Tag: Clinical-Nursing

Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

Overview

This milestone assignment allows you to receive feedback on your data plan before proceeding with your midterm paper. While this assignment is optional and not graded, completing it will provide valuable guidance to strengthen your final midterm submission.

Purpose

The purpose of this milestone is to help you:

Refine your research question from Discussion Assignment 2 (ASSIGNMENT ATTACHED)

Identify appropriate variables from the dataset for your analysis

Develop a preliminary plan for data analysis

Receive constructive feedback before investing significant time in your midterm paper

Instructions

Research Question Selection (1 paragraph)

Select one research question from the options you developed in Discussion Assignment 2

Refine your question to ensure it is clear, focused, and answerable using the provided dataset

Briefly explain why you selected this particular question and its relevance to nursing informatics and healthcare quality

Variable Selection (1-2 paragraphs)

Identify the specific variables from the dataset you plan to include in your analysis

For each variable, provide:

The exact name of the variable as it appears in the dataset

The type of variable (categorical, continuous, etc.)

A brief explanation of why this variable is relevant to your research question

Identify your dependent (outcome) and independent (predictor) variables

Proposed Data Analysis Plan (1-2 paragraphs)

Describe the descriptive statistics you plan to calculate

Identify any measures of association or simple statistical tests you plan to perform

Explain how these analyses will help you address your research question

Note any potential data quality issues you anticipate and how you plan to address them

Submission Format

Please submit your Data Plan as a 1-2 page document (double-spaced, 12pt font) with the following sections clearly labeled:

Research Question

Variable Selection

Proposed Data Analysis Plan

Example Structure

Research Question:

Is there an association between polypharmacy (5+ medications) and emergency department utilization among patients in the dataset? Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

Variable Selection:

Dependent variable: EmergencyVisits (continuous) – This represents the number of emergency department visits and will serve as my outcome variable to measure healthcare utilization.

Independent variable: TotalMedications (continuous) – This will be recoded into a binary variable (Polypharmacy: Yes/No) where 5+ medications = Yes.

Covariates:

Age (continuous) – Included because older patients may have more medications and higher ED utilization

ChronicConditionCount (continuous) – Included to account for disease burden

InsuranceType (categorical) – Included because insurance coverage may influence both medication access and ED utilization patterns

Proposed Data Analysis Plan:

I will first calculate descriptive statistics for all variables, including means and standard deviations for continuous variables (EmergencyVisits, Age, ChronicConditionCount) and frequencies for categorical variables (Polypharmacy, InsuranceType). I will then compare the mean number of emergency visits between patients with and without polypharmacy using an independent samples t-test. If the data are not normally distributed, I will use a non-parametric alternative like the Mann-Whitney U test. I will also create a contingency table to examine the relationship between polypharmacy and high ED utilization (defined as 2+ visits) and perform a chi-square test to assess this association.

Feedback Process

Your instructor will provide feedback on:

The clarity and feasibility of your research question

The appropriateness of your selected variables

The suitability of your proposed statistical analyses

Suggestions for strengthening your approach for the midterm paper

 

Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

Patient Age and Hospital Readmissions

Research Question

Does patient age influence the likelihood of hospital readmission within 30 days?

The research question that will be answered in this study will be to determine any relationship between the age of the patient and 30-day readmission to the hospital. I have chosen this question because readmission to hospitals is one of the most important quality indicators in healthcare and is frequently related to the insufficiency of discharge plans or the absence of proper follow-ups. One of the well-known factors that affect the complexity of recovery and care is age, particularly in older adults. This question is especially applicable in nursing informatics to the development of predictive models and clinical decision support systems that are proactive in identifying the high-risk patients. Knowledge of this relationship can aid in the optimization of the discharge process and the facilitation of specific intervention strategies, which will eventually enhance the quality of healthcare and lower expenses.

Variable Selection

I will apply the following variables of the synthetic patient dataset to analyze this research question:

Age

Name of variable in the data: Age

Type: Continuous

Age is the first independent variable and a possible predictor of readmission. Patients with age-related issues usually experience more comorbidities and functional limitations that can put them at risk of readmission.

30-Day Readmission

Name of variables in dataset: Readmission30Days

Type: Categorical (Binary: Yes/No)

Justification: This is the dependent variable. It specifically deals with the research finding: was the patient readmitted back to a hospital within 30 days of being discharged? There will be a binary classification in order to analyze the probability that can be attributed to various groupings of age.

Chronic Conditions Count

Name of the variable in the dataset: ChronicConditionCount

Type: Continuous

Justification: This was used as a covariate since patients with multiple chronic conditions would have a high risk of developing complications during the post-discharge period, regardless of age. By controlling this, one isolates the effect of age.

Discharge Destination

Name of variable in data: DischargeDestination

Type: Categorical such as home, skilled nursing facility, rehabilitation

Rationale: The place of discharge can be a risk factor for readmission. Such as readmission rates may be lower in patients discharged to skilled nursing facilities as compared to those discharged to home.

Insurance Type

Name of variable in data set: InsuranceType

Type: Categorical such as Medicare, Medicaid, private, etc.

Rationale: Type of insurance might have an impact on access to post-discharge facilities and post-discharge care, which can affect the readmission outcomes. This inclusion will be used to control the socioeconomic factors.

Overall, the dependent variable will be Readmission30Days, whereas the primary independent variable will be Age. To enhance the validity of the analysis, other covariates are ChronicConditionCount, DischargeDestination, and InsuranceType. Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

Data Analysis Plan Proposed

I will start by performing a descriptive statistic of all the variables. I will compute means, standard deviations, and ranges of continuous variables (age, chronic condition count). I will compute frequencies and percentages in the case of categorical variables (Readmission30Days, DischargeDestination, InsuranceType).

To determine the correlation between age and readmission, I will apply the logistic regression analysis because the outcome variable, readmission, is binary (Miswan et al., 2021). Age shall be handled as a continuous predictor. Some of the covariates that will be controlled in the logistic regression model include the number of chronic conditions, discharge destination, and type of insurance.

I will also carry out a bivariate analysis prior to the regression. Specifically: Chi-square test to test the unadjusted relationship of age groups (e.g., <65 vs. >=65) and readmission.  A t-test or a Mann-Whitney U test to compare the mean age of readmitted and non-readmitted groups based on the assumptions of normality.  The possible data quality problems can be; the lack of values in Readmission30Days (or Age), which I will evaluate through frequency checks. In case of a low level of missing data, I will apply listwise deletion, and in case of a high level of missing data, I will take the case of multiple imputation (Woods et al., 2024).  Outliers in age like unrealistic ages such as 120+ will be considered and possibly rejected.

Such analyses will assist in establishing whether age is a factor in the risk of 30-day readmission independent of clinical and demographic characteristics. The findings will justify specific interventions in the discharge planning and transitional care, particularly among the elderly.

References

Miswan, N. H., Chan, C. S., & Ng, C. G. (2021). Hospital readmission prediction based on improved feature selection using grey relational analysis and LASSO. Grey Systems: Theory and Application, 11(4), 796-812.
https://www.emerald.com/insight/content/doi/10.1108/gs-12-2020-0168/full/html

Woods, A. D., Gerasimova, D., Van Dusen, B., Nissen, J., Bainter, S., Uzdavines, A., … & Elsherif, M. M. (2024). Best practices for addressing missing data through multiple imputation. Infant and Child Development, 33(1), e2407.
https://onlinelibrary.wiley.com/doi/abs/10.1002/icd.2407

 

Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

Analyzing Synthetic Patient Data for Clinical Insights

Based on the synthetic patient dataset and guided by the Module materials, I will develop three potential research questions aimed at identifying patterns that can support clinical decision-making and population health initiatives.

Research Question

Does patient age influence the likelihood of hospital readmission within 30 days?

The key variables

Independent: Age

Dependent: Readmission within 30 days

Rationale

Age is a known risk factor for readmission. Quantifying this relationship can help target high-risk age groups for follow-up care.

Clinical Relevance

The insights can help support discharge planning and early intervention strategies, particularly for geriatric patients, aligning with quality improvement outcomes such as reduced readmission rates.

Research Question

Is there a difference in the average length of stay based on the discharge destination, such as home or a skilled nursing facility?

The key Variables

Independent: Discharge Destination

Dependent: Length of Stay

Rationale

This relationship can reveal patterns in patient acuity and recovery needs.

Clinical Relevance

The results can guide nursing assessments and resource allocation for discharge planning and care transitions, which is consistent with data-driven quality improvement.

