Assignment Prompt & Instructions
Bj week 5
– 2 years ago
**files (3)**
– ## TheCriticalRoleofNursesinImprovingMedicationAdherenceforStrokePatients.docx
– ## Unit5-KTAPart1Template.docx
– NU700Unit4AssignmentResourceLinks.pdf
**## TheCriticalRoleofNursesinImprovingMedicationAdherenceforStrokePatients.docx**
2
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
Student’s name
Institution affiliation
NU700: Advanced Nursing Practice
Professor Smith
March 25, 2024
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
As nurses, we witness firsthand the challenges patients face attempting to take medications as ordered. Some forget doses, others cannot afford them, and many just don't understand the significance of the medications. For stroke survivors, though, taking medication is not about obeying doctor's orders—it is quite literally a matter of life and death. Take Mr. Johnson, for example, a 68-year-old stroke survivor whom I cared for. Even after multiple education sessions, he often missed his blood thinners, proclaiming, "I feel fine." Two months later, he had a second, more severe stroke. Cases such as his are all too common, unfortunately. Studies show that almost half of all stroke patients do not take their medications as directed, which puts them at a much higher risk of repeat strokes (Zhang et al., 2024). This is not a mere statistic—it is a crisis that can be addressed by nurses. This article will explore why medication compliance among stroke patients is necessary, how they are obstructed, and the significant contribution nurses can offer to increase compliance.
**The Problem: Why Medication Adherence Matters for Stroke Patients**
**A Silent Epidemic with Deadly Consequences**
Stroke is the fifth leading cause of death and a primary cause of disability in the US (Centers for Disease Control and Prevention [CDC], 2023). Many survivors are unaware that risk of recurrence of stroke is highest in the first year following a stroke—and staying off medication significantly raises that risk. Middleton et al. (2024) discovered that research indicated that medication non-adherence was linked with a 30% higher risk of recurrence of stroke and with a sharp increase in hospitalization rates.
**Barriers to Adherence**
Based on my own experience, nonadherence reasons are mixed but prevalent
1. “I don't feel sick, so why take pills?”
Stroke patients do not have recurrent symptoms and thus may be unaware of needing chronic medication.
2. Cognitive Impairment
Memory loss and disorientation after a stroke may lead to the patient forgetting to recall dosages.
3. Financial Constraints
Zhang et al. (2024) found that 1 in every 5 stroke patients omit doses due to financial concerns.
4. Complex Medication Regimens
Stroke patients are typically on 10 or more medications a day, which leads to frustration and mistakes.
**Evidence-Based Nursing Interventions**
1.
**Personalized Nurse-Led Education**
Repeated research proves that education initiated by nurses improves compliance. Gibson et al. (2021) found that patients suffering from a stroke who received personalized, nurse-initiated education were 35% more likely to be compliant. Nurses should provide clear, concise explanations, as opposed to handing a patient a pillbox, and apply the teach-back method, in which patients explain information in their own words. Cognitively impaired patients may benefit from visual aids such as color-coded charts of medication.
2.
**Simplifying Medication Schedules**
Middleton et al. (2024) found that patients suffering from stroke were three times more likely to adhere to medications when regimens were simplified. Nurses can collaborate with doctors and pharmacists to encourage once-daily dosages or combined pills wherever possible.
3.
**Leveraging Technology**
Research by Cassier-Woidasky et al. (2024) revealed that automated reminders like text messages and pill alarms decreased missed doses by 50%. Patients can be assisted by nurses in setting up medication reminders on their mobile phones. For elderly patients, the suggestion of simple battery-powered pill alarms is very effective.
**The Nurse’s Role in Driving Change**
1. Be a Patient-Provider Liaison: Physicians may not always have an understanding of the challenge that patients face in adhering to complicated regimens. Nurses should advocate for simpler drug schedules and mediate patient concerns.
2. Overcome Financial Barriers: Most patients are unwilling to acknowledge that they cannot afford their drugs. Nurses must directly inquire about financial issues and refer patients to prescription assistance programs.
3. Involve Family Members: Recovery from a stroke is teamwork. Educating family members and caregivers can immensely enhance compliance.
4. Follow Up Relentlessly: One of the quickest and easiest checks, a one-week post-discharge phone call check-in, will identify early compliance issues.
