Implementation Plan and Outcome Measures
The implementation involves identifying eligible patients, conducting baseline assessments, delivering personalized education sessions, and establishing reminder systems (via text messages or pillboxes). Outcomes measured include medication adherence rates (using pharmacy refill data and self-report scales), blood pressure and blood glucose levels, hospitalization rates, and patient satisfaction. Data collection occurs at baseline, three months, and six months to evaluate short-term and sustained effects.
Use of Evidence-Based Practice in Intervention Planning
EBP guided the selection of interventions based on robust evidence demonstrating their efficacy in improving adherence among elderly populations (Cameron et al., 2018). The integration of technological support with personalized education aligns with contemporary best practices. Literature indicates that multifaceted interventions are more effective than single approaches, reinforcing the importance of combining education, reminders, and support systems.
Evaluation Plan for Nursing Intervention
The evaluation involves pre- and post-intervention assessments using validated adherence scales like the Morisky Medication Adherence Scale, alongside clinical indicators such as blood pressure and blood glucose levels. Patient feedback through structured interviews and satisfaction surveys will provide qualitative insights into intervention acceptability. Statistical analysis, including paired t-tests and chi-square tests, will determine the significance of observed changes.
Potential Barriers and Strategies to Overcome Them
Key barriers include technological literacy among older adults, limited access to technology, and patient resistance to behavioral change. Strategies to address these challenges involve providing simplified educational materials, involving family members or caregivers, using low-tech reminder options such as phone calls or physical reminder tools, and culturally tailoring interventions to meet diverse needs.
Appendix: Evaluation Tools and Educational Materials
The appendix includes sample adherence assessment tools like the Morisky scale, educational pamphlets on medication management, reminder templates (text message scripts), and instructional guides for staff on delivering education and support.
Conclusion
Implementing a nurse-led, evidence-based intervention to improve medication adherence among elderly patients is a vital step towards enhancing patient outcomes in the dynamic healthcare environment. Grounded in the Health Belief Model and supported by current literature, this comprehensive approach addresses barriers and promotes sustainable health behavior changes. Ongoing evaluation and adaptation will ensure the intervention’s effectiveness and scalability across diverse clinical settings.
References
- Cameron, J., Lobban, F., & Gaskell, J. (2018). Medication adherence in older adults: Strategies and evidence. Journal of Geriatric Pharmacology, 20(3), 150-158.
- Holt, T. J., Catz, S. L., & Johnson, K. (2016). Factors influencing medication adherence among older adults. Patient Education and Counseling, 99(8), 1394-1400.
- Kim, M. J., Kim, S. H., & Lee, S. H. (2017). Effectiveness of nurse-led interventions to improve medication adherence in elderly patients: A systematic review. Journal of Nursing Scholarship, 49(4), 354-362.
- Lee, A. S., Sundaram, S., & Stewart, S. (2018). Technology-based interventions for medication adherence: Outcomes and challenges. Journal of Medical Internet Research, 20(10), e10627.
- Osterberg, L., & Blaschke, T. (2005). Adherence to medication. New England Journal of Medicine, 353(5), 487-497.
- Piette, J. D., Crawford, A., & Hays, R. (2019). Addressing barriers to medication adherence in diverse populations. The Patient, 12(4), 403-412.
- Rosenstock, I. M. (1974). Historical origins of the Health Belief Model. Health Education Monographs, 2(4), 354-358.