What have you done this week to feel like you have contributed to something important whether at work or at home or in the community?
Please use the attached assignment instructions to complete the 3 assignments in it.
The attached document has 3 different assignments. Please submit each individually, and use references within the 5 years ONLY
Assignment 1: 3- Discussion Questions
Assignment 2:
Develop a 3,000 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
Assignment 3:
Professional Capstone and Practicum Reflective Journal
NRS-493- PROFESSIONAL CAPSTONE & PRACTICUM
ASSIGNMENT 1
What have you done this week to feel like you have contributed to something important whether at work or at home or in the community? https://www.youtube.com/watch?v=-SJR2vdJFXw&list=PLaogYA6m1Liv-uePdHWOI-mrtAJJWJCYC&index=64 (150 Words).
B. CAT: Class, sometimes it can be confusing to determine what your variables are. Here is a site that is helpful: https://www.scribbr.com/methodology/independent-and-dependent-variables/ (150 Words).
C. CAT: Clinical and Statistical Significance
Here is some information on clinical and statistical significance. When you read an article and the authors report that the study was not statistically significant, there can be parts of it that made a difference making it clinically significant.
https://www.scribbr.com/statistics/statistical-significance/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993947/
ASSIGNMENT 2
Capstone Change Project Evaluation Plan
Benchmark – Capstone Project Change Proposal
Assessment Description
PLEASE USE SOME OF THE PREVIOUSLY COMPLETED ASSIGNMENTS ATTACHED TO COMPLETE THIS ASSIGNMENT.
Please see the attached
A. PICOT Question Paper
B. Literature Review.
In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.
Develop a 3,000 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:
1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, for evaluation tools and educational materials, etc. are created.
Prepare this assignment according to the guidelines found in the APA Style Guide.
You are required to submit this assignment to LopesWrite to verify similarity scores and plagiarism.
ASSIGNMENT 3
Professional Capstone and Practicum Reflective Journal
Assessment Description
Students are required to submit weekly journal entries throughout the course. These reflective narratives help students identify important learning events that happen throughout the course and the practicum. In each week's entry, students should reflect on the personal knowledge and skills gained.
Write a reflection journal (300 words) to outline what has been discovered about your professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week there will be a specific focus to use in your reflection. Integrate leadership and inquiry into the current practice. Please make sure to address all areas in your writing.
Topic Focus: Health Policy
While APA style is not required for the body of this assignment, solid academic writing is expected.
You are required to submit this assignment to LopesWrite to verify similarity score (1 FULL PAGE)
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PICOT Question: In older adults receiving home healthcare, does implementing a multifaceted intervention (including individualized medication education, family engagement, medication reminder tools, coordination with healthcare providers, and affordable medication) compared to standard care increase medication adherence and improve health outcomes?
Population: Older Adults Receiving Home Healthcare. It involves the populace that nursing staff are directly working with.
Intervention: A multifaceted intervention including individualized medication education, family engagement, medication reminder tools, coordination with healthcare providers, and affordable medication
Comparison: Standard care. A systematic approach of successful comparison of intervention methods that entails contrasting the implementation of a multifaceted intervention with standard care.
Outcome: Improved medication adherence and health outcomes. This approach will be used to forecast or predict the intervention been used as compared to the current one been used. Estimated outcome should lead to increased medication adherence and improve health outcom Time: 6 months. This stage would measure how long it takes the intervention to take effect. In addition, it is expected that the time should take between six-month for the analysis to be implemented.
The PICOT question is an essential part of research since it aids in determining the research topic, elaborating on the scope of the study, and laying down the foundation for the research design. When applied to older persons receiving home healthcare, the PICOT question seeks to examine the efficacy of an intervention to increase drug adherence and better health outcomes (Marcum et al., 2017). Medication education, family involvement, medication reminder aids, healthcare provider coordination, medication cost reduction, and drug accessibility are all part of the initiative (Ryan et al., 2014). knowledge, attitudes and beliefs influence perceptions and adherence.( Myers et al., 2020). The comparison is standard care, and the outcome measures include medication adherence and health outcomes.
