Assignment Prompt & Instructions
BJ week 6
– 2 years ago
**files (3)**
– ## TheCriticalRoleofNursesinImprovingMedicationAdherence111.docx
– ## Unit6-KTAPart2Template.docx
– Module51.docx
**## TheCriticalRoleofNursesinImprovingMedicationAdherence111.docx**
2
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
Beverly Jordan
Herzing University
NU700 Knowledge for Nursing Practice
Module 4 Resubmission
Dr. Jessica Clark
04/08/2025
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
**Introduction**
Medication nonadherence in stroke survivors is a significant public health issue, and studies suggest that 30-50% of patients do not follow prescribed regimens, resulting in avoidable complications (Arkan et al., 2022). This is a critical concern since the secondary risk for stroke significantly increases when drugs like antihypertensives and anticoagulants are not appropriately taken. Nurses, the first point of contact in health care, have a unique chance to act on this threat through systematic action. Ongoing patient interaction provides real-time evaluation of challenges such as cognitive impairment, budget constraints, and literacy levels (Berardinelli et al., 2024). Targeted education with follow-up enables nurses to act at the right moment to reduce the risk of nonadherence. Medication nonadherence undermines not only individual patient outcomes but also overburdens the health systems with recurrent hospitalization and prolonged recovery. Nurses have excellent chances to detect signs of nonadherence early in their routine care interactions. By detecting it early, they can decrease readmission and healthcare costs. Their ability to visualize the cycle of patient needs enables them to develop tailored approaches that bridge knowledge gaps and improve long-term adherence.
**Practice Problem Overview**
Medication nonadherence among stroke patients is a complex problem driven by medical, psychological, and socioeconomic determinants. Arkan et al. (2022) established that merely 33.9% of stroke patients showed high adherence, and fear of side effects and lack of confidence in medication overuse were the main discourages. Post-stroke cognitive impairments further complicate compliance by disrupting memories regarding dosing or treatment needs. In addition, cumbersome multidrug regimens on a frequent schedule—a frequent regimen in stroke—induce more confusion and omissions (Kumar et al., 2024). A crossover between supervised medication is a sensitive, vulnerable point during in-hospital treatments. In the absence of proper support, there is a high risk of recurrence, disability, and death, which further provides a rationale for consistent nursing interventions. Most patients are sent home without sufficient support systems, and this heightens the likelihood of missing medication or abandoning it altogether. Most stroke survivors battle depression or anxiety, which also influences motivation to adhere to multifaceted regimens. Without structured guidance, even patients with good intentions will default on treatment. This fact highlights the importance of nurses acting as continued contact points for medication management after discharge.
**Literature Review: Potential Intervention**
Evidence indicates that interventions by nurses are highly effective at encouraging medication compliance among stroke survivors. Interventions typically integrate patient education, regimen simplification, and technological support to overcome multifactorial barriers to adherence. Berardinelli et al. (2024) conducted a systematic review of patients with chronic diseases, noting that patient education by a nurse in the face-to-face format significantly improved adherence, with particularly robust increases in patients with stroke and cardiovascular diseases. They recognized that nurses' ability to deliver personalized education on medication aims, potential side effects, and dosing time helped to moderate patients' misconceptions and concerns, which are crucial risk factors for nonadherence (Arkan et al., 2022). The teach-back method, under which patients repeat instructions to them in their own words verbally, was very effective for stroke patients with cognitive impairments. Informational personalization of the patient's level of functioning is one of the strongest points of nurse-initiated interventions. By using everyday language, visual aids, and interactive teaching modalities, nurses ensure maximum knowledge retention in patients with cognitive impairments. Second, follow-up frequently helps strengthen learning and enforces accountability. Combined, these steps turn information into action plans that patients can uphold outside the clinical setting.
Technology-enabled nurse interventions were also seen as promising. Zhang et al. (2024) compared several randomized controlled trials of eHealth programs delivered by nurses and registered a 50% reduction in missed doses using digital reminders and virtual follow-up. These programs increased adherence and functional recovery by engaging the patients in the rehabilitation program. Kumar et al. (2024) also demonstrated that structured nurse involvement in stroke care teams led to decreased treatment intervals and higher medication adherence rates, notably risky medication like anticoagulants. Their meta-analysis reported that nurse-led protocols reduced door-to-needle times by nearly 20 minutes and enhanced functional outcomes at three months in the same breath. Online platforms enable nurses to monitor compliance in real-time and initiate timely interventions as required. These systems also engage patients with reminders and progress feedback, enhancing a more incredible feeling of control. Of equal importance is the reality that virtual programs led by nurses remove the burden of transport and scheduling inconvenience, particularly for stroke survivors who have limited mobility. This accessibility ensures that more patients receive organized, ongoing care.