**Conclusion**
Medication nonadherence in stroke patients is not only a clinical issue—it is an issue of people. Every dose that is not taken is one patient who can't, won't, or doesn't know how to take their medications. Fortunately, nurses can make this change. Through the combination of compassion and evidence-based practice—such as individualized education, regimen simplification, technology support, and follow-up—nurses can avoid future strokes, save lives, and promote patient health. Mr. Johnson's second stroke may have been prevented.
References
Cassier-Woidasky, A. K., Middleton, S., Dale, S., Coughlan, K., D’Este, C., McInnes, E., … & Pfeilschifter, W. (2024). Quality in Acute Stroke Care (QASC) Germany: improving efficiency in stroke care with nurse-initiated FeSS-protocols.
_Neurological Research and Practice_,
_6_(1), 48.
[https://link.springer.com/article/10.1186/s42466-024-00352-1](https://link.springer.com/article/10.1186/s42466-024-00352-1)
CDC. (2024). Stroke Facts. Center for Disease Control and Prevention (CDC).
[https://www.cdc.gov/stroke/data-research/facts-stats/index.html](https://www.cdc.gov/stroke/data-research/facts-stats/index.html)
Gibson, J., Coupe, J., & Watkins, C. (2021). Medication adherence early after stroke: using the Perceptions and Practicalities Framework to explore stroke survivors’, informal carers’ and nurses’ experiences of barriers and solutions.
_Journal of Research in Nursing_,
_26_(6), 499-514.
[https://journals.sagepub.com/doi/pdf/10.1177/1744987121993505](https://journals.sagepub.com/doi/pdf/10.1177/1744987121993505)
Middleton, S., Cassier-Woidasky, A. K., & Dale, S. (2024).
_Ademuyiwa, I. Y., & Okubadejo, N. U. (2021). Effect of a nurse-led secondary stroke prevention intervention on medium-term stroke outcome in a teaching hospital in Nigeria: a quasi-experimental study. Journal of Clinical Sciences, 18(3), 168-173._ [https://journals.lww.com/jocs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01971469-202118030-00008](https://journals.lww.com/jocs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01971469-202118030-00008)
Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led ehealth programme on functional outcomes and quality of life of patients with stroke: A pooled analysis of randomized controlled trials.
_Frontiers in Public Health_,
_12_, 1395270.
[https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/pdf](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/pdf)
**## Unit5-KTAPart1Template.docx**
**Knowledge-to-Action Part 1: Intervention**
Student Name
Herzing University
NU 700: Knowledge for Nursing Practice
Full Faculty’s Name and Credentials
Month date, year
1
8
**Knowledge-to-Action Part 1: Intervention**
It is always good to start a paper with a grabbing statistic (with citation) or statement regarding the topic (the problem which was identified in your article from Week 4) to capture the attention of the reader. Provide a sentence or two discussing the professional nurses’ role in using evidence from the literature to address a practice problem. End the introduction paragraph with a purpose or thesis statement as your last sentence of the paragraph to introduce the
**main points/sections** of your paper. Example: The purpose of this paper is to… discuss a clinical practice problem and provide a literature summary of an evidence-based intervention to address this problem in the clinical practice setting.
TIP: (be more
**specific** using the problem you have identified and your clinical setting when creating the purpose statement).
Practice Problem Overview
Provide the name of the Unit 4 article and be sure that you are providing appropriate citations. Clearly identify and state the overarching problem within this article’s practice setting (Ex: The clinical practice problem identified within the article is…….). Provide an overview of the information contained within the selected article that supports the existence and significance of the problem. Including information such as participants/setting of the article and data or statistics adds credibility to the significance of the problem.
**A problem needs to be a real problem, or it is not worth addressing-prove there is a real problem**. This section is only about a problem, not a diagnosis or an intervention.
**TIP: Only provide info from the
**initially selected article from Unit 4** and edits as suggested by the faculty.
**Literature Review: Potential Intervention**
Search current literature about the clinical practice problem and interventions that address the Unit 4 problem. Select
**ONE** intervention that would be the best option to address the problem in YOUR CURRENT clinical practice setting (ex: Family Practice Clinic). Provide a sentence or two to explain what the intervention is. Then develop
**a literature review** of the intervention, synthesizing three (3) sources of scholarly literature. The literature review should ideally compare/contrast the following topics among all the supporting literature validating the intervention as effective to address the clinical problem.