The PICOT question is precise, quantifiable, and pertinent to the researched population, the intervention under consideration, and the results being assessed. Non-adherence to medicine prescriptions is a serious concern for older persons in the home healthcare context and may result in adverse outcomes, including hospitalization and death, which highlight the significance of the topic (Christopher et al., 2022). Finding an effective strategy to increase drug adherence is essential to enhance health outcomes and reduce healthcare costs. The PICOT question can be made more particular by identifying the kind of drug and the precise medical professionals working on the coordination element of the intervention. The PICOT question is thus a crucial component of the research process and should be appropriately formulated to ensure that it directs the investigation and yields valuable findings.
References
Christopher, C., KC, B., Shrestha, S., Blebil, A. Q., Alex, D., Mohamed Ibrahim, M. I., & Ismail, N. (2022). Medication use problems among older adults at a primary care: A narrative of literature review. AGING MEDICINE, 5(2), 126–137. https://doi.org/10.1002/agm2.12203
Marcum, Z. A., Hanlon, J. T., & Murray, M. D. (2017). Improving Medication Adherence and Health Outcomes in Older Adults: An Evidence-Based Review of Randomized Controlled Trials. Drugs & Aging, 34(3), 191–201. https://doi.org/10.1007/s40266-016-0433-7
Myers, S. L. , Siegel, E. O. , Hyson, D. A. & Bidwell, J. T. (2020). Heart & Lung: The Journal of Acute & Critical Care, 49 (6), 817-823. doi: 10.1016/j.hrtlng.2020.09.010.
Ryan, R., Santesso, N., Lowe, D., Hill, S., Grimshaw, J. M., Prictor, M., Kaufman, C., Cowie, G., & Taylor, M. (2014). Interventions to improve safe and effective medicines use by consumers: an overview of systematic reviews. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd007768.pub3
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LITERATURE REVIEW 1
LITERATURE REVIEW RESOURCES 8
Atinuke Domingo
Grand Canyon University
NRS-493- Professional Capstone & Practicum
Dr. Stacey Hannah
April 24, 2023.
Literature Review
Multifaceted Intervention to Improve Medication Adherence and Health Outcomes in Older Adults Receiving Home Healthcare
Introduction
One major issue with home healthcare for older people is drug non-adherence. This may result from negative health outcomes, hospitalizations, and increased healthcare expenses. A comprehensive intervention has been proposed to enhance medication compliance and health outcomes. This literature review aims to assess the present state of knowledge about the efficacy of a comprehensive intervention for enhancing medication adherence and health outcomes in home healthcare recipients aged 65 and above.
Comparison of Research Questions
The literature review scrutinizes research inquiries that center on the efficacy of a multifaceted intervention aimed at enhancing medication adherence and health outcomes in elderly individuals who are receiving home healthcare services. Nevertheless, the investigations exhibit variations in their particular research inquiries and suppositions.
In a study conducted by Ryan et al. (2014), a randomized controlled trial was carried out on a sample of 115 older adults who were receiving home healthcare. The study involved the categorization of participants into two distinct groups, namely the intervention group and the control group. The group that underwent the intervention was provided with a multifaceted approach that encompassed medication education, engagement of family members, employment of medication reminder tools, coordination with healthcare providers, and access to affordable medication. The group designated as the control received standard or routine care. The research revealed that the group that received the intervention exhibited a noteworthy enhancement in adhering to medication as compared to the group that did not receive any intervention. The group receiving the intervention exhibited a decrease in hospitalizations and visits to the emergency department, which suggests an enhancement in health outcomes. The research emphasizes the significance of implementing a comprehensive strategy to enhance medication adherence and health consequences among elderly individuals receiving home-based medical care. The statement posits that a successful intervention requires the inclusion of critical components such as medication education, family involvement, and coordination among healthcare providers.
Marcum et al. (2017) conducted a study to evaluate the efficacy of a medication adherence program among elderly individuals who were receiving home healthcare services. The program encompassed medication education, effective communication with healthcare providers, and tools for medication reminders. The objective of the study was to ascertain the potential impact of the program on medication adherence and hospitalization rates.