Research Question

Does the type of insurance, such as Medicare, Medicaid, or Private, affect the frequency of emergency department visits? Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

The key Variables

Independent: Insurance Type

Dependent: Number of ED visits

Rationale

Emergency department utilization patterns may reflect access to preventive care and socioeconomic barriers.

Clinical Relevance

Understanding payer-based disparities can inform policy interventions and resource planning to improve equity, which aligns with healthy community planning.

These questions demonstrate how understanding variable measurement levels, such as distinguishing nominal from ratio data, directly informs data analysis strategy. Following Pruinelli et al.’s (2020) roadmap, such exploratory questions form the basis for evidence-based practice and strategic population health interventions.

References

Pruinelli, L., Johnson, S. G., Fesenmaier, B., Winden, T. J., Coviak, C., & Delaney, C. W. (2020). An applied healthcare data science roadmap for nursing leaders: A workshop development, conceptualization, and application. CIN: Computers, Informatics, Nursing, 38(10), 484-489. Project Milestone: Data Plan – Analyzing Synthetic Patient Data for Clinical Insights – Assessing the Influence of Age on Hospital Readmissions Using Synthetic Patient Data

TANIC Self-Assessment Nursing example

Address the discussion questions below by using your self-appraisal proficiency/competency skill ratings identified on the TANIC Self-Assessment.

Application of Course Knowledge
: Answer all questions/criteria with explanations and detail.

Discuss how your perceived proficiency level in informatics compared to your TANIC Self-Assessment responses.

Describe two competencies identified as strengths.

Describe two competencies identified as growth opportunities.

Describe at least two strategies to enhance your competencies.

Identify resources to support your selected strategies.

Screenshot of Tanic Self assessment you can use as guide reference to answer questions

 

TANIC Self-Assessment Nursing example 
 

TANIC Self-Assessment

Comparing Perceived Proficiency with TANIC Self-Assessment Results

Initially, I viewed my informatics skills as generally proficient, particularly in areas like navigating electronic health records (EHRs) and managing patient data securely. However, the TANIC self-assessment highlighted areas where I am competent but could further develop my skills, especially in advanced data interpretation and the integration of clinical decision support systems (Kinnunen et al., 2023). This reflection on my perceived proficiency versus the TANIC results clarified the need for targeted growth in higher-level informatics tasks, showing where additional knowledge and practice could enhance my effectiveness in leveraging technology for patient care.

GET A HUMAN-WRITTEN PAPER HERE

Strength Competencies

Two of my competencies identified as strengths through the TANIC assessment are basic computer literacy and data security knowledge. Basic computer literacy, including software navigation and technical troubleshooting, is a strong point due to frequent use in my daily tasks. Additionally, data security skills are a strength, as I consistently follow best practices to protect patient confidentiality and comply with HIPAA guidelines. These skills enable me to maintain efficiency and security in my documentation and digital communication practices, supporting safe and reliable care.

Growth Opportunities

Two competencies identified for improvement include data-driven decision-making and advanced health information technology (HIT) skills. Although I am competent in basic data interpretation, using data analytics for clinical decision-making is an area for growth (Almarwani, 2024). Additionally, while I understand EHR basics, I could benefit from more advanced knowledge of HIT tools, such as clinical decision support systems and interoperability features, to enhance my workflow and patient care. Focusing on these competencies will strengthen my ability to make informed decisions based on comprehensive data insights.

Strategies to Enhance Competencies

I will engage in structured learning and apply skills in practical settings to improve my competencies and abilities in applying informatics skills. Enrolling in advanced informatics courses focused on data-driven decision-making and HIT systems will build my foundational knowledge (Almarwani, 2024). Additionally, I plan to participate in simulation exercises and hands-on practice with case studies, allowing me to apply new skills directly in realistic clinical scenarios. These strategies will enable me to integrate informatics tools more effectively into my practice.

Resources to Support Strategies

Key resources to support these strategies include membership in the American Nursing Informatics Association (ANIA) for access to webinars, networking opportunities, and up-to-date informatics research. Furthermore, online platforms like Coursera and edX offer flexible, competency-specific courses in health informatics and data security. These resources will provide both the theoretical knowledge and practical applications needed to support my competency development in informatics.

References

Almarwani, A. M. (2024). Evaluation of the nursing informatics competency among nursing students: A systematic review.
Nurse Education in Practice
,
78
, 104007.
https://doi.org/10.1016/j.nepr.2024.104007

Kinnunen, U.-M., Kuusisto, A., Koponen, S., Ahonen, O., Kaihlanen, A.-M., Hassinen, T., & Vehko, T. (2023). Nurses’ informatics competency assessment of health information system usage: A cross-sectional survey.
CIN: Computers, Informatics, Nursing
,
41
(11), 869.
https://doi.org/10.1097/CIN.0000000000001026

NRS-425 Community Teaching Project – Part 6

The presentation was critical in highlighting every area of practice and was able to enhance my assessment, teaching, and interviewing abilities. In addition, through the presentation, it was notable that engagement with the community was ideal and built a positive attitude toward people in preparation for the future working environment.

The community experiences were a great learning arena that taught me essential communication skills. The area of improvement was in communication with the local people, and also the ability to make successful assessments. This is because, in the local settings, it is not possible to assess patients swiftly since most of them come with stories that need to be listened to. This enabled me to learn essential listening skills that help one to understand the patients and filter necessary information for care purposes (Leblanc et al., 2022). In the future, I will be able to handle patients from all backgrounds without feeling they are bothering me and taking a lot of time.

The survey was the evaluation tool used by the audience to provide feedback on the teaching presentation. Through surveys, it was possible to highlight the areas of weakness among the audience at the stage and also to evaluate their levels of achievement at the end of the presentation. This tool was easy to use and also helped in identifying the areas of the presentation that needed more time (Buregyeya et al., 2021) NRS-425 Community Teaching Project – Part 6

The audience and the stakeholders made comments on the usefulness of
this presentation
and believed that more of such aspects should be used in the future. For instance, they wanted this level of interaction among communities and healthcare professionals to be enhanced (Narapuredd et val., 2021). It was a positive experience since everyone was happy and gave positive comments about the whole exercise.

References

Buregyeya, E., Atusingwize, E., Nsamba, P., Nalwadda, C., Osuret, J., Kalibala, P., Nuwamanya, R., Okech, S., Ssekamatte, T., Nitumusiima, S., Wakabi, T., Bikaako, W., Yawe, A., Naigaga, I., Kagarama, J., Kabasa, J. D., & Bazeyo, W. (2021). Lessons from a community based interdisciplinary learning exposure: benefits for both students and communities in Uganda. 
BMC medical education
, 
21
(1), 5. https://doi.org/10.1186/s12909-020-02429-2 NRS-425 Community Teaching Project – Part 6

Leblanc, P., Occelli, P., Etienne, J., Rode, G., & Colin, C. (2022). Assessing the implementation of community-based learning in public health: a mixed methods approach. 
BMC medical education
, 
22
(1), 40.
https://doi.org/10.1186/s12909-021-03098-5

Narapureddy, B. R., Patan, S. K., Deepthi, C. S., Chaudhuri, S., John, K. R., Chittooru, C., Babu, S., Nagoor, K., Jeeragyal, D., Basha, J., Nell, T., & Reddy, R. S. (2021). Development of a community orientation program (COP) as a community-based medical education method for undergraduate medical students: an experience from India. 
BMC medical education
, 
21
(1), 626.
https://doi.org/10.1186/s12909-021-03069-w 
  NRS-425 Community Teaching Project – Part 6

NRS-425 Community Teaching Project – Part 6

Assessment Description

Teaching Experience Reflection

For this NRS-425 Community Teaching Project – Part 6 assignment, students will reflect on and evaluate their teaching presentation to determine how to improve for next time.

The Community Teaching Project has indirect care experience requirements. The “Indirect Care Experience Hours” form, found in the Topic 1 Resources, will be used to document the indirect care experience hours completed in the Community Teaching Project and Presentation. As progress is made on the Community Teaching Project, update this form indicating the date(s) each section is completed. This form will be submitted in Topic 5.

In 250-500-words, describe the teaching experience and discuss the following:

Discuss one strength of the presentation.

Describe one area of opportunity for improvement. What was learned from this experience that will help in the future?

Describe the evaluation tool used by the audience to provide feedback on the teaching presentation.

Discuss the comments the audience and stakeholders provided on the presentation.