Organizing the review will help the writer compare and contrast all 3 articles. These are some ways you can compare and contrast the literature to capture all significant elements in the review:
Purpose of the Study
Settings/Participants or Population
Level of Evidence, Relevant Data, Statistics, or Themes
Outcomes/Findings
Limitations or Gaps in the Research
This is NOT a summary of individual articles and their findings on an intervention. It is the SYNTHESIS of all the articles into one literature review.
**Example Literature Review: Simulation**
Due to the multifaceted nature of healthcare, new nurses must be ready upon graduation to enter the workforce with well-developed clinical judgement, self-confidence, and psychomotor skills. Simulation was determined to be the best evidence-based intervention from the literature to address these requirements in a prelicensure nursing program. Three evidence-based articles are represented in this literature review to support the intervention of simulation-based learning in nursing education.
Ahn and Kim (2019) found in a quasi-experimental study of 69 participants that simulation improved learning outcomes and self-confidence by 26% when perception of the simulation scenario was viewed positively. Likewise, Kaddoura (2020) found in systematic review of literature from the past 10 years, that the safe learning environment of simulation contributes to nursing students’ critical thinking and confidence. Similar to Kaddoura (2020), Fisher and King (2017) conducted a qualitative survey of 25 senior nursing students and found themes to support that simulation improved the transfer of theoretical knowledge to clinical, enhanced confidence levels, and expanded clinical competencies necessary as a practice-ready nurse.
Go into more depth about the settings, participants, types of studies conducted, any data/analysis, and outcomes. This discussion should be approximately 3 paragraphs that compare and contrast the literature in this way regarding a single intervention. End this section with your thoughts and why you believe it is
**the**
**best one for your clinical practice setting** based on the literature review.
*TIP: Review these videos to help with developing a literature review.
[https://www.youtube.com/watch?v=Vc_Yu_61Ymg](https://www.youtube.com/watch?v=Vc_Yu_61Ymg)
[**https://www.youtube.com/watch?v=kW6Uzn-8uMI**](https://www.youtube.com/watch?v=kW6Uzn-8uMI)
Conclusion
Bring the reader back to the main topic of this paper which is the practice problem and the professional nurses’ role in using evidence from the literature to address a practice problem. You should also restate or rephrase your purpose/thesis statement. In a conclusion, you should NOT add new ideas or new information, rather summarize and reflect on key elements of the paper. You can end the conclusion by clarifying the intent and importance of the paper for the reader (Ex: why was this paper important to healthcare)?
***Bonus Tip: While there is no specific page requirement, an in-depth review of the clinical practice problem and supporting literature, along with the introduction & conclusion sections is suggested to be no less than 3 pages. With title and reference pages, a total of 5 pages minimum is suggested.
**References**
Make sure to include functioning doi/url links for retrieval that take the reader to the full article.
This paper should be supported by no less than
**4 scholarly sources with citations/references**.
**NU700Unit4AssignmentResourceLinks.pdf**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu700unit4assignmentresourcelinks-pdf-10251615)
**NU700Unit4AssignmentResourceLinks.pdf**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu700unit4assignmentresourcelinks-pdf-10251615)
**## TheCriticalRoleofNursesinImprovingMedicationAdherenceforStrokePatients.docx**
2
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
Student’s name
Institution affiliation
NU700: Advanced Nursing Practice
Professor Smith
March 25, 2024
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
As nurses, we witness firsthand the challenges patients face attempting to take medications as ordered. Some forget doses, others cannot afford them, and many just don't understand the significance of the medications. For stroke survivors, though, taking medication is not about obeying doctor's orders—it is quite literally a matter of life and death. Take Mr. Johnson, for example, a 68-year-old stroke survivor whom I cared for. Even after multiple education sessions, he often missed his blood thinners, proclaiming, "I feel fine." Two months later, he had a second, more severe stroke. Cases such as his are all too common, unfortunately. Studies show that almost half of all stroke patients do not take their medications as directed, which puts them at a much higher risk of repeat strokes (Zhang et al., 2024). This is not a mere statistic—it is a crisis that can be addressed by nurses. This article will explore why medication compliance among stroke patients is necessary, how they are obstructed, and the significant contribution nurses can offer to increase compliance.
