NURS FPX 4905 Assessment 4 Improving Medication Adherence Among Older Adults with Hypertension
Hypertension is one of the foremost causes of morbidity and mortality across the globe, and older adults are disproportionately more impacted as a function of age-related physiological changes and comorbidities. In spite of the efficacy of the available anti-hypertensive drugs, improving medication adherence in older adults remains a critical challenge, as low adherence rates continue to limit optimal blood pressure control and increase the risk of preventable complications such as stroke, heart failure, and kidney disease. The important role of focusing on medication adherence within this group of patients is contributing to patient safety and quality care and lowering the cost of care. The capstone project of NURS FPX 4905 Assessment 4 will therefore focus on using evidence-based interventions and the idea of interprofessional collaboration to improve adherence to prescribed medication among the elder group with hypertension, hence leading to improved health outcomes and achievement of organizational and national healthcare objectives.
Leading a Practice Change to Improve Medication Adherence
Leadership has long been central in nursing practice, and continues to be central in the domain of quality improvement efforts more broadly (Yastaas et al., 2023). I have employed concepts related to transformational leadership in the role of a baccalaureate-prepared nurse to cross-connect all the involved stakeholders, create the culture of accountability, and promote evidence-based practice in my clinical setting. With the creation of a clear vision of the improvement of medication adherence, I was able to organize interdisciplinary meetings with physicians, pharmacists, and social workers in interdisciplinary planning with the goal of creating a patient-centered intervention. The implementation of training sessions with the nursing
staff whereby they could be reminded of the importance of motivational interviewing and teach-back strategies to use during the organization of patient education programs was one of the effective leadership behaviors conducted, which is emphasized in NURS FPX 4905 Assessment 4. By applying motivational interviewing successfully, nurses can increase the medication adherence and self-efficacy of their patients. I also contributed to the suggestion of the technological solutions, e.g., the use of electronics reminders and telehealth follow-ups to take care of the patient already released.
Applying Quality and Safety Principles
In NURS FPX 4905 Assessment 4, the safety of patients and high-quality care are the most significant values of nursing practice as the institutions like the Institute of Medicine and the Quality and Safety Education of Nurses (QSEN) assert. It can lead to the impossibility to manage hypertension, which will lead to adverse events and readmission which are risky (Huang et al., 2023). I mitigated such risks by applying concepts of quality improvement such as the root cause analysis and the PDSA cycles to identify the barriers and test potential solutions. The analysis with the root cause revealed the primary reasons that contributed to lack of adherence to b, complicated medication schedules, and low health literacy. Consequently, we developed the simplified medical routines and liaised with the pharmacists in the preparation of medication reconciliation and deprescribing, where relevant. Also, we conducted a pilot study targeting patients who were non-adherent to medication, providing them with personalized medication schedules and medication-dispensing containers, which resulted in a significant reduction in missed doses. Safety standards were required to be complied with all the interventions, and we observed the patients regarding the potential of drug interaction and adverse events.
Communicating and Collaborating with the Interprofessional Team
The successful relationship between professionals promotes more care coordination, reduced mistakes in drug-related areas, and patient compliance (Abdalla et al., 2023). To support the healthcare team, I established communication lines all the time through the weekly huddles and electronic health record (EHR) check-ups. I collaborated with pharmacists to provide medication counseling and with social workers to address socioeconomic barriers, such as transportation and finances, that prevent patients from being able to adhere to medication. This method of collaboration is consistent with the ANA Code of Ethics that indicates the role of a nurse to create a great collaborative context. Also, I used shared decision-making to engage patients and their families, as it is critical to patient empowerment as a means to maintain adherence. The interdisciplinary team was also able to coordinate with the community services by connecting them with other senior centers in the community and home health agencies so that they would be supported beyond the hospital stay.
All the decisions taken in NURS FPX 4905 Assessment 4 throughout this project were in accordance with the professional standards of nursing and policies adopted within the organization. These interventions address the suggestions of American Heart Association (AHA), in the treatment of hypertension as well as the Joint Commission National Patient Safety Goals, specifically medication safety. The criteria of patient education material that I adhered to are health-friendly and culturally appropriate as they are linked to the health literacy principle identified by the Agency of Healthcare Research and Quality (AHRQ).