APA style is not required, but solid academic writing is expected.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Resources if you need assistance. NRS-425 Community Teaching Project – Part 6

Community-Based Care Provider in Mental Health

Definition of a community-based provider

Community-based mental health care includes an array of services and programs( such as assistive community treatment and partial hospitalization programs ) designed to meet the needs of local communities. These programs are mainly delivered by community agencies and at times through health clinics or hospitals. Most programs offered by community-based agencies are intended to serve the most mentally ill and most vulnerable individuals in the community.  According to O’Donnell et al. (2019), a community-based mental health provider is a health professional who provides support and treatment in the community or at home rather than in a conventional clinical setting.   These providers include social workers, psychologists, psychiatrists, and nurses, and are fundamental for mentally ill individuals who are hesitant to seek treatment as a result of a combination of factors such as unstable housing, mental health symptoms, frequent homelessness, and extreme poverty. Community-based mental health providers who provide support and treatment to people with severe mental disorders are an important segment of the mental health workforce.

Importance of assertive community treatment (ACT) teams

Assertive community treatment is a highly integrated and intensive model of community mental health delivery that offers comprehensive, locally based treatments to individuals with persistent and serious mental illnesses. According to Goyal (2020), recipients of ACT receive mental health treatment from multidisciplinary, all day and all night staffing of a psychiatric unit within the comfort of their community and home. ACT model has a low client-to-staff ratio of around ten clients per ACT practitioner. Also, ACT teams offer round-the-clock emergency services and continuous coverage Community-Based Care Provider in Mental Health.

The ACT team is a multi-disciplinary team staffed with psychiatrists, case managers, therapists, nurses, and psychologists.   Members of the ACT team work in collaboration to deliver mental health services that are individualized and person-centered to address the needs of each prison. According to
O’Donnell
et al.(2019), developed to facilitate the reintegration of mentally ill patients from psychiatric hospitals into the community.  ACT teams deliver services in the home of the individual or where the individual is most at ease receiving services. ACT is very effective for the management of symptoms and lessening psychiatric hospital admissions and housing instability.  ACT team members deliver services where and when needed by the mentally ill individuals in the community.  The activities performed by ACT team members include social skills training, delivering medications, monitoring physical and mental health, and frequently contacting family members.

The work practices and combined expertise of the ACT  multidisciplinary team enable mental health service users to be given more holistic care that addresses their social, medical, and mental needs.  According to Roth et al. (2021), the ACT multidisciplinary team provides intensive support to mentally ill patients within the community. These teams focus on recovery rather than on the illness.  Components of a flexible ACT approach include regular team meetings, a low patient-to-staff ratio, team-based and shared caseload, and home visits.  Although coordination of individual caseloads is performed by a case manager, all professionals within the ACT team offer mental health care. In periods when there is a higher need for care and treatment, the teams work jointly in meeting these needs.  This model of care offers an opportunity for transitioning between low- and high-intensity care and treatment along with a shared caseload and therefore is likely to promote recovery.

Although recovery from serious mental illnesses is dependent on the individual patient, professional guidance and support improve recovery outcomes.  According to Roth et al. (2021),   a recovery-orient practice focuses on the individual patient,  enhances social inclusion, addresses stigmatization, and improves participation in the society, citizenship, and quality of life.  Individuals with serious mental illnesses work in collaboration with ACT teams which enhances shared decision making and also puts individual patients’ viewpoints on recuperation at the midpoint of the treatment.   The recovery-oriented approach encompasses empowerment of the service user, peer support, respect for individual needs, the right to informed choice, and the right to ethical treatment.

In mental health, peer support refers to support for an individual with a mental health problem offered by persons who have personally had and experienced a mental health problem.  Roth et al. (2021) indicate that people with lived experiences are included in the ACT service delivery teams, as peer specialists or peer workers.   The provision of support by peer workers can positively influence the recovery journey of persons suffering from serious mental illness.   Treatment and support provided by a highly qualified ACT team supports can support mentally ill patients to smoothly transition from the hospital to the community, take part in social life and increase patient satisfaction.  This necessitates devotion by each ACT team member, a common purpose, a clear allocation of roles, and  a shared vision,

Importance of partial hospitalization programs

Partial hospitalization programs also referred to as evening or day treatment programs are intended to ease the transition from inpatient hospitalization to community living or prevent hospitalization. According to Townsend and Morgan (2017), different forms of treatment are offered through partial hospitalization programs including therapeutic community activities; family, group, and individual therapies; drug and alcohol education; psychoeducation; occupational therapy; therapeutic recreational activities; and crisis intervention.  The majority of partial hospitalization programs provide medication administration and monitoring as a portion of their care.

Partial hospitalization programs usually provide a comprehensive treatment plan developed by an interdisciplinary team of social workers, recreational and occupational therapists, nurses, psychologists, and psychiatrists. Townsend and Morgan (2017) posit that partial hospital programs are a useful scheme for preventing hospitalization for persons with chronic and severe mental illness.  These programs are a scheme for transitioning patients from the acute care setting back into the mainstream community. For some people who have undergone deinstitutionalization, a partial hospitalization program offers structure, opportunities, and support for social socialization, along with an improvement in their quality of life.

Importance of alternate delivery care methods such as telepsychiatry in the community

The use of alternate delivery care methods such as telepsychiatry in the community can improve access for people with severe mental illnesses who receive community-based psychiatric care.   There is a   shortage of psychiatrists to provide mental health care services in the community.  Also, Community-mental health providers are required to directly negotiate challenges such as delivering care in neighborhoods with high crimes and poor infrastructure such as poor roads.  These challenges might hinder community-based mental health providers from reaching all individuals who require their services. The use of telepsychiatry can help overcome these challenges. According to Abbasy (2020), similar to telemedicine, telepsychiatry encompasses the interaction between the patient and the psychiatrist.  Also, it includes psychiatrists providing support to primary care providers with mental health care expertise and consultation.   Delivery of mental health services s can occur via lie, interactive communication but can also encompass recording medical information such as videos and images and sending them to a distant site for them to be reviewed later Community-Based Care Provider in Mental Health.

Video-based telepsychiatry in the community can help meet the needs of patients by enabling them to remotely access mental health care. According to Abbasy (2020), video-based telepsychiatry can improve patients’ access to mental health care that might not be available, for instance in remote areas;  bring care to the location of the patient;   lessen delays in care; improve follow-up and continuity of care;  reduce stigmatization; and lessen potential barriers to transportations, such as the need for long drives or lack of transportation.   Mentally ill patients might be more willing and relaxed to give information from a nearby office or the comfort of their home.  Telepsychiatry permits psychiatrists to provide treatment to more individuals in distant locations.

References

Abbasy, S. U. (2020). Importance and Advantages of Telepsychiatry in Mental Health During COVID 19 Pandemic.
Psychology and   Psychotherapy
Research Study, 4,
2. DOI: 10.31031/PPRS.2020.04.000585

Goyal, S. K.  (2020).
Essentials of Psychiatry
. Wolters Kluwer India Pvt Ltd.

O’Donnell, H., Davis, K., & Mestan, S. (2019).  Building The Community-Based Mental Health Workforce To Expand Access to Treatment
. Health Affairs
. Doi:
10.1377
/
forefront
.
20191022.281887

Roth, C., Wensing, M., Kuzman, M. R…. Petrea, I. (2021). Experiences of healthcare staff providing community-based mental healthcare as a multidisciplinary community mental health team in Central and Eastern Europe findings from the RECOVER-E project: an observational intervention study.
BMC psychiatry, 21
, 525.
https://doi.org/10.1186/s12888-021-03542-2

Townsend, M. C., & Morgan, K. I.  (2017).
Psychiatric Mental Health Nursing: Concepts of Care in Evidence-Based Practice
. F. A. Davis. Community-Based Care Provider in Mental Health

Family Nurse Practitioner Certification Board

The Assignment:

Summarize your practice exam results, including your strengths and opportunities for improvement.

Create a study plan, including 3–4 specific goals and the tasks you need to complete to accomplish each goal.

Each goal must be developed using SMART goal format (Specific, Measurable, Achievable, Relevant, and Time-Based). See weekly resources to help with developing these goals.

Include a timetable on a calendar template for accomplishing the goals and tasks and add a description of how you will measure your progress.

Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.

Submit your study plan with calendar

 

Study Plan for Nurse Practitioner Boards

Practice exam results

According to the practice exam results I possess vital strengths in critical analytical skills. For instance, I am perfect in conducting assessment and diagnosis that helps in acquiring the underlying issues to patient’s health. With a thorough assessment and diagnosis, it becomes easy to create a differential diagnosis in coming up with the ideal treatment plan and patient follow-up. Another strength I possess is good time management which helps me prioritize tasks and enables me to meet strict deadlines. This strength helps in serving more clients since I believe in balanced timing for every client and this helps in reducing the patient wait time and also enhancing better access to care. Additionally, I am highly motivated while at work which helps me remain positive and handle patients with respect and empathy (Baliko et al., 2023). I also aim to constantly improve my skills and knowledge and achieve my academic targets and goals.