**The Problem: Why Medication Adherence Matters for Stroke Patients**
**A Silent Epidemic with Deadly Consequences**
Stroke is the fifth leading cause of death and a primary cause of disability in the US (Centers for Disease Control and Prevention [CDC], 2023). Many survivors are unaware that risk of recurrence of stroke is highest in the first year following a stroke—and staying off medication significantly raises that risk. Middleton et al. (2024) discovered that research indicated that medication non-adherence was linked with a 30% higher risk of recurrence of stroke and with a sharp increase in hospitalization rates.
**Barriers to Adherence**
Based on my own experience, nonadherence reasons are mixed but prevalent
1. “I don't feel sick, so why take pills?”
Stroke patients do not have recurrent symptoms and thus may be unaware of needing chronic medication.
2. Cognitive Impairment
Memory loss and disorientation after a stroke may lead to the patient forgetting to recall dosages.
3. Financial Constraints
Zhang et al. (2024) found that 1 in every 5 stroke patients omit doses due to financial concerns.
4. Complex Medication Regimens
Stroke patients are typically on 10 or more medications a day, which leads to frustration and mistakes.
**Evidence-Based Nursing Interventions**
1.
**Personalized Nurse-Led Education**
Repeated research proves that education initiated by nurses improves compliance. Gibson et al. (2021) found that patients suffering from a stroke who received personalized, nurse-initiated education were 35% more likely to be compliant. Nurses should provide clear, concise explanations, as opposed to handing a patient a pillbox, and apply the teach-back method, in which patients explain information in their own words. Cognitively impaired patients may benefit from visual aids such as color-coded charts of medication.
2.
**Simplifying Medication Schedules**
Middleton et al. (2024) found that patients suffering from stroke were three times more likely to adhere to medications when regimens were simplified. Nurses can collaborate with doctors and pharmacists to encourage once-daily dosages or combined pills wherever possible.
3.
**Leveraging Technology**
Research by Cassier-Woidasky et al. (2024) revealed that automated reminders like text messages and pill alarms decreased missed doses by 50%. Patients can be assisted by nurses in setting up medication reminders on their mobile phones. For elderly patients, the suggestion of simple battery-powered pill alarms is very effective.
**The Nurse’s Role in Driving Change**
1. Be a Patient-Provider Liaison: Physicians may not always have an understanding of the challenge that patients face in adhering to complicated regimens. Nurses should advocate for simpler drug schedules and mediate patient concerns.
2. Overcome Financial Barriers: Most patients are unwilling to acknowledge that they cannot afford their drugs. Nurses must directly inquire about financial issues and refer patients to prescription assistance programs.
3. Involve Family Members: Recovery from a stroke is teamwork. Educating family members and caregivers can immensely enhance compliance.
4. Follow Up Relentlessly: One of the quickest and easiest checks, a one-week post-discharge phone call check-in, will identify early compliance issues.
**Conclusion**
Medication nonadherence in stroke patients is not only a clinical issue—it is an issue of people. Every dose that is not taken is one patient who can't, won't, or doesn't know how to take their medications. Fortunately, nurses can make this change. Through the combination of compassion and evidence-based practice—such as individualized education, regimen simplification, technology support, and follow-up—nurses can avoid future strokes, save lives, and promote patient health. Mr. Johnson's second stroke may have been prevented.
References
Cassier-Woidasky, A. K., Middleton, S., Dale, S., Coughlan, K., D’Este, C., McInnes, E., … & Pfeilschifter, W. (2024). Quality in Acute Stroke Care (QASC) Germany: improving efficiency in stroke care with nurse-initiated FeSS-protocols.
_Neurological Research and Practice_,
_6_(1), 48.
[https://link.springer.com/article/10.1186/s42466-024-00352-1](https://link.springer.com/article/10.1186/s42466-024-00352-1)
CDC. (2024). Stroke Facts. Center for Disease Control and Prevention (CDC).
[https://www.cdc.gov/stroke/data-research/facts-stats/index.html](https://www.cdc.gov/stroke/data-research/facts-stats/index.html)
Gibson, J., Coupe, J., & Watkins, C. (2021). Medication adherence early after stroke: using the Perceptions and Practicalities Framework to explore stroke survivors’, informal carers’ and nurses’ experiences of barriers and solutions.
_Journal of Research in Nursing_,
_26_(6), 499-514.