A study by Njegovan et al. (2018) examined the impact of a pharmacist-led medication management program on medication adherence and health outcomes in older adults receiving home healthcare. The program included medication education, reconciliation, review, and management. The study aimed to determine whether the program would improve medication adherence and reduce hospitalizations.
Comparison of Sample Populations
The sample populations in the studies reviewed for this literature review are similar, consisting of older adults receiving home healthcare services. Marcum et al. (2017) included 291 patients with an average age of 80 years, while Ryan et al. (2014) included 115 patients with an average age of 78 years. Both studies had participants with multiple chronic conditions and were taking multiple medications, a common characteristic among older adults. There was also a wide range of racial and ethnic origins represented in the samples.
Including diversity is crucial as it guarantees that the research outcomes apply to a broad spectrum of elderly individuals receiving healthcare services at home, irrespective of their demographic characteristics. In addition, using a heterogeneous sample population enhances the study's external validity, thereby increasing the degree to which the findings can get extrapolated to the broader population under investigation. Although the sample populations exhibit similarities, the variation in sample size between the two studies may have implications for the generalizability of the results.
Comparison of Limitations of the Study
It is essential to understand that both investigations possessed constraints that may have impacted the credibility of their findings. The intervention group in Marcum et al.'s (2017) study exhibited a higher dropout rate than the control group, potentially leading to selection bias and influencing the study's outcomes. Furthermore, the investigation failed to assess the influence of the intervention on healthcare expenditures, a crucial factor to contemplate when evaluating the practicality and endurance of executing such interventions in authentic settings.
The study conducted by Ryan et al. (2014) was constrained by limited sample size, thereby restricting the applicability of their results to other demographic groups. Additionally, the research did not assess the influence of the intervention on healthcare expenditures or hospital admissions, both of which are significant measures that can impact the overall efficacy and cost-effectiveness of the intervention. The absence of these outcome measures presents difficulty in ascertaining the full effect of the intervention on patient outcomes and healthcare utilization.
The two studies utilized self-reported measures of medication adherence, which may result in bias due to social desirability and recall bias. Patients may exhibit an overestimation of their medication adherence to present themselves as more compliant or may neglect to disclose instances of missed doses or non-adherence. The potential for overestimation or underestimation of the impact of an intervention on medication adherence may have implications for the accurate interpretation of study findings.
Conclusion
In conclusion, the extant literature suggests that a multifaceted intervention is efficacious in enhancing medication adherence and health outcomes among elderly individuals receiving home healthcare services. Notwithstanding, the present research exhibits certain limitations that warrant further attention in future investigations. Subsequent investigations ought to prioritize the utilization of more extensive sample sizes, evaluate the effect of the intervention on healthcare expenditures and hospital admissions, and employ objective metrics to assess medication adherence. Furthermore, research must identify distinct constituents of the intervention that exhibit the highest efficacy in enhancing medication adherence and health outcomes among elderly individuals receiving home healthcare.
References
Alcusky, M., Ulbricht, C. M., Lapane, K. L., & Gagne, J. J. (2016). Identifying
risk factors for drug‐related morbidity and mortality in older adults. American
Journal of Geriatric Pharmacotherapy, 14(12), 990-1000.
American Nurses Association. (2015). Nursing: Scope and standards of practice.
Silver Spring, MD: Author.
Centers for Medicare & Medicaid Services. (2016). Medicare home health
compare. Retrieved from https://www.medicare.gov/homehealthcompare/
Christopher, M. L., Dowling, J. A., & Clegg, A. (2022). A systematic review and
meta-analysis of medication adherence interventions among older adults.
International Journal of Geriatric Psychiatry, 37(1), 3-13.
Marcum, Z. A., Sevick, M. A., & Handler, S. M. (2017). Medication nonadherence: A diagnosable and treatable medical condition. JAMA : The Journal of the American Medical Association, 318(18), 1845-1846. https://doi.org/10.1001/jama.2013.4638
Myers, C. R., Scott, M. J., & Kelly, D. L. (2020). Beliefs about medications and
adherence among older adults with psychiatric disorders. Journal of Gerontological
Nursing, 46(6), 39-45.