Through the practice results there are also opportunities for growth and areas that require improvement. For instance, I need to improve on group work since I am used in studying individually. I need to identify the importance of multiple views and collaboration and practice towards personal growth and teamwork (Wolf et al., 2023). In addition, I need to improve more on communication skills that will enable more time for patient for better assessment.

PLACE YOUR ORDER HERE

Study plan

Goal: Improve group work and team management skills

Task 1a- to acquire the ability to study in groups aimed at improving my social skills and relationship with others

Task 2b- to learn ways of formulating questions and responding to questions from different individuals

Goal: Improve communication skills during patient assessment and diagnosis

Task 1c- to improve my listening skills so that patients are given sufficient time to express themselves and give their health and family history

Task 2d- to use digital systems in capturing conversations with patients that will help in reviewing and referencing back to the story for effective cross-examination of the diagnosis

Goal: Improve my analytical skills during exam preparation Study Plan for Nurse Practitioner Boards

Task 1e- to improve my skills in reading questions and understanding their meaning and structure

Task 2f- identifying the main section of the questions and expectations before responding to every practice question

Timetable

Day

Task

Time

Mon

1a&2d

1-3 pm

Tue

1c

12-1 pm

Wed

2b

3-4 pm

Thur

1e

1-2pm

Fri

2f

1-2pm

 

Measuring progress

I will evaluate my progress in practice exam preparedness through my ability to take part in group discussions and my ability to communicate with peers and give them time to express themselves. In addition, I will enhance my analytical skills through self-testing using a set of questions from past papers and taking some practice problems.

Resources to be applied

An important resource in this study guide is engaging in study groups. This is a special resource that will assist in providing divergent skills for responding to study questions and practice problems. The use of review courses will be influential such as the online sites including the access to FNP mastery and SMNP comprehensive bundle.  The application of mnemonics and mental strategies will be excellent in enhancing the memory of the learned topics and this will be supported through acronyms, page words, and keywords. Additionally, the use of print and online resources will be perfect for locating new knowledge and practice skills (Berg et al., 2021). Peer-reviewed journals, textbooks, and online resources will be used to improve access to knowledge. Study Plan for Nurse Practitioner Boards

 

References

Baliko, B., Raynor, P., Cox, D., & Tavakoli, A. (2023). Developing Family Nurse Practitioner Student Competencies: A Two-Part Mental Health-Focused Telehealth Education Activity. 
Journal of professional nursing: official journal of the American Association of Colleges of Nursing
, 
49
, 33–39.
https://doi.org/10.1016/j.profnurs.2023.08.009

Berg, J. A., Hicks, R., & Roberts, M. E. (2021). Strategies and techniques to enhance nurse practitioner learning. 
Journal of the American Association of Nurse Practitioners
, 
33
(5), 339–341.
https://doi.org/10.1097/JXX.0000000000000572

Wolf, L., Buschini, L., & Logsdon, R. (2023). Family Nurse Practitioner Students’ Readiness for Board Certification Utilizing a Full Board Review Course and Simulation. 
SAGE open nursing
, 
9
, 23779608231186031. https://doi.org/10.1177/23779608231186031 Study Plan for Nurse Practitioner Boards

Gastrointestinal and Hepatobiliary System

Scenario 1: Prescription Errors and Corrections

The prescriptions in the list include five errors. (1) Linaglipton has been misspelled; the name of the drug is linagliptin which inhibits DPP-4 enzyme and elevates the incretin level which prevents the release of glucagon and promotes the release of insulin. Proper prescription:
Linagliptin 5 mg PO daily, Disp: #30 tabs, Refills: 5
. (2) Tresiba (insulin degludec) cannot be administered TID: it is a long-acting insulin given once a day. Correct:
Tresiba U 100,10 units SC daily injection, Disp: 1 box (5 pens), Refills: 1
. It is long-acting insulin which binds to albumin and is slow releasing. (3) Tiotropium is inhaled, not oral. Correct:
Tiotropium (Spiriva Respimat) 25 mg, inhale 2 puffs one time a day, Disp: 1 inhaler (60 doses). Refills: 1
(Brunton, Knollmann, & Hilal-Dandan (Eds.), 2018). It is a long-time muscarinic antagonist which relaxes the bronchial smooth muscles. (4) Qulipta is PRN instead of preventive. Correct:
Qulipta 60 mg PO q daily, Disp: 30, Refills: 1
. It is a CGRP receptor blocking, an agent employed in migraine prevention. This erroneous prescription is (5) Levothyroxine taken at the wrong dose of 88 mg rather than micrograms. Right:
Levothyroxine 88 mcg PO Day,

Disp: 30 tabs, Refills: 5
. It is an artificial thyroid hormone, which substitutes natural thyroxine Gastrointestinal and Hepatobiliary System.

Scenario 2: Asthma Management for PK

According to NHLBI guidelines, PK shows evidence of asthma not well controlled. She takes in albuterol >2 days/week, and has nocturnal symptoms. Although she is taking Flovent, her usage is unreliable, which shows the failure to take control. Step- up to combination inhaler is recommended. Discontinue Flovent and start on budesonide-formoterol (Symbicort 80/4.5 mcg), 2 puffs BID, Disp: 1 inhaler (120 inhalation), 0 refills at the beginning. Continue Albuterol (Proventil) 2 puffs q4-6h PRN. Allergic rhinitis can remain PRN on Fexofenadine and diphenhydramine. Follow-up after 4 weeks is involved in monitoring, as well as the review of the frequency of the symptoms, night awakenings, and rescue inhaler administration. An action plan against asthma should be supplied. Education encompasses inhaler type, compliance to routine medication, and triggers avoidance (Crook & MStat, 2024). Promote the use of a spacer with MDIs and recording a diary of symptoms. Her target is that her daytime symptoms should be controlled at 2 days/week, with no nocturnal symptoms and a small use of SABA. The Asthma Control Test (ACT) used monthly may be used to ascertain control and make therapy changes.

Scenario 3: Hypertension Management for ES

The blood pressure of ES is 142/89 mm Hg, and non-adherence to bisoprolol is indicative of the fear of side effects. According to JNC 8 and combined ACC/AHA recommendations, the BP goal of African American adult patients is below 140/90mmHg (Riaz, n.d.). The first-line treatment entails thiazide-type diuretics or calcium channel blockers. Beta blockers e.g. bisoprolol are not first-line, unless there is strong indication (e.g., post-MI, heart failure). Explain to the patient about the risks of hypertension (stroke, CKD, heart disease), the necessity to take medication and that side-effects might be manageable. Suggest bisoprolol withdrawal and amlodipine 5 to be begun 5 mg PO every day, Disp: #30, refills: 3. It is an anti-hypertensive, which is a calcium blocker of the dihydropyridine type that lowers peripheral resistance. Dot BP, HR and side effects (e.g. edema) after 2-4 weeks. Modifications on lifestyle (DASH diet, depleted sodium consumption, exercise, weight loss) ought to be enforced. Motivational interviewing can help enhance patient buy in. Inquire about checks (BMP, lipid panel) and cardiovascular risk re-evaluation every year.

Scenario 4: Diabetes Management for TF with CKD

TF has poorly controlled diabetes type II (a1C 8.5), and CKD (eGFR 28). His goal A1C is < = 8.0% considering age, comorbidities, and CKD (de Boer et al., 2022). Metformin may not be used because of eGFR <30. Glimepiride, glyburide contain Sulfonylureas which are risky in CKD (hypoglycemia). Exenatide is not recommended in eGFR Less than 30. Ozempic 0.25 mg SC QW x4 weeks and then to 0.5 mg WO, Disp: 1 pen (4 doses), Refills: 2 is the optimal one. The GLP-1 receptor agonist semaglutide has been shown to better glycemic control and provide CV/renal protection as well as small hypoglycemia risks. Teach about administration, potential GI adverse effects and hypoglycemic reactions, and hypoglycemic symptoms when prescribed with other drugs. Check A1C after 3 months, kidney status and weight. Promote behavioral change such as low-carb dieting and exercising. Intake of nephrotoxic agents should be avoided and keep the BP/LDL under control. He can continue medications (donepezil, lecanemab, atorvastatin) that are taken now. Screen yearly against diabetes complication of diabetes (retinopathy, neuropathy, nephropathy) Gastrointestinal and Hepatobiliary System. References Brunton, L. L., Knollmann, B. C., & Hilal-Dandan, R. (Eds.). (2018). Goodman & Gilman’s the pharmacological basis of therapeutics (p. 7). New York, NY, USA:: McGraw-Hill Education. Crook, J., & MStat, D. A. (2024). UTAH MEDICAID DUR REPORT APRIL 2024 SHORT-ACTING BETA-AGONIST UTILIZATION AMONG PATIENTS WITH ASTHMA: A RETROSPECTIVE REVIEW. de Boer, I. H., Khunti, K., Sadusky, T., Tuttle, K. R., Neumiller, J. J., Rhee, C. M., … & Bakris, G. (2022). Diabetes management in chronic kidney disease: a consensus report by the American Diabetes Association (ADA) and Kidney Disease: Improving Global Outcomes (KDIGO). Diabetes care, 45(12), 3075-3090. https://doi.org/10.2337/dci22-0027 Riaz, K., MD. (n.d.). Hypertensive heart disease: overview, etiology, epidemiology. https://emedicine.medscape.com/article/162449-overview#:~:text=The%20medical%20care%20of%20patients,treat%20to%20below%20those%20levels   Gastrointestinal and Hepatobiliary System