[https://journals.sagepub.com/doi/pdf/10.1177/1744987121993505](https://journals.sagepub.com/doi/pdf/10.1177/1744987121993505)
Middleton, S., Cassier-Woidasky, A. K., & Dale, S. (2024).
_Ademuyiwa, I. Y., & Okubadejo, N. U. (2021). Effect of a nurse-led secondary stroke prevention intervention on medium-term stroke outcome in a teaching hospital in Nigeria: a quasi-experimental study. Journal of Clinical Sciences, 18(3), 168-173._ [https://journals.lww.com/jocs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01971469-202118030-00008](https://journals.lww.com/jocs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01971469-202118030-00008)
Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led ehealth programme on functional outcomes and quality of life of patients with stroke: A pooled analysis of randomized controlled trials.
_Frontiers in Public Health_,
_12_, 1395270.
[https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/pdf](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/pdf)
**## Unit5-KTAPart1Template.docx**
**Knowledge-to-Action Part 1: Intervention**
Student Name
Herzing University
NU 700: Knowledge for Nursing Practice
Full Faculty’s Name and Credentials
Month date, year
1
8
**Knowledge-to-Action Part 1: Intervention**
It is always good to start a paper with a grabbing statistic (with citation) or statement regarding the topic (the problem which was identified in your article from Week 4) to capture the attention of the reader. Provide a sentence or two discussing the professional nurses’ role in using evidence from the literature to address a practice problem. End the introduction paragraph with a purpose or thesis statement as your last sentence of the paragraph to introduce the
**main points/sections** of your paper. Example: The purpose of this paper is to… discuss a clinical practice problem and provide a literature summary of an evidence-based intervention to address this problem in the clinical practice setting.
TIP: (be more
**specific** using the problem you have identified and your clinical setting when creating the purpose statement).
Practice Problem Overview
Provide the name of the Unit 4 article and be sure that you are providing appropriate citations. Clearly identify and state the overarching problem within this article’s practice setting (Ex: The clinical practice problem identified within the article is…….). Provide an overview of the information contained within the selected article that supports the existence and significance of the problem. Including information such as participants/setting of the article and data or statistics adds credibility to the significance of the problem.
**A problem needs to be a real problem, or it is not worth addressing-prove there is a real problem**. This section is only about a problem, not a diagnosis or an intervention.
**TIP: Only provide info from the
**initially selected article from Unit 4** and edits as suggested by the faculty.
**Literature Review: Potential Intervention**
Search current literature about the clinical practice problem and interventions that address the Unit 4 problem. Select
**ONE** intervention that would be the best option to address the problem in YOUR CURRENT clinical practice setting (ex: Family Practice Clinic). Provide a sentence or two to explain what the intervention is. Then develop
**a literature review** of the intervention, synthesizing three (3) sources of scholarly literature. The literature review should ideally compare/contrast the following topics among all the supporting literature validating the intervention as effective to address the clinical problem.
Organizing the review will help the writer compare and contrast all 3 articles. These are some ways you can compare and contrast the literature to capture all significant elements in the review:
Purpose of the Study
Settings/Participants or Population
Level of Evidence, Relevant Data, Statistics, or Themes
Outcomes/Findings
Limitations or Gaps in the Research
This is NOT a summary of individual articles and their findings on an intervention. It is the SYNTHESIS of all the articles into one literature review.
**Example Literature Review: Simulation**
Due to the multifaceted nature of healthcare, new nurses must be ready upon graduation to enter the workforce with well-developed clinical judgement, self-confidence, and psychomotor skills. Simulation was determined to be the best evidence-based intervention from the literature to address these requirements in a prelicensure nursing program. Three evidence-based articles are represented in this literature review to support the intervention of simulation-based learning in nursing education.
Ahn and Kim (2019) found in a quasi-experimental study of 69 participants that simulation improved learning outcomes and self-confidence by 26% when perception of the simulation scenario was viewed positively. Likewise, Kaddoura (2020) found in systematic review of literature from the past 10 years, that the safe learning environment of simulation contributes to nursing students’ critical thinking and confidence. Similar to Kaddoura (2020), Fisher and King (2017) conducted a qualitative survey of 25 senior nursing students and found themes to support that simulation improved the transfer of theoretical knowledge to clinical, enhanced confidence levels, and expanded clinical competencies necessary as a practice-ready nurse.
