BJ week 7

NU 700 Assignment: Unit 7 - KTA Part 3 Evaluation Measures

Instructions: Utilize the template to provide responses to each prompt. Please do not include a cover/title page for the assignment.

NAME OF Suzie Q. Student, RN, BSN

STUDENT:

Part 1: Questions

Questions:	Type Answers in the Spaces below-you may bullet when possible; leave out any “fluff” as this should be a quick glance summary of the project/process
1. Describe the practice problem you identified for the Unit 4 assignment (with in-text citation)	Provide a condensed description of the practice setting and problem provided in the article chosen from Unit 4 (with in-text citation). Basic data is needed to support the existence of the problem (with in-text citation)
2. Provide a brief overview of the alternate intervention you identified for the Unit 5 assignment (with in-text citations)	Explain what the literature says about the selected intervention (with in-text citations). Basically, condense the literature summary from Unit 5.
3. Provide a succinct Aim Statement for the improvement process you would launch for implementing your identified alternate intervention. Use the link below to access IHI Worksheet to guide creation of this succinct (one line) statement. https://www.ihi.org/sites/default/files/2023-11/IHITool_Aim-Statement-Worksheet.pdf	One Sentence Statement: Ex: By January 31, 2020, of children under the age of 12 for whom a Health Needs Assessment is recommended, 95% will receive the assessment in Middlesex County (IHI, 2019) *Note the AIM is SMART: this is the direction of what we want to achieve Specific Measurable Attainable Realistic Time-limited
4. Discuss who will be involved in the improvement process, and why. Utilize a minimum of one resource to support this discussion (in-text citation).	Explain how to develop a diverse improvement process team (with in-text citation). Patient/families can be part of the team. · List the team members & their role · List the rationale for their inclusion Ex: Team Members: 1. Graduate Student · Role-Team Leader · Rationale-IT Expert Here is a great resource to guide this discussion for your alternative improvement process: https://www.ihi.org/how-improve-model-improvement-forming-team
5. What measure(s) will you utilize to evaluate the outcome of implementing your identified alternate intervention? Provide a rationale why you selected/identified the measure(s). Use the link below to access IHI’s resource on Improvement Measures. https://www.ihi.org/how-improve-model-improvement-establishing-measures	Present the quality measure(s) with data collection methods and the rationale for why you chose this/these method(s). Outcome measure-Shows how the system is impacting patient. Links back to the numeric goal within the aim statement; typically, there is one outcome measure. · Method: Ex: Likert surveys, pre/post surveys, rates · Rationale: explain why choosing an outcome measure and rationale for the type of data being collected. Process measure-Are the current processes effective; looks at the parts/steps in the system · Method: Ex: chart review, qualitative surveys · Rationale: explain why choosing a process measure and rationale for the type of data being collected.
6. What is your desired outcome from implementing your alternate intervention?	What is tangible evidence the AIM has been met; what you personally would want to achieve from the implementation of this intervention if done in a real-world setting. What did YOU learn from this theoretical quality improvement project? Personalize this section.

Part 2: APA Reference List

Please provide a minimum of 3 APA references that correspond with citations within the table. Use APA format.

References

2

The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients

Beverly Jordan

Herzing University

NU700 Knowledge for Nursing Practice

Module 4 Resubmission

Dr. Jessica Clark

04/08/2025

The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients

Introduction

Medication nonadherence in stroke survivors is a significant public health issue, and studies suggest that 30-50% of patients do not follow prescribed regimens, resulting in avoidable complications (Arkan et al., 2022). This is a critical concern since the secondary risk for stroke significantly increases when drugs like antihypertensives and anticoagulants are not appropriately taken. Nurses, the first point of contact in health care, have a unique chance to act on this threat through systematic action. Ongoing patient interaction provides real-time evaluation of challenges such as cognitive impairment, budget constraints, and literacy levels (Berardinelli et al., 2024). Targeted education with follow-up enables nurses to act at the right moment to reduce the risk of nonadherence. Medication nonadherence undermines not only individual patient outcomes but also overburdens the health systems with recurrent hospitalization and prolonged recovery. Nurses have excellent chances to detect signs of nonadherence early in their routine care interactions. By detecting it early, they can decrease readmission and healthcare costs. Their ability to visualize the cycle of patient needs enables them to develop tailored approaches that bridge knowledge gaps and improve long-term adherence.