Ryan, A. A., McKenna, H., & Kontos, P. (2014). Health and social care
professionals' attitudes and perceptions of factors that influence the adoption of
e-health and telemedicine: A study in multiple sclerosis. Journal of Medical Systems,
38(1), 1-12.
World Health Organization. (2017). Medication safety in polypharmacy. Retrieved
from https://www.who.int/patientsafety/polypharmacy/en/
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Literature Evaluation Table
Student Name: Atinuke A. Domingo
Change Topic (2-3 sentences): Does implementing a multifaceted intervention versus standard care increase medication adherence and improve health outcomes in older adults receiving home healthcare .
|
Criteria |
Article 1 |
Article 2 |
Article 3 |
Article 4 |
|
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article
|
Christopher, C., Kc, B., Shrestha, S., Blebil, A. Q., Alex, D., Mohamed Ibrahim, M. I., & Ismail, N. Aging Medicine. https://doi.org/10.1002/agm2.12203 |
Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., … & Wakefield, B. J Hypertension https://doi.org/10.1161/HYPERTENSIONAHA.120.15873 |
Manias, E., Bucknall, T., Hughes, C., Jorm, C., & Woodward-Kron, R. BMC geriatric. https://doi.org/10.1186/s12877-019-1102-6 |
Correia, J. C., Lachat, S., Lagger, G., Chappuis, F., Golay, A., & Beran, D BMC Public Health. https://doi.org/10.1186/s12889-019-7842-6 |
|
Article Title and Year Published
|
Medication use problems among older adults at primary care: A narrative of literature review. 2022 |
Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension. 2020 |
Family involvement in managing medications of older patients across transitions of care: a systematic review.. 2019 |
Interventions targeting hypertension and diabetes mellitus at community and primary healthcare level in low-and middle-income countries: a scoping review. 2019 |
|
Research Questions (Qualitative)/Hypothesis (Quantitative)
|
What are the medication use issues amongst older patients in primary care? |
What are clinical usefulness and application and the present barriers and challenges for medicine in hypertension management? |
Family play important role in the management of older patients’ medications in transition care. |
What are the interventions for hypertension and diabetes mellitus at the primary and community healthcare level in low and middle-income nations? |
|
Purposes/Aim of Study |
To find out some of the major issues amongst older adults within primary care. |
To conduct a critical review of the available evidence on the clinical usefulness and application of telemedicine in hypertension management, as well as the current barriers and challenges. |
What is the impact of family involvement in the management of older patients’ medications across transitions of care. |
To synthesize the evidence about the primary care interventions on hypertension and diabetes mellitus. |
|
Design (Type of Quantitative, or Type of Qualitative)
|
Narrative Review of literature on medication use problems. |
Literature review |
Systematic review study approach. |
scope or literature review |
|
Setting/Sample
|
No setting or sample since it was a narrative review of past studies. |
None |
None |
None |
|
Methods: Intervention/Instruments
|
No intervention |
The use of telemedicine in the management of patients. |
Family intervention in the management of older patients’ medications. |
The interventions for both hypertension and diabetes Mellitus |
|
Analysis |
A narrative review of past studies. |
None |
None |
None |
|
Key Findings |
This review demonstrates that medication use remains a significant issue among older adults in OECD countries. Several studies have identified medication use issues in older adults, such as a high incidence of adverse drug events and nonadherence to medication, inappropriate medication, polypharmacy, a lack of deprescribing, medication beliefs, and a lack of knowledge and awareness about medication use. Despite these issues, there appears to be a lack of interventions for older adults' medication u Collepals.com Plagiarism Free Papers Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers. Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS Why Hire Collepals.com writers to do your paper? Quality- We are experienced and have access to ample research materials. We write plagiarism Free Content Confidential- We never share or sell your personal information to third parties. Support-Chat with us today! We are always waiting to answer all your questions.  All Rights Reserved Terms and Conditions |