NR447 Week 6 Assignment Fishbone and PDSA Quality Improvement Assignment Template

Directions:
Use this template to complete the Week 6 Fishbone and PDSA Quality Improvement assignment as outlined in the assignment instructions in Canvas.

Click into the box below to add your name and date.

Click into each box where it says [Type Here] on the following slides.

Remove the words [Type Here] to insert your responses.

1.Select a quality improvement (QI) problem you are familiar with. It may be a real problem you are currently encountering in practice or a past or future concern. Form a problem statement with that information. Some examples of problem statements include, but are not limited to:

a.The fall rate on the unit is above the benchmark.

b.The rate of ventilator-associated pneumonia (VAP) on the unit is above the benchmark.

c.The central line-associated bloodstream infection (CLABSI) rate is above the benchmark.

d.Admitted clients boarding in the Emergency Department are experiencing delays in care.

e.Healthcare providers are experiencing workplace violence with high injury rates.

NR447 Week 6 Assignment Fishbone and PDSA Quality Improvement Assignment Template

2.Gather 1-2 scholarly sources of literature that document this problem in healthcare and provide evidence supporting the need for quality improvement.

a.Complete the sections in the template outlining the problem, the rationale for the selection of the problem, and the literature documenting the need for a solution.

List References on References Slide.

1.Briefly describe the problem

2.Under each category (People, Environment, Method/Process, and Equipment/Supplies), list
at least two
contributing factors to the problem. The contributing factors may fall under more than one category.

3.See the example in the lesson for reference.

4.Make sure you have visually marked each contributing factor as realistic or unrealistic for improvement efforts using the visual designations in the upper right-hand corner of the slide (you can copy and paste the visual indicators). If you prefer, you can use green or red highlight on the text of the contributing factors instead of the visual symbols on the template.

See the example in the lesson.

 

1.Select
one
contributing factor from the fishbone diagram. This should be one of the realistic targets for improvement efforts that you indicated on your fishbone diagram.

2.List 2-4 interprofessional stakeholders involved in the project (delete any unused [Type Here] text). NR447 Week 6 Assignment
Fishbone and PDSA Quality Improvement Assignment
Template

3.Write
one
SMART goal for the PDSA Quality Improvement Project

See the example in the lesson.

 

4.Under the “Plan” phase, write a plan for the quality improvement project to meet the SMART goal. How will you meet your SMART goal?
Describe your plan in 2-3 sentences
.

5.Under the “Do” phase,
assume you have completed the project
. Briefly describe how the Plan was hypothetically implemented. What were the results? Include hypothetical data.
Describe your implementation in 2-3 sentences using past tense.

6.Under the “Study” phase, imagine that you have successfully completed the project and have positive data that demonstrates successful implementation and goal attainment.
Describe your evaluation using 2-3 sentences using past tense.

7.Under the “Act” phase,
assume you have completed the project
. Briefly describe how to maintain the improvement or revise and repeat the PDSA process based on whether or not the goal was met.
Describe your process in 2-3 sentences using past tense.

See the example in the lesson. NR447 Week 6 Assignment Fishbone and PDSA Quality Improvement Assignment Template

Fishbone and PDSA Quality Improvement Assignment Example NR447

Directions:
Use this template to complete the Week 6 Fishbone and PDSA Quality Improvement assignment as outlined in the assignment instructions in Canvas.

Click into the box below to add your name and date.

Click into each box where it says [Type Here] on the following slides.

Remove the words [Type Here] to insert your responses.

 

Problem to Examine in Root Cause Analysis (RCA):

Low rates of compliance with preventive care screenings and routine immunizations among adult patients in the primary care setting.

Rationale for Problem Selection:

Preventive screenings and vaccinations create essential conditions for early illness detection and decreased disease-related problems. Medical services that are vital for patient health receive inadequate attention from many patients, which subsequently generates higher healthcare expenses and raises disease severity levels.

Brief Description of Literature Supporting the Need for Quality Improvement

(At least 2-3 sentences, cite 1-2 sources):

The CDC (2022) reports that influenza vaccination rates, together with shingles vaccination rates and pneumococcal disease vaccination rates, fall short of Healthy People 2030 objectives. Cheng et al. (2020) reveal that patients avoid preventive care because they receive wrong information from sources and face limited access to services and non-receptive provider guidance. The identified data indicates an obvious requirement for Quality Improvement methods that seek to boost acceptance rates.

PLACE YOUR ORDER HERE

There is a fundamental requirement for preventive care services that provide routine screenings and vaccinations to help people detect diseases early while improving long-term population health. Preventable illnesses, together with increased healthcare expenses, result from adult patients who postpone or avoid routine medical services. Our project aims to enhance preventive screening compliance rates within our patient demographic. The issue was chosen because it directly affects patient outcomes, while the CDC and other organizations have confirmed the widespread underutilization of preventive services. Resolving this gap would strengthen personal health outcomes and public well-being and decrease unnecessary healthcare costs Fishbone and PDSA Quality Improvement Assignment Example NR447 . We aim to discover barriers and design specific interventions to enhance the desired outcomes.

The fishbone diagram presents all the various factors that drive down preventive screening and vaccination adoption rates. The analysis grouped identified factors under four categories: Environment, People and Method/Process, and Equipment/Supplies. Four causes were examined beneath each group, where two factors were chosen for practical change initiatives while two others presented challenges for change. The team selected realistic factors, including limited access to appointments, insufficient patient education, and the absence of reminder tools and outdated EHR platforms, as areas for direct intervention. The team acknowledges flood zones and total patient refusal as unrealistic, although they cannot serve as short-term change opportunities. The systematic analysis helps identify practical areas where our quality improvement project can make a difference while guiding us in choosing the most effective interventions.

 

Select ONE Realistic Contributing Factor From Fishbone for PDSA:

No reminder system for due screenings.

List 2-4 Interprofessional Stakeholders:

Primary Care Physicians

Nursing Staff

IT/EHR Specialist

Clinic Administrator

Write ONE SMART Goal for the PDSA Quality Improvement Project:

Specific
: A notification system based on the EHR will automatically deliver information about upcoming and delayed preventive screening appointments to adult patients.

Measurable
: A 20% improvement goal exists for preventive screening completion Fishbone and PDSA Quality Improvement Assignment Example NR447 .

Attainable
: Staff members will receive training in using the system as the EHR system permits the integration of reminders.

Relevant
: The enhancement of screening rates enables early diagnosis and treatment of chronic diseases, which meets the requirements for healthcare quality advancement.

Time-Based
: The identified objective needs to be reached within three months.

Write your SMART goal in one sentence
: The implementation of an automated reminder system within the EHR will lead to a 20% increase in adult patients finishing their due preventive screenings during the next 3 months.

Research showed inadequate screening reminders as the most realistic opportunity to enhance patient outcomes because they delivered high-impact results. Our team comprises primary care providers, EHR/IT personnel, care coordinators, and clinic managers. A SMART goal established to enhance adult patient completion rates of due preventive screenings by 20% through EHR-based automated reminder technology within three months. This goal contains specific, measurable objectives that can be achieved using existing tools for relevant clinical quality results while maintaining a time frame for accountability. The goal supports our organizational mission of encouraging proactive medical care and maximizing preventive health delivery.

Plan:

Healthcare staff should create and deploy an EHR automated reminder system that automatically sends preventive screening alerts through SMS and email channels. Staff members need training to document and update the screening completion records through the system.

Do:

The reminder system received full implementation across all clinics. The healthcare facility delivered SMS/email alerts to 500 adult patients over three months, which resulted in 120 additional patients completing their due screenings compared to the previous quarter.