Go into more depth about the settings, participants, types of studies conducted, any data/analysis, and outcomes. This discussion should be approximately 3 paragraphs that compare and contrast the literature in this way regarding a single intervention. End this section with your thoughts and why you believe it is
**the**
**best one for your clinical practice setting** based on the literature review.
*TIP: Review these videos to help with developing a literature review.
[https://www.youtube.com/watch?v=Vc_Yu_61Ymg](https://www.youtube.com/watch?v=Vc_Yu_61Ymg)
[**https://www.youtube.com/watch?v=kW6Uzn-8uMI**](https://www.youtube.com/watch?v=kW6Uzn-8uMI)
Conclusion
Bring the reader back to the main topic of this paper which is the practice problem and the professional nurses’ role in using evidence from the literature to address a practice problem. You should also restate or rephrase your purpose/thesis statement. In a conclusion, you should NOT add new ideas or new information, rather summarize and reflect on key elements of the paper. You can end the conclusion by clarifying the intent and importance of the paper for the reader (Ex: why was this paper important to healthcare)?
***Bonus Tip: While there is no specific page requirement, an in-depth review of the clinical practice problem and supporting literature, along with the introduction & conclusion sections is suggested to be no less than 3 pages. With title and reference pages, a total of 5 pages minimum is suggested.
**References**
Make sure to include functioning doi/url links for retrieval that take the reader to the full article.
This paper should be supported by no less than
**4 scholarly sources with citations/references**.
**NU700Unit4AssignmentResourceLinks.pdf**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu700unit4assignmentresourcelinks-pdf-10251615)
**## TheCriticalRoleofNursesinImprovingMedicationAdherenceforStrokePatients.docx**
2
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
Student’s name
Institution affiliation
NU700: Advanced Nursing Practice
Professor Smith
March 25, 2024
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
As nurses, we witness firsthand the challenges patients face attempting to take medications as ordered. Some forget doses, others cannot afford them, and many just don't understand the significance of the medications. For stroke survivors, though, taking medication is not about obeying doctor's orders—it is quite literally a matter of life and death. Take Mr. Johnson, for example, a 68-year-old stroke survivor whom I cared for. Even after multiple education sessions, he often missed his blood thinners, proclaiming, "I feel fine." Two months later, he had a second, more severe stroke. Cases such as his are all too common, unfortunately. Studies show that almost half of all stroke patients do not take their medications as directed, which puts them at a much higher risk of repeat strokes (Zhang et al., 2024). This is not a mere statistic—it is a crisis that can be addressed by nurses. This article will explore why medication compliance among stroke patients is necessary, how they are obstructed, and the significant contribution nurses can offer to increase compliance.
**The Problem: Why Medication Adherence Matters for Stroke Patients**
**A Silent Epidemic with Deadly Consequences**
Stroke is the fifth leading cause of death and a primary cause of disability in the US (Centers for Disease Control and Prevention [CDC], 2023). Many survivors are unaware that risk of recurrence of stroke is highest in the first year following a stroke—and staying off medication significantly raises that risk. Middleton et al. (2024) discovered that research indicated that medication non-adherence was linked with a 30% higher risk of recurrence of stroke and with a sharp increase in hospitalization rates.
**Barriers to Adherence**
Based on my own experience, nonadherence reasons are mixed but prevalent
1. “I don't feel sick, so why take pills?”
Stroke patients do not have recurrent symptoms and thus may be unaware of needing chronic medication.
2. Cognitive Impairment
Memory loss and disorientation after a stroke may lead to the patient forgetting to recall dosages.
3. Financial Constraints
Zhang et al. (2024) found that 1 in every 5 stroke patients omit doses due to financial concerns.
4. Complex Medication Regimens
Stroke patients are typically on 10 or more medications a day, which leads to frustration and mistakes.
**Evidence-Based Nursing Interventions**
1.
**Personalized Nurse-Led Education**
Repeated research proves that education initiated by nurses improves compliance. Gibson et al. (2021) found that patients suffering from a stroke who received personalized, nurse-initiated education were 35% more likely to be compliant. Nurses should provide clear, concise explanations, as opposed to handing a patient a pillbox, and apply the teach-back method, in which patients explain information in their own words. Cognitively impaired patients may benefit from visual aids such as color-coded charts of medication.
2.