The interventions work because nurses' unique role is to provide uninterrupted, patient-centered care. By combining education with evidence-based support interventions such as simplified dosing regimens, reminding, and motivational interviewing, the practical and psychological barriers to adherence can be overcome by nurses (Berardinelli et al., 2024). This integrated approach is particularly vital for stroke patients who have complex medication schedules to add to their cognitive and physical impairment. The literature consistently supports nurse-implemented interventions to reduce preventable complications and improve long-term outcomes in this high-risk population.
**Conclusion**
Medication nonadherence among stroke patients is a highly complex issue of life-and-death consequences. Nurses with evidence-based practice measures like customized education are the best professionals to address this issue. In the literature review, the efficacy of nurse-implemented interventions for improving adherence, reducing the number of stroke recurrences, and enhancing the quality of life in patients is promoted. With the application of these interventions, nurses can implement research into practice and assist patients in receiving the support they need to manage their medications effectively.
References
Arkan, G., Ordin, Y. S., Ozturk, V., & Ala, R. T. (2022). Investigation of medication adherence and factors affecting it in patients with stroke.
_Journal of Neuroscience Nursing_,
_54_(1), 35-41.
[https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx](https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx)
Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024, November). Nurse-Led Interventions for Improving Medication Adherence in Chronic Diseases: A Systematic Review. In
_Healthcare_ (Vol. 12, No. 23, p. 2337). MDPI.
[https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/](https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/)
Kumar, A., Kumar, M., Verma, P., Pal, R., Nagi, M., Mahesh, K. V., … & Khurana, D. (2024). Effects of stroke nurse-led acute stroke management on treatment time benchmarks, intravenous thrombolysis rates, and patient outcomes: A systematic review and meta-analysis.
_Journal of Stroke and Cerebrovascular Diseases_, 108216.
[https://www.sciencedirect.com/science/article/pii/S1052305724006591](https://www.sciencedirect.com/science/article/pii/S1052305724006591)
Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led health program 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/full](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/full)
**## Unit6-KTAPart2Template.docx**
**Knowledge-to-Action: Intervention SWOT Analysis**
Student Name
Herzing University
NU 700: Knowledge for Nursing Practice
Nancy Delmont DNP, RN, CNE
Month Date, Year
1
8
**Knowledge-to-Action: Intervention SWOT Analysis**
It is always good to start a paper with a grabbing statistic (with citation) 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 for implementation of an improvement project. 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 the clinical practice problem of hospital acquired infections and provide a strengths, weaknesses, opportunities, and threats (SWOT) analysis of evidence-based intervention to address a clinical practice problem in YOUR practice setting
*TIP: (be more
**specific** using the problem, practice setting, and intervention you have identified 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.
**Implementation**
Provide a few sentences to explain the intervention you selected from the Unit 5 paper and why it was the best for YOUR practice (don’t forget to state the practice setting) as a lead into the Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis. Refer the reader to Table 1.
**Table 1**
_SWOT Analysis Chart_
| | |
| — | — |
| Strengths<br>· Use bullet points to list 3 <br>**Strengths** of YOUR <br>**practice** that would <br>**support** change were you to implement the selected intervention | Weaknesses<br>· Use bullet points to list 3 <br>**Weaknesses** of YOUR <br>**practice** that would <br>**resist** change were you to implement the selected intervention |
| Opportunities<br>· Use bullet points to list 3 <br>**Opportunities** that a change might <br>**result in** were you to implement the selected intervention | Threats<br>· Use bullet points to list 3 <br>**Threats** that represent an <br>**actual or potential**<br>**barrier** were you to implement the selected intervention. |
*TIP-Strengths and Weaknesses are internal to the practice; Opportunities and Threats are external in relation to the practice. Provide citations & references as applicable to your organization and/or other sources in the narrative content, particularly opportunities and threats.