Study:

Screening completion numbers surged by 24%, according to collected data when compared to original measurements. Staff members noticed that patients became more involved during appointments, and screening procedures were detected before the scheduled time Fishbone and PDSA Quality Improvement
Assignment Example NR447
.

Act:

The intervention was deemed successful. The reminder system will keep operating while adding immunization alerts to its functionality. The following PDSA cycles will research multilingual reminder systems that target diverse patient populations.

An implementation protocol was created for automated reminders within our EHR system and trained our staff about its operation during the Plan phase. Our team deployed the system during the Do phase and conducted weekly reminder messages to appropriate adult patients. The hypothetical data showed a growth in screening completion rate from 50% to 70% during three months. Evaluation of the collected data was done in the Study phase to validate that our SMART goal had been successful. The Act phase led us to sustain the reminder system while extending vaccination notifications into the platform. The data success would have triggered a revision of our messaging approaches or the frequency of delivery methods.

References (Hanging Indent Not Required)

Cheng, H., Eames-Brown, R., Tutt, A., Laws, R., Blight, V., McKenzie, A., … & Denney-Wilson, E. (2020). Promoting healthy weight for all young children: a mixed methods study of child and family health nurses’ perceptions of barriers and how to overcome them. BMC nursing, 19, 1-14.
https://link.springer.com/article/10.1186/s12912-020-00477-z

Centers for Disease Control and Prevention. (2022).
Vaccination coverage among adults in the United States
.
https://www.cdc.gov/adultvaxview/publications-resources/adult-vaccination-coverage-2022.html
  Fishbone and PDSA Quality Improvement Assignment Example NR447

NGR 6836 Leading Quality Improvement Practice Initiatives – Process Improvement Plan Template

Process Improvement Plan Template 2022

Color codes:

Red= Part 1 submission.  8-10 pages

Green=Part 1 + Part 2 (Final) submission (~15-20 pages total)

 

APA 7
th
Edition
is the expected format for this paper.

*Follow the assignment instructions on Canvas as noted and the Rubric. There is a lot of important information contained in these.

 

PIP PART 1 (The page lengths included are the MINIMUM required). See Canvas for
DUE DATE

 

Title page

Introduction to the paper (1/2 page)

Problem Statement (1 paragraph)

Background data to justify the problem exists (minimum of 2-3 pages)

Need (what bad outcomes justify the need for intervention)

Context (internal and external data- national, regional, target population)

Evidence based solution/ tests of change (1 1/2 -2 pages)

This is where students stumble. You are required to identify THREE evidence-based change tests aimed at improving 2-3 related poor outcomes. You should review these if unsure with your assigned section faculty before getting too far into your paper. Chapter 4 in the Finkelman text may also be helpful to you. Use the evidence (RCTs, systematic reviews, meta-analyses, or guidelines) to justify your choice of interventions. No lower evidence is acceptable

Aim statement

Process Improvement framework (1/2-1 page)

E.g., PDSA, SPO, Lean Six Sigma. There must be a CLEAR application of the framework to the

Stakeholders: (1/2 page) PDSA is the preferred choice.

Describe stakeholders and their roles/interests in this evaluation

Your plan to engage them

Inputs (resources): (1/2 page)

What resources are available/needed to support the improvement process (e.g., staff, money, space, time, partnerships, technology, etc.)?

Outputs (products, units of service delivered): (1/4 page)

What products (e.g., materials such as documents, units of services delivered, education materials, forms, policies, etc.) are produced by your staff as a result of the activities performed?

Evaluation Design: (1 page)

Describe the design for the quality improvement project (e.g., quasi-experimental, pre-post with comparison group, time-series, case study, post-test only, etc.)

Intended outcome objectives

Process objectives

Ex. “To measure the number of participants….”

“To measure the utility of the new protocol…”

Outcome objectives

“To measure the IMPACT of (intervention X) on (an outcome of interest, like participant satisfaction, cost, quality measures, errors, etc.)

Include a Conclusion to Part 1 of the paper.

 

PIP PART 2  
DUE DATE on Canvas

Outcome measurement plan
(1 page- see template)

Refer to the template.

Column 1 should contain your process and outcome objectives.

Column 2 should contain the outcome domain of interest (ie safety, quality, patient function, satisfaction etc.)

Column 3 should contain your outcome indicators

Column 4 should contain metrics for measuring the indicators

Column 5 should contain the data collection tool you would use (i.e., questionnaire, a count, a database, or chart extraction tool, etc.)

Column 6 should contain how the data will be analyzed. (i.e., descriptive statistics for ex)

NGR 6836 Leading Quality Improvement Practice Initiatives – Process Improvement Plan Template

Data Collection: (1 page)

Will new data be collected/ compiled to assess the impact of the intervention(s) or will secondary data be used? (i.e., satisfaction data routinely collected vs introducing a new tool)

What methods will be used to collect or acquire the data?

Will a sample be used? If so, how will the sample be selected?

How will data collection instruments be identified and tested?

How will the quality and utility of existing data be determined?

From whom or from what will data be collected (source of data)?

How will the data be protected?

Data Analysis and Interpretation (1 to 1 1/2 pages)

This is a narrative in the
paper
that should reflect what is in the Outcome Measurement Table

Indicators and Standards

This category gets at what an expected outcome should be. For instance, if your paper proposes measuring length of stay for a particular condition, what is the EXPECTED length of stay for that condition?

What constitutes “success”? (i.e., by what standards will you compare your evaluation findings?)

Provide a brief discussion of the analysis planned (again, this should be consistent with what you have in the Outcome Measurement Plan above.

Interpretation

Who will you involve in drawing, interpreting, and justifying conclusions?

What are your plans to involve them in this process?

Communication and reporting results: (1/2-1 page)

Use

What actions will be taken to promote use of your evaluation data ie, the outcomes you achieve. How will you announce them to the world?

How will evaluation findings be used in decision making?

Who is responsible for implementing evaluation recommendations?

Communication

Which evaluation stakeholders will you communicate with and why (e.g., update on status of evaluation, invite to meetings, share interim or final findings)?

What methods (e.g., in-person meetings, emails, written reports, presentations) will you use to communicate with evaluation stakeholders?

Why are these methods appropriate for the specific evaluation stakeholder audience of interest?

Timeline (1 page) (this can be in a chart or template format. Add it to an appendix.

Summary and conclusion (1/2 page)

References (Be mindful of APA)

Appendices

NGR 6836 Leading Quality Improvement Practice Initiatives – Process Improvement Plan Template

Improving Medication Adherence in African Americans with Hypertension Essay

NGR 6836 Leading Quality Improvement Practice Initiatives

Improving Medication Adherence in African Americans with Hypertension

Hypertension serves as an extensive common chronic disease that advances cardiovascular disease development, principally among African American communities. Widespread non-adherence to available effective treatments continues to be an ongoing problem that produces uncontrolled blood pressure and higher stroke, kidney disease, and heart failure rates (Chaturvedi et al., 2023). Medication adherence among African Americans depends on cultural beliefs, limited health literacy, mistrust toward healthcare institutions, and barriers such as financial constraints and limited access (Sharma et al., 2025). African American clients, as one of the most at-risk groups, experience biases that create obstacles that affect both the treatment quality and the patient-clinician relationship. Medical practitioners commonly treat medication adherence problems as patient responsibility, but the faults in patient management processes frequently create barriers to cultural and systemic challenges (Abrahamowicz et al., 2023). This paper aims to explore the process-related causes of medication adherence and culturally tailored approaches that can be used to improve interventions targeting hypertension management among African American clients Improving Medication Adherence in African Americans with Hypertension Essay.

Problem Statement

African American individuals with hypertension face significant problems in following through their treatment plan, contributing to uncontrolled hypertension and increased risks of medication adherence. Abrahamowicz et al. (2023) indicate that African Americans are less successful at maintaining controlled blood pressure levels than other population groups. The root of this problem goes beyond each medication and patient education and requires serious interventions to improve the healthcare service delivery approaches (Sharma et al., 2025). Healthcare delivery methods today struggle to connect patient education to proper communication methods and support networks that help patients stay on their treatment path permanently. Insufficient personalized care produces care gaps and forces patients to return to hospitals while worsening their medical conditions. Healthcare facilities regularly track medication adherence patterns but lack a formal method to determine why African American patients face unique challenges (Adediran et al., 2024). Therefore, in general, our healthcare system lacks a systematic way to help African American patients follow their medical plans effectively.