**Simplifying Medication Schedules**
Middleton et al. (2024) found that patients suffering from stroke were three times more likely to adhere to medications when regimens were simplified. Nurses can collaborate with doctors and pharmacists to encourage once-daily dosages or combined pills wherever possible.
3.
**Leveraging Technology**
Research by Cassier-Woidasky et al. (2024) revealed that automated reminders like text messages and pill alarms decreased missed doses by 50%. Patients can be assisted by nurses in setting up medication reminders on their mobile phones. For elderly patients, the suggestion of simple battery-powered pill alarms is very effective.
**The Nurse’s Role in Driving Change**
1. Be a Patient-Provider Liaison: Physicians may not always have an understanding of the challenge that patients face in adhering to complicated regimens. Nurses should advocate for simpler drug schedules and mediate patient concerns.
2. Overcome Financial Barriers: Most patients are unwilling to acknowledge that they cannot afford their drugs. Nurses must directly inquire about financial issues and refer patients to prescription assistance programs.
3. Involve Family Members: Recovery from a stroke is teamwork. Educating family members and caregivers can immensely enhance compliance.
4. Follow Up Relentlessly: One of the quickest and easiest checks, a one-week post-discharge phone call check-in, will identify early compliance issues.
**Conclusion**
Medication nonadherence in stroke patients is not only a clinical issue—it is an issue of people. Every dose that is not taken is one patient who can't, won't, or doesn't know how to take their medications. Fortunately, nurses can make this change. Through the combination of compassion and evidence-based practice—such as individualized education, regimen simplification, technology support, and follow-up—nurses can avoid future strokes, save lives, and promote patient health. Mr. Johnson's second stroke may have been prevented.
References
Cassier-Woidasky, A. K., Middleton, S., Dale, S., Coughlan, K., D’Este, C., McInnes, E., … & Pfeilschifter, W. (2024). Quality in Acute Stroke Care (QASC) Germany: improving efficiency in stroke care with nurse-initiated FeSS-protocols.
_Neurological Research and Practice_,
_6_(1), 48.
[https://link.springer.com/article/10.1186/s42466-024-00352-1](https://link.springer.com/article/10.1186/s42466-024-00352-1)
CDC. (2024). Stroke Facts. Center for Disease Control and Prevention (CDC).
[https://www.cdc.gov/stroke/data-research/facts-stats/index.html](https://www.cdc.gov/stroke/data-research/facts-stats/index.html)
Gibson, J., Coupe, J., & Watkins, C. (2021). Medication adherence early after stroke: using the Perceptions and Practicalities Framework to explore stroke survivors’, informal carers’ and nurses’ experiences of barriers and solutions.
_Journal of Research in Nursing_,
_26_(6), 499-514.
[https://journals.sagepub.com/doi/pdf/10.1177/1744987121993505](https://journals.sagepub.com/doi/pdf/10.1177/1744987121993505)
Middleton, S., Cassier-Woidasky, A. K., & Dale, S. (2024).
_Ademuyiwa, I. Y., & Okubadejo, N. U. (2021). Effect of a nurse-led secondary stroke prevention intervention on medium-term stroke outcome in a teaching hospital in Nigeria: a quasi-experimental study. Journal of Clinical Sciences, 18(3), 168-173._ [https://journals.lww.com/jocs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01971469-202118030-00008](https://journals.lww.com/jocs/_layouts/15/oaks.journals/downloadpdf.aspx?an=01971469-202118030-00008)
Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led ehealth programme on functional outcomes and quality of life of patients with stroke: A pooled analysis of randomized controlled trials.
_Frontiers in Public Health_,
_12_, 1395270.
[https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/pdf](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/pdf)
**## Unit5-KTAPart1Template.docx**
**Knowledge-to-Action Part 1: Intervention**
Student Name
Herzing University
NU 700: Knowledge for Nursing Practice
Full Faculty’s Name and Credentials
Month date, year
1
8
**Knowledge-to-Action Part 1: Intervention**
It is always good to start a paper with a grabbing statistic (with citation) or statement regarding the topic (the problem which was identified in your article from Week 4) to capture the attention of the reader. Provide a sentence or two discussing the professional nurses’ role in using evidence from the literature to address a practice problem. End the introduction paragraph with a purpose or thesis statement as your last sentence of the paragraph to introduce the
**main points/sections** of your paper. Example: The purpose of this paper is to… discuss a clinical practice problem and provide a literature summary of an evidence-based intervention to address this problem in the clinical practice setting.