Practice Problem Overview

Medication nonadherence among stroke patients is a complex problem driven by medical, psychological, and socioeconomic determinants. Arkan et al. (2022) established that merely 33.9% of stroke patients showed high adherence, and fear of side effects and lack of confidence in medication overuse were the main discourages. Post-stroke cognitive impairments further complicate compliance by disrupting memories regarding dosing or treatment needs. In addition, cumbersome multidrug regimens on a frequent schedule—a frequent regimen in stroke—induce more confusion and omissions (Kumar et al., 2024). A crossover between supervised medication is a sensitive, vulnerable point during in-hospital treatments. In the absence of proper support, there is a high risk of recurrence, disability, and death, which further provides a rationale for consistent nursing interventions. Most patients are sent home without sufficient support systems, and this heightens the likelihood of missing medication or abandoning it altogether. Most stroke survivors battle depression or anxiety, which also influences motivation to adhere to multifaceted regimens. Without structured guidance, even patients with good intentions will default on treatment. This fact highlights the importance of nurses acting as continued contact points for medication management after discharge.

Literature Review: Potential Intervention

Evidence indicates that interventions by nurses are highly effective at encouraging medication compliance among stroke survivors. Interventions typically integrate patient education, regimen simplification, and technological support to overcome multifactorial barriers to adherence. Berardinelli et al. (2024) conducted a systematic review of patients with chronic diseases, noting that patient education by a nurse in the face-to-face format significantly improved adherence, with particularly robust increases in patients with stroke and cardiovascular diseases. They recognized that nurses' ability to deliver personalized education on medication aims, potential side effects, and dosing time helped to moderate patients' misconceptions and concerns, which are crucial risk factors for nonadherence (Arkan et al., 2022). The teach-back method, under which patients repeat instructions to them in their own words verbally, was very effective for stroke patients with cognitive impairments. Informational personalization of the patient's level of functioning is one of the strongest points of nurse-initiated interventions. By using everyday language, visual aids, and interactive teaching modalities, nurses ensure maximum knowledge retention in patients with cognitive impairments. Second, follow-up frequently helps strengthen learning and enforces accountability. Combined, these steps turn information into action plans that patients can uphold outside the clinical setting.

Technology-enabled nurse interventions were also seen as promising. Zhang et al. (2024) compared several randomized controlled trials of eHealth programs delivered by nurses and registered a 50% reduction in missed doses using digital reminders and virtual follow-up. These programs increased adherence and functional recovery by engaging the patients in the rehabilitation program. Kumar et al. (2024) also demonstrated that structured nurse involvement in stroke care teams led to decreased treatment intervals and higher medication adherence rates, notably risky medication like anticoagulants. Their meta-analysis reported that nurse-led protocols reduced door-to-needle times by nearly 20 minutes and enhanced functional outcomes at three months in the same breath. Online platforms enable nurses to monitor compliance in real-time and initiate timely interventions as required. These systems also engage patients with reminders and progress feedback, enhancing a more incredible feeling of control. Of equal importance is the reality that virtual programs led by nurses remove the burden of transport and scheduling inconvenience, particularly for stroke survivors who have limited mobility. This accessibility ensures that more patients receive organized, ongoing care.

The interventions work because nurses' unique role is to provide uninterrupted, patient-centered care. By combining education with evidence-based support interventions such as simplified dosing regimens, reminding, and motivational interviewing, the practical and psychological barriers to adherence can be overcome by nurses (Berardinelli et al., 2024). This integrated approach is particularly vital for stroke patients who have complex medication schedules to add to their cognitive and physical impairment. The literature consistently supports nurse-implemented interventions to reduce preventable complications and improve long-term outcomes in this high-risk population.

Conclusion

Medication nonadherence among stroke patients is a highly complex issue of life-and-death consequences. Nurses with evidence-based practice measures like customized education are the best professionals to address this issue. In the literature review, the efficacy of nurse-implemented interventions for improving adherence, reducing the number of stroke recurrences, and enhancing the quality of life in patients is promoted. With the application of these interventions, nurses can implement research into practice and assist patients in receiving the support they need to manage their medications effectively.

References

Arkan, G., Ordin, Y. S., Ozturk, V., & Ala, R. T. (2022). Investigation of medication adherence and factors affecting it in patients with stroke.  Journal of Neuroscience Nursing,  54(1), 35-41. https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx

Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024, November). Nurse-Led Interventions for Improving Medication Adherence in Chronic Diseases: A Systematic Review. In  Healthcare (Vol. 12, No. 23, p. 2337). MDPI. https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/

Kumar, A., Kumar, M., Verma, P., Pal, R., Nagi, M., Mahesh, K. V., ... & Khurana, D. (2024). Effects of stroke nurse-led acute stroke management on treatment time benchmarks, intravenous thrombolysis rates, and patient outcomes: A systematic review and meta-analysis.  Journal of Stroke and Cerebrovascular Diseases, 108216. https://www.sciencedirect.com/science/article/pii/S1052305724006591

Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led health program on functional outcomes and quality of life of patients with stroke: A pooled analysis of randomized controlled trials.  Frontiers in Public Health,  12, 1395270. https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/full