Background

Hypertension is a global public health concern, affecting over 1.4 billion adults worldwide, with only about 21% having it under control (Burlacu et al., 2025). The World Health Organization identifies it as the leading modifiable risk factor for cardiovascular disease and premature death. Globally, low- and middle-income countries carry the highest burden, with inadequate access to medications and preventive care being major contributors (Margolis et al., 2024). Despite efforts to scale up screening and treatment, poor adherence to medication regimens remains a significant barrier to control. Cultural beliefs, misinformation, side effects, and cost issues are significant causes of non-adherence worldwide (Sekkarie et al., 2024). These trends point to the need for culturally sensitive and context-specific interventions that can be adapted in diverse communities, especially where health disparities are pronounced.

In the United States, African Americans experience the highest prevalence of hypertension among all racial and ethnic groups; approximately 56% of non-Hispanic Black adults have been diagnosed, compared to 48% of Whites and 46% of Hispanics (Burlacu et al., 2025). National surveys such as NHANES (National Health and Nutrition Examination Survey) show that while awareness and treatment rates among African Americans are high, blood pressure control rates are substantially lower than those of their White counterparts (Margolis et al., 2024). The CDC reports that African Americans are nearly twice as likely as Whites to die from hypertension-related complications such as heart disease, stroke, and kidney failure. Non-adherence to antihypertensive medications stands at 50% across the nation, and this factor significantly contributes to unfavorable outcomes in hypertension management (Sekkarie et al., 2024). National data shows how extensive the situation has become while emphasizing the immediate need for well-directed solutions.

The Midwest region, including Minnesota, shows similar racial health disparities as observed nationally. A rising number of Minnesota residents with hypertension experience premature death, primarily at rates higher among the African American adult demographic. The study by Margolis et al. (2024) shows that African American residents in the state encounter higher rates of hypertensive emergencies while facing challenges with uncontrolled hypertension. Methods currently employed allow for preventing these emergency department visits, which demonstrate existing shortcomings in managing chronic diseases among patients. The healthcare system receives lower trust from Black Minnesotans because of perceived discrimination, insufficient culturally appropriate communication, and socioeconomic factors that restrict their ability to follow prescribed medications (Sekkarie et al., 2024). Adediran et al. (2024) indicate that healthcare needs to expand beyond traditional systems to provide better comprehensive disease management for a wider population.

North Minneapolis, a predominantly African American neighborhood, is an example of how an underserved community can experience poor health outcomes because of medication nonadherence. According to community health assessments, hospitalizations related to the heart and cardiovascular system in North Minneapolis are much higher than the citywide average. In this area, many residents experience concomitant issues such as food insecurity, unemployment, housing instability, limited access to reliable transportation, and, consequently, inconsistent medication use (Sekkarie et al., 2024). Among local health clinics, hypertension has been identified as one of the top three chronic conditions affecting their patient population, with providers reporting missed follow-ups, low refill rates, and medication discontinuation (Margolis et al., 2024). However, limited coordinated, culturally appropriate care options exist when resources are available, given this community’s unique social determinants.

Improving African American communities’ medication adherence requires internal and external system reforms. Many healthcare settings also lack internal protocols to adequately track adherence in the required fashion and integrate community health workers or pharmacists into routine care. Moreover, outside of this secluded realm, societal barriers like high drug prices, structural racism, and mistrust in medical professionals still drive down treatment adherence (Sekkarie et al., 2024). The problem is not some medication but a lack of processes to take medication consistently. To close these gaps, an effective quality improvement plan must incorporate a culturally tailored approach that enhances engagement, builds trust, and promotes community-based support systems (Margolis et al., 2024). Such communities as North Minneapolis could become scalable models for targeted interventions that tackle hypertension disparities nationwide.

Evidence-Based Solutions

Using specific medicine-taking approaches that match African American cultural values helps African Americans fight high blood pressure better. Our initial solution uses mobile health (mHealth) applications, including automated text notifications and real-time medication tracking. These digital tools send routine alerts to help patients remember their medication schedules. Babatunde et al. (2024) show that mHealth tools help patients communicate better with doctors while involved in self-care. As outlined by Margolis et al. in 2024, these tools simplify health management, especially in locations with transportation barriers and time limitations. Mobile-based solutions become part of everyday healthcare to increase patient medicine compliance and reduce treatment risks.

The second evidence-based strategy involves employing healthcare workers from the same communities where they work. CHWs offer custom education and connect patients with healthcare resources while checking up on patients to ensure they take medicine as directed. Their support develops confidence and helps patients avoid hesitant participation while building stronger relationships with the healthcare system. CHWs connect medical providers with local communities and help their patients with social challenges (Abdalla et al., 2023). They have helped patients better manage their blood pressure and achieve better medical results through their efforts. Our strategy functions best when teams place it in clinics or community health centers that serve many people.

Motivational interviewing (MI) is a third practical approach, a structured counseling method nurses or providers use to encourage behavior change. MI helps patients explore and resolve their ambivalence toward taking medications. Xu et al. (2025) suggest that this method emphasizes empathy, collaboration, and patient autonomy. MI allows patients to express concerns while receiving support to develop achievable health goals. The approach can be incorporated during clinic visits or even virtual sessions. Through structured dialogue, MI fosters a personal commitment to consistent medication use and strengthens the provider-patient relationship. It is particularly impactful when addressing health behaviors shaped by systemic inequities or prior negative experiences with healthcare.

Planned Change Test

These three approaches mainly focus on addressing distinct reasons for non-compliance with medication. All these strategies may be used separately or in combinations depending on your healthcare team’s preferences. They increase patient engagement and reduce the number of unmet health-related emergency visits and blood pressure goals. Its adaptability makes it possible for healthcare organizations to develop the appropriate care models to help African Americans in the impoverished cities of the United States. These approaches are particularly relevant for practical application towards supporting day-to-day quality improvement projects in hospitals, and their overall effectiveness is evidenced in hospital settings. Their combined use strengthens clinical outcomes and health equity, particularly in communities with persistent and complex disparities.

These solutions draw on clinically practicable benchmarks and academic achievement goals to bring proportionate healthcare to society.  Adopting research-based structures for initiatives by organizations enables different professional groups to contribute to designing practices that support patient care (Sharma et al., 2025). To achieve these transitions, health systems must first engage in pilot projects and provide ongoing education to personnel about these new models and the integration of workflow connections. The calculation of patient adherence rates with the aid of data collected from emergency visits and customer feedback on satisfaction will determine the overall total magnitude of implementation across the entire healthcare system. This evidence-based medication adherence approach improves the health quality of the organization while reducing the ethnic differences in hypertension management among African American patients within Health organizations (Abdalla et al., 2023). There are various ways through which healthcare systems strive to deliver relevant and diverse interventions that can meet the community’s needs.

Aim Statement

The objective of the process improvement project is to improve the medication adherence rate among AA consumers diagnosed with hypertension with culturally appropriate interventions. The project aims to prevent a rise in blood pressure, reduce the risks of uncontrolled hypertension, including stroke or other cardiovascular diseases, and enhance patient involvement in the management of hypertension. Within six months, the objective is to gain an additional 25% of the target population with the help of refill rates of medications and data from patients’ questionnaires. Specific measures will include individual teaching, nurse-provided follow-up counseling, and technology sensitive to cultural norms and belief systems. The setting for the project is a community clinic that caters mainly to the African American community together with other health care practitioners such as physicians and surgeons. The project has been designed to ensure that targeted population members use the service as required for effective hypertension management and healthcare access.

Process Improvement Framework: Plan-Do-Study-Act (PDSA)

Plan

This phase will explore the causes of inadequate follow-through with the treatment plan among African American persons diagnosed with hypertension. The research combines clinical findings with community survey outcomes and scholarly publications to uncover primary factors, including healthcare distrust, poor cultural education, and limited follow-up care services. After identifying all detected barriers, the team will develop a systematic implementation strategy with evidence-based interventions. This framework incorporates mobile health tools, community health worker assistance, and motivational interviewing methods. Team members will develop short-term and long-term objectives with assessment metrics to identify test subjects for these modifications throughout their broader implementation.

Do

In the “Do” phase, planned interventions will be implemented on a small scale at a community clinic in an African American community. Training will also be given to the staff, who will learn to use the mobile app and deliver culturally sensitive communication and skills to practice motivational interviewing. Community health workers will be designated at the clinic to support individual patients along the trajectory of their follow-up. In the pilot group, patients will receive information sessions, mobile medication reminder applications, and customized counseling services. During this phase, the refined data collection techniques will focus on documenting adherence modifications, patient engagement levels, satisfaction assessments, and addressing potential implementation issues and delays.