TIP: (be more
**specific** using the problem you have identified and your clinical setting when creating the purpose statement).
Practice Problem Overview
Provide the name of the Unit 4 article and be sure that you are providing appropriate citations. Clearly identify and state the overarching problem within this article’s practice setting (Ex: The clinical practice problem identified within the article is…….). Provide an overview of the information contained within the selected article that supports the existence and significance of the problem. Including information such as participants/setting of the article and data or statistics adds credibility to the significance of the problem.
**A problem needs to be a real problem, or it is not worth addressing-prove there is a real problem**. This section is only about a problem, not a diagnosis or an intervention.
**TIP: Only provide info from the
**initially selected article from Unit 4** and edits as suggested by the faculty.
**Literature Review: Potential Intervention**
Search current literature about the clinical practice problem and interventions that address the Unit 4 problem. Select
**ONE** intervention that would be the best option to address the problem in YOUR CURRENT clinical practice setting (ex: Family Practice Clinic). Provide a sentence or two to explain what the intervention is. Then develop
**a literature review** of the intervention, synthesizing three (3) sources of scholarly literature. The literature review should ideally compare/contrast the following topics among all the supporting literature validating the intervention as effective to address the clinical problem.
Organizing the review will help the writer compare and contrast all 3 articles. These are some ways you can compare and contrast the literature to capture all significant elements in the review:
Purpose of the Study
Settings/Participants or Population
Level of Evidence, Relevant Data, Statistics, or Themes
Outcomes/Findings
Limitations or Gaps in the Research
This is NOT a summary of individual articles and their findings on an intervention. It is the SYNTHESIS of all the articles into one literature review.
**Example Literature Review: Simulation**
Due to the multifaceted nature of healthcare, new nurses must be ready upon graduation to enter the workforce with well-developed clinical judgement, self-confidence, and psychomotor skills. Simulation was determined to be the best evidence-based intervention from the literature to address these requirements in a prelicensure nursing program. Three evidence-based articles are represented in this literature review to support the intervention of simulation-based learning in nursing education.
Ahn and Kim (2019) found in a quasi-experimental study of 69 participants that simulation improved learning outcomes and self-confidence by 26% when perception of the simulation scenario was viewed positively. Likewise, Kaddoura (2020) found in systematic review of literature from the past 10 years, that the safe learning environment of simulation contributes to nursing students’ critical thinking and confidence. Similar to Kaddoura (2020), Fisher and King (2017) conducted a qualitative survey of 25 senior nursing students and found themes to support that simulation improved the transfer of theoretical knowledge to clinical, enhanced confidence levels, and expanded clinical competencies necessary as a practice-ready nurse.
Go into more depth about the settings, participants, types of studies conducted, any data/analysis, and outcomes. This discussion should be approximately 3 paragraphs that compare and contrast the literature in this way regarding a single intervention. End this section with your thoughts and why you believe it is
**the**
**best one for your clinical practice setting** based on the literature review.
*TIP: Review these videos to help with developing a literature review.
[https://www.youtube.com/watch?v=Vc_Yu_61Ymg](https://www.youtube.com/watch?v=Vc_Yu_61Ymg)
[**https://www.youtube.com/watch?v=kW6Uzn-8uMI**](https://www.youtube.com/watch?v=kW6Uzn-8uMI)
Conclusion
Bring the reader back to the main topic of this paper which is the practice problem and the professional nurses’ role in using evidence from the literature to address a practice problem. You should also restate or rephrase your purpose/thesis statement. In a conclusion, you should NOT add new ideas or new information, rather summarize and reflect on key elements of the paper. You can end the conclusion by clarifying the intent and importance of the paper for the reader (Ex: why was this paper important to healthcare)?
***Bonus Tip: While there is no specific page requirement, an in-depth review of the clinical practice problem and supporting literature, along with the introduction & conclusion sections is suggested to be no less than 3 pages. With title and reference pages, a total of 5 pages minimum is suggested.
**References**
Make sure to include functioning doi/url links for retrieval that take the reader to the full article.
This paper should be supported by no less than
**4 scholarly sources with citations/references**.
**NU700Unit4AssignmentResourceLinks.pdf**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/nu700unit4assignmentresourcelinks-pdf-10251615)