In addition, the program is consistent with the ethical principles of beneficence and autonomy because I have been considering patient safety in the context of individual agency. All the communications and interventions with patients are documented in the EHR, which implies that I complied with the demands of the institution concerning the continuity of care and data
privacy. This conformity to the evidence-based practice, observance of the regulations, and standard ethics demonstrates the character of the professional responsibility allied to the nursing practice, which is highlighted in NURS FPX 4905 Assessment 4.
Improving Population Health and Addressing Health Disparities
The immediate consequences of this initiative on the population health will be decreasing the modifiable risk factors (that is, medication non-adherence) in a vulnerable population group. Older patients are usually at an age where they must address additional matters that are related to cognitive dysfunction and polypharmacy, which adds to their adherence problems (Horvat et al., 2024). “Initiatives that emphasize aligning interventions with patients’ needs will help patients adhere to medication, promote equity, and address social determinants of health. Moreover, the underserved population was targeted by outreach activities to ensure that they could not access care services. We have reduced the cost factors by organizing to meet community pharmacies that offer home delivery and cheap generics. This conforms to the objectives of Healthy People 2030, whereby the elimination of health disparities and the promotion of health equity are advocated. The initial data pertaining to our pilot program show a positive population-wide effect since the compliance rates increased by 25 per cent and the blood pressure measurements softened considerably.
Evaluating the Project Outcomes and Sustaining Change
It is essential to achieve continuous evaluation to ensure effectiveness and sustainability of practice change (Abdalla et al., 2023). We tracked the adherence trends by self-reporting of patients, refills in pharmacy, and follow-up to the blood pressure establishment of up to three months. Suggestions made by the patient and staff were incorporated to make modifications in the intervention strategies continuously. In NURS FPX 4905 Assessment 4, to illustrate an example, some patients expressed the feeling that they were more at ease when they received
digital reminders, as opposed to paper calendars; hence, we intended to identify opportunities where mobile health would be integrated into the plan. To justify the further implementation of the plan, I suggested that the opportunity be used to observe the adherence during the process of carrying out a regular nursing examination and record reminder messages in the EHR work cycle.
In addition, I also incorporated myself into the quality improvement team to make sure that medication adherence serves as a key performance indicator of hypertension management in our facility. These advantages will be supported through periodic education of the staff and feedback mechanisms on customers in a bid to act on emerging challenges.
Conclusion
The problem of medication nonadherence is not only the subject of appearance but it is also outside of the scope of our management practice, and needs to be approached by a patient-oriented, evidence-based intervention. Being assisted by appropriate leadership, interpretability, adherence to quality and safety rules, and devotion to the principles of professional ethics, the issue identified in the context of this capstone project demonstrates how nurses can make their considerable contribution to the improvement of patient outcomes. The project will contribute to the enhancement of the control of hypertension in older population and low hospitalization rates, and quality of life of older population, addressing mainly the barriers that affect older population specifically the most. They have to be long-term because the pressure on assessing the performance and the continuous enhancement will contribute to their successful performance in the long-term. In NURS FPX 4905 Assessment 4, the utilization of the featured project exemplifies the instrumental role of nurses as change agents and leaders in enhancing healthcare provision and population health.
References
Abdalla, M., Bolen, D., Brettler, J., Egan, M., Ferdinand, C., Ford, D., Lackland, T., Wall, K., & Shimbo, D. (2023). Implementation strategies to improve blood pressure control in the United States: A scientific statement from the American Heart Association and American Medical Association. Hypertension, 80(10), e143–e157. https://doi.org/10.1161/HYP.0000000000000232
Horvat, M., Eržen, I., & Vrbnjak, D. (2024). Barriers and facilitators to medication adherence among the vulnerable elderly: A focus group study. Healthcare, 12(17), 1723. https://doi.org/10.3390/healthcare12171723
NURS FPX 4905 Assessment 4
Huang, X., Xu, N., Wang, Y., Sun, Y., & Guo, A. (2023). The effects of motivational interviewing on hypertension management: A systematic review and meta-analysis. Patient Education and Counseling, 112, 107760. https://doi.org/10.1016/j.pec.2023.107760
Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients’ outcomes: A systematic review. Nursing Reports, 13(3), 1271–1290. https://doi.org/10.3390/nursrep13030108