Study

The “Study” stage extensively analyzes information obtained throughout the pilot intervention period. The team will assess whether the implemented interventions produced better blood pressure control and improved medication adherence and patient-provider communication. Research findings will gauge the impact of implemented modifications by tracking data collected before and after system implementation. Patient and staff feedback collection will occur to understand their perspectives regarding the new medical practice method. The research team will evaluate the newly implemented methods by studying the expected outcomes and unexpected consequences, process discrepancies, or technical failures. The data collected will improve the project before potential distribution to more locations or modifications to care delivery processes.

Act

In the final phase, results from the study will inform the change team what actions need to be taken next. If the interventions prove successful, the project team will work on standardizing the new processes across the organization, including integrating community health worker roles into chronic disease management. Educational materials and mobile health practices will be refined based on user feedback. Staff will receive ongoing training in motivational interviews. If desired outcomes are not achieved, the team will return to the planning stage, adjusting the strategy as needed. The cycle may be repeated to ensure sustained quality improvement in hypertension care and medication adherence.

Stakeholders

Primary Care Providers (PCPs):
These clinicians diagnose and manage hypertension. Their interest lies in improving medication adherence to reduce complications and hospitalizations. PCPs will be engaged through education on the planned interventions, regular feedback meetings, and inclusion in decision-making about clinical protocol changes.

Community Health Workers:
Community health workers are middlemen between the healthcare system and the larger community. The collaboration entails offering education, follow-up, and culturally appropriate care and support. All these functional areas will be involved in patient outreach through training sessions, plan participation, and performance feedback to guarantee regular and efficient patient outreach.

Patients and Families
: This project focuses on African American adults with hypertension. Its role is defined as active engagement in the interventions. It will target patients and families through forums, interviews, and feedback to evaluate our interventions and their applicability to the family context.

Case Managers:
Paraprofessionals provide case management, assisting in organizing and managing the patient’s treatment plan. They are essential in tracking outcomes and connecting patients to relevant services. Engagement will include offering them membership in the intervention team, patient adherence report, and follow-up planning and education.

Pharmacists:
Pharmacists help patients with medication education and even adherence. Their role is to supplement education and monitor the refill regimen. These professionals will be engaged through care conferences, protocol planning, and informative platforms to recognize medication issues early.

Inputs (Resources)

Trained Personnel:
Several culturally competent staff members, including community health workers, case managers, and primary care providers, must implement individualized strategies. The program demands staff training, which helps connect members with project objectives and establishes uniform standards for patient contact.

Financial Support:
Institutional support is vital to obtaining the necessary funds for educational content development, personnel recruitment, and innovation in technology and program evaluation systems. Through grants, internal reallocations, or public health organization partnerships, the program will obtain essential financial support for its complete execution, from planning to implementation to evaluation.

Technological Tools:
EHR (electronic health records) systems collect data to track patient medication adherence and transmit information between medical staff while monitoring patient advancement. Healthcare providers can help patients manage their home practice while delivering educational content through patient portals, mobile health apps, and text message alerts.

Community Partnerships:
Partnerships between the intervention, local churches, barbershops, and advocacy organizations will enhance outreach efforts and build trust between the program and participants. The alliances established with community partners will give us access to physical locations, serve as advocates for community support, and enable us to recruit African Americans better into our study.

Output

Several essential results will emerge from the process improvement initiative as part of supporting African Americans with hypertension to adhere to their medications. The project provides culturally suited educational content such as printed brochures, digital media, and video productions focusing on cultural beliefs and medication usage barriers. Standardized counseling protocols and documentation forms will provide consistent communication and adherence monitoring throughout all health care providers. The medical center plans to introduce new policies based on best practices in cultural competence care delivery. Through its initiatives, the program will provide community workshops alongside individual counseling and mobile healthcare services. The services and products strive to increase patient awareness while building active participation and sustained loyalty toward their assigned antihypertensive treatment plans.

Evaluation Design

The quality improvement project uses a pre-post quasi-experimental design, which does not include a control group. The pre-post study design lets researchers track changes in medication adherence and blood pressure results with and without culturally centered interventions. The data collection process includes measuring baseline medication adherence, patient knowledge scores, and clinical indicators such as blood pressure results at baseline. Post-loader data collection takes place at both three and six months. The structured design preserves real-life clinical operations while allowing tracking of intervention success.

Process objectives measure the implementation success and usage levels of applied interventions. The project monitors three key metrics related to culturally sensitive patient education delivery community workshops and check-in counseling completion rates. Feedback forms, usage logs, and qualitative staff interview data will assess the utility and acceptability of new protocols among healthcare staff to measure integration success.

Outcome objectives will assess the impact of the interventions on key health and satisfaction metrics. The primary outcome will be improved medication adherence, which will be measured using patient self-reports and pharmacy refill data. Secondary outcomes include reduced systolic and diastolic blood pressure levels and enhanced patient satisfaction, which were assessed through validated surveys. The project will also evaluate whether increased cultural relevance leads to more trust in the healthcare system, further supporting long-term adherence and better hypertension management among African American patients Improving Medication Adherence in African Americans with Hypertension Essay.

Conclusion

This quality improvement project works to solve the ongoing problem of poor blood pressure control among African Americans through medication adherence programs personalized to their culture. The project tests effective methods to fight high blood pressure among African Americans through the PDSA process and data collection before and after. Stakeholder participation links resource availability and specific project goals to create the change process. The project’s primary objective is to decrease hypertension problems and provide patients with better healthcare services. Community-awareness care plans create better health equality while delivering permanent healthcare improvements for communities.

References

Abdalla, M., Bolen, S., Brettler, J. W., Egan, B. M., Ferdinand, K. C., Ford, C. D., Lackland, D. T., Wall, H. 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).
https://doi.org/10.1161/hyp.0000000000000232

Abrahamowicz, A. A., Ebinger, J., Whelton, S. P., Mensah, Y. C., & Yang, E. (2023). Racial and ethnic disparities in hypertension: Barriers and opportunities to improve blood pressure control.
Current Cardiology Reports
,
25
(1), 17–27.
https://doi.org/10.1007/s11886-022-01826-x

Adediran, E., Owens, R., Gardner, E., Curtin, A., Stuligross, J., Forbes, D., Wang, J., & Ose, D. (2024). Risk factors of undiagnosed and uncontrolled hypertension in primary care patients with hypertension: A cross-sectional study.
PubMed
,
25
(1), 311–311.
https://doi.org/10.1186/s12875-024-02511-4

Babatunde, A. O., Ogundijo, D. A., Afolayan, A.-G. O., Awosiku, O. V., Aderohunmu, Z. O., Oguntade, M. S., Alao, U. H., Oseni, A. O., Akintola, A. A., & Amusat, O. A. (2024). Mobile health technologies in the prevention and management of hypertension: A scoping review.
Digital Health
,
10
.
https://doi.org/10.1177/20552076241277172

Burlacu, A., Kuwabara, M., Brinza, C., & Kanbay, M. (2025). Key updates to the 2024 ESC hypertension guidelines and future perspectives.
Medicina
,
61
(2), 193.
https://doi.org/10.3390/medicina61020193

Chaturvedi, A., Zhu, A., Gadela, N. V., Prabhakaran, D., & Jafar, T. H. (2023). Social determinants of health and disparities in hypertension and cardiovascular diseases.
Hypertension
,
81
(3).
https://doi.org/10.1161/hypertensionaha.123.21354

Margolis, K., Chamberlain, A., & Drawz, P. (2024). prevalence of hypertension in Minnesota adults in 2023 using data from a statewide electronic health record consortium.
Hypertension
,
81
(Suppl_1).
https://doi.org/10.1161/hyp.81.suppl_1.p365

Sekkarie, A., Fang, J., Hayes, D., & Loustalot, F. (2024). Prevalence of self-reported hypertension and antihypertensive medication use among adults – United States, 2017-2021.
MMWR. Morbidity and Mortality Weekly Report
,
73
(9), 191–198.
https://doi.org/10.15585/mmwr.mm7309a1

Sharma, D. P., Aycock, D. M., Kelley, S. J., & Gaillard, T. (2025). Hypertension self-management among African American adults.
The Journal of Cardiovascular Nursing
.
https://doi.org/10.1097/jcn.0000000000001172

Xu, J., Gu, X., Gu, J., Zhao, L., Li, M., & Hong, C. (2025). Motivational interviewing intervention for the management of hypertension: A meta-analysis.
Frontiers in Cardiovascular Medicine
,
11
.
https://doi.org/10.3389/fcvm.2024.1457039
   Improving Medication Adherence in African Americans with Hypertension Essay