Improving Medication Adherence in Diabetic Patients in Home Health Care

Once IRB approval for your proposal is obtained, learners will commence the implementation phase of the DPI Project. For the remainder of the course, learners are required to develop working drafts of Chapters 4 and 5 of the final DPI Project. These chapters will undergo further revision in DNP-965 with the requirement that the entire DPI Project will be submitted to the DPI Committee at the end of DNP-965.

General Requirements:

TOPIC: Improving Medication Adherence in Diabetic Patients in Home Health Care Settings

This Paper should be about 25 pages long including the reference pages

Student should use Credible and Verifiable Academic Resources

Please use the Criterion in the Manuscript attached to Complete the assignment

Criterion must be attached with each stage or heading criteria

Please start the Project with a 1 page introduction that Summarizes the Chapter

Use the following information to ensure successful completion of the assignment: Improving Medication Adherence in Diabetic Patients in Home Health Care

· Remember to use the appropriate forms and templates (if required) for completing this assignment. These are available on the PI Workspace of the DC Network.

· Doctoral learners are required to use APA style for their writing assignments.

· 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.

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Directions:

Submission of the completed DPI Project – Working Draft Chapter 5 is the recommended deliverable to progress through the DPI Project implementation phase. Locate the “Final DPI Project Template” in the PI Workspace area of the DC Network and utilize it to develop and submit initial and ongoing working versions of Chapter 5 of your DPI Project.

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network. Improving Medication Adherence in Diabetic Patients in Home Health Care

QUALITY IMPROVEMENT PROJECT 2

 

Improving Medical Adherence in Diabetic Patients in Home Health Care Settings

Submitted by

Bola Odusola-Stephen

Direct Practice Improvement Project Proposal

Doctor of Nursing Practice

Grand Canyon University

Phoenix, Arizona

February 15, 2021.

 

Chapter 4

Introduction

Quality improvement in nursing is entailed in facilitating important strategies that can be used in enhancing outcomes in a healthcare setting. The chapter begins by introducing the descriptive data and offering visual representation for the collected data for enhanced understanding. The results section offer an evidence based as well as safety and quality improvement type of report for future reference and improvement. Tools to use for effectiveness in quality improvement are also offered to enhance success in future nursing practices.

 

Criterion	Learner Score (0, 1, 2, or 3)	Chairperson Score (0, 1, 2, or 3)	Comments or Feedback
INTRODUCTION (TOTHE CHAPTER) This section of Chapter 4 briefly restates the problem statement, the methodology, the clinical question(s) or phenomena, and offers a statement about what will be covered in this chapter.
Re-introduces the purpose of the practice project.
Briefly describes the project methodology and/or clinical question(s) tested.
Provides an orienting statement about what will be covered in the chapter.
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document. Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).

 

 

Descriptive Data

Table 1. Socio-demographic characteristics of patients (n=114)
Variables	Frequency	Percent
Age (years) 30-40 41-50 51-60 61-70 Above 70	8 17 31 28 30	7.0 14.9 27.2 24.6 26.3
Sex Male Female	51 63	44.7 55.3
Occupation Artisans Unemployed Civil servant Professionals Trading Retiree	6 10 11 28 29 30	5.3 8.8 9.6 24.6 25.4 26.3
Educational qualification No formal education Primary Secondary Tertiary	11 22 32 49	9.6 19.3 28.1 43.0
Marital status Single Married Widowed Divorced	5 89 17 3	4.4 78.1 14.9 2.6

Studies reveal that diabetic patients have an issue with taking their medications at home which has caused a lot of issues in their health. The table below shows data collected from different people with different status in the sample population used for this research study. When looked at the age factor it is evident that those as people grow older, they usually become less adhering to their medications while at home. The issue of age may be associated with the various side effects of aging that may be present in people. As people grow older their memory may be weak and cases of forgetting crucial issues are common. To handle the issue of forgetfulness and loss of memory as people age there is the need for the healthcare practitioners to keep a close monitoring of the identified patients.

The females are considered to be highly likely to forget to take their medications or adhere to taking their medications while at home because of the many activities they indulge in during their daily operations from work activities to household activities. When looked at from the employedt vs unemployed status, the unemployed have a higher level of adherence to medication while at home as compared to the employed people who have lost adherence to medications while at home. This may be associated to the many activities that the employed people indulge in during their day as compared to the unemployed who have enough time relaxing and managing their schedules Improving Medication Adherence in Diabetic Patients in Home Health Care.

Table 4. Association between socio-demographic characteristics and opinion on costs of medication as the reason for medication non-adherence. Costs as reason (Rank) (n=96)
Variables	Number	Mean rank	Kruskal-Wallis (p-value)
Age (year) 30- 40 41-50 51-60 61-70 Above 70	7 16 27 25 21	46.21 50.16 55.13 38.60 51.26	0.246
Sex Males Females	43 53	45.63 50.83	0.343
Occupation Artisan Civil servant Unemployed Retiree Trading Professional	4 8 9 23 26 26	24.75 79.81 45.56 34.67 45.13 59.13	0.000*
Educational qualification No formal education Primary Secondary Tertiary	9 19 23 45	54.17 54.97 40.30 48.82	0.297
Marital status Single Married Widowed Divorced	4 78 11 3	29.50 49.76 55.05 17.0	0.071
Level of significance p< 0.05, * = Significant difference

Alongside the socio-demographic factors that have been discussed above in an attempt to explain the key reasons as to why there is the issue of lack adherence to the diabetic medications that people have been given is that one regarding the costs of medication. Most of the individuals revealed that they have an issue with adhering to medications because of the cost associated with the given medications. Diabetic medications can be quite costly making people to be less adhering to the medications especially due to the many combinations that the patients are required to take for full recovery.

 

Criterion	Learner Score (0, 1, 2, or 3)	Chairperson Score (0, 1, 2, or 3)	Comments or Feedback
DESCRIPTIVE DATA This section of Chapter 4 provides a narrative summary of the population or sample characteristics and demographics of the participants in the project. It establishes the number of subjects, gender, age, level (if appropriate), organization, or setting (if appropriate). The use of graphic organizers, such as tables, charts and graphs to provide further clarification and promote readability, is encouraged.
Provides a narrative summary of the population or sample characteristics and demographics.
Graphic organizers are used as appropriate to organize and present coded data, as well as descriptive data such as tables, histograms, graphs, and/or charts.
Section is written in a way that is well structured, has a logical flow, uses correct paragraph structure, uses correct sentence structure, uses correct punctuation, and uses correct APA format.
NOTE: Once the document has been approved by your chairperson and your committee and is ready to submit for review, please remove all of these assessment tables from this document. Score 0 (not present); 1(unacceptable; needs substantial edits); 2 (present, but needs some editing); 3 (publication ready).

Data Analysis Procedures

This QI project uses the mobilize as well as the assess, plan, implement and Track process type of approach to arrive at the research outcomes indicated in this chapter. The sample entailed adult patients with T2DM who had at least a single oral diabetic type of medication prescribed to them. 194 patients met the identified criteria for inclusion in the sample. This project took place over 12 weeks. Initially, the identified recruitment regarding participants in the study was planned to take place for ten weeks but it was eventually extended to two more weeks so as to facilitate the enlisting of more participants for enhanced feasibility as well as efficacy of the study (Steinberg & Miller, 2015). At the start of the project associated implementation, there was carrying out of individual as well as group education types of meetings with the identified medical assistants as well as providers so as to train them on the manner in which to implement the given interventions. The project began with the adjusting of the given techniques in the implementation of the identified Interventions through the utility of the run charts. Prelusion of the data collection and data analysis materials happened next.

To analyze the given data tally sheets were utilized in counting the daily number regarding the patients who have been involved in the completion of the LON pre survey as well as there was recording the scores in the same type of document. There was the summarizing of the demographic data through computing the identified frequency as well as mean, the standard deviation and the identified percentages so as to effectively describe the given participants. There was thereafter a generation of a run chart so as to come up with an analysis of whether or not the 80% regarding the eligible parents received the identified DAEP. There were three categories regarding the LON scores which included the low from 0-1 as well as medium ones from 2-7 and the high ones from 8-36 ( Steinberg & Miller, 2015)Improving Medication Adherence in Diabetic Patients in Home Health Care.

The differences that existed between the identified LON scores pre as well as the post intervention distinctions were analyzing through the use of the identified sign test as well as the Mann Whitney U test. Nonetheless, there was summarization or the identified adherence rate regarding the given participants through the calculation of the identified mean as well as standard deviation and the median. These analysis were essential in offering increased knowledge on the adherence rate among the individuals and come up with an average of the identified figures for use for future references and in coming up with the right set of interventions. Finally, the analysis practice ended with the analysis of the identified relationship that exists between the identified adherence associated rates post Interventions Lon scores through the utility of the Pearson correlation coefficient.

Through out the collection and the Analysis Procedures, there was effective ensuring of the maintenance of privacy as well as confidentiality during the identified chart associated audit through the de-identification of the Pearson information by the participants using the codes. Nonetheless, it is important to note that printed data along with information were secured at the identified organiztaion in a locked file cabinet within a secured office. All the identified electronic data was stores on a password protected and an encrypted computer. To ensure there is effective sustainability regarding the identified aspect of practice change, the identified providers will go on addressing the outcomes from the identified adherence estimator regarding the medium to high score regarding the LON to medications. They will as well be following up on the identified adherence rate that was reported from the identified analysis during the assessment of the responses given for every participant. Implementation of the various interventions presented by different scholars along with researchers will be vital in the extension of the identified patients who have other chronic illnesses like hyperlipidemia along with hypertension so as to address the issue of inappropriate medical adherence among the patients ( Steinberg & Miller, 2015)Improving Medication Adherence in Diabetic Patients in Home Health Care.