Strengths
Provide a narrative discussion of the
**strengths of YOUR practice** (internal) that would support change were you to implement the selected intervention
**.**(Ex: healthcare team)
**Weaknesses**
Provide a narrative discussion of the
**weaknesses of YOUR practice** (internal) that would resist change were you to implement the selected intervention. (Ex: existing technology (EPIC)
**Opportunities**
A narrative discussion of
**opportunities that a change might result in** (external) were you to implement the selected intervention
**.**(Ex: competitive advantage).
**Threats**
A narrative discussion of
**Threats** that represent an
**actual or potential**
**barrier (external)** were you to implement the selected intervention. (Ex: New Legislation).
**TIP: The narrative should elaborate on each bullet listed. The narrative is not about the intervention itself, rather, it is the analysis of the feasibility to
**implement** the intervention & sustain it.
**Conclusion**
Bring the reader back to the main topic of this paper which is the practice problem and the professional nurses’ role for implementation of an improvement project. 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)?
**TIP: Notice the Conclusion is a Level 1 Header, centered, and bolded. A conclusion section should be included in all scholarly papers as a place to summarize the paper. It is normally one paragraph in length, succinct, and restates the main points of your paper. If you need to add cited information, move that information to a previous section of your paper.
***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.
**While there is no minimum number of references, scholarly writing for this course is best when supported by no less than 3 current journal articles.
**Module51.docx**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/module51-docx-10256275)
**Module51.docx**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/module51-docx-10256275)
**## TheCriticalRoleofNursesinImprovingMedicationAdherence111.docx**
2
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
Beverly Jordan
Herzing University
NU700 Knowledge for Nursing Practice
Module 4 Resubmission
Dr. Jessica Clark
04/08/2025
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
**Introduction**
Medication nonadherence in stroke survivors is a significant public health issue, and studies suggest that 30-50% of patients do not follow prescribed regimens, resulting in avoidable complications (Arkan et al., 2022). This is a critical concern since the secondary risk for stroke significantly increases when drugs like antihypertensives and anticoagulants are not appropriately taken. Nurses, the first point of contact in health care, have a unique chance to act on this threat through systematic action. Ongoing patient interaction provides real-time evaluation of challenges such as cognitive impairment, budget constraints, and literacy levels (Berardinelli et al., 2024). Targeted education with follow-up enables nurses to act at the right moment to reduce the risk of nonadherence. Medication nonadherence undermines not only individual patient outcomes but also overburdens the health systems with recurrent hospitalization and prolonged recovery. Nurses have excellent chances to detect signs of nonadherence early in their routine care interactions. By detecting it early, they can decrease readmission and healthcare costs. Their ability to visualize the cycle of patient needs enables them to develop tailored approaches that bridge knowledge gaps and improve long-term adherence.
**Practice Problem Overview**
Medication nonadherence among stroke patients is a complex problem driven by medical, psychological, and socioeconomic determinants. Arkan et al. (2022) established that merely 33.9% of stroke patients showed high adherence, and fear of side effects and lack of confidence in medication overuse were the main discourages. Post-stroke cognitive impairments further complicate compliance by disrupting memories regarding dosing or treatment needs. In addition, cumbersome multidrug regimens on a frequent schedule—a frequent regimen in stroke—induce more confusion and omissions (Kumar et al., 2024). A crossover between supervised medication is a sensitive, vulnerable point during in-hospital treatments. In the absence of proper support, there is a high risk of recurrence, disability, and death, which further provides a rationale for consistent nursing interventions. Most patients are sent home without sufficient support systems, and this heightens the likelihood of missing medication or abandoning it altogether. Most stroke survivors battle depression or anxiety, which also influences motivation to adhere to multifaceted regimens. Without structured guidance, even patients with good intentions will default on treatment. This fact highlights the importance of nurses acting as continued contact points for medication management after discharge.
**Literature Review: Potential Intervention**
Evidence indicates that interventions by nurses are highly effective at encouraging medication compliance among stroke survivors. Interventions typically integrate patient education, regimen simplification, and technological support to overcome multifactorial barriers to adherence. Berardinelli et al. (2024) conducted a systematic review of patients with chronic diseases, noting that patient education by a nurse in the face-to-face format significantly improved adherence, with particularly robust increases in patients with stroke and cardiovascular diseases. They recognized that nurses' ability to deliver personalized education on medication aims, potential side effects, and dosing time helped to moderate patients' misconceptions and concerns, which are crucial risk factors for nonadherence (Arkan et al., 2022). The teach-back method, under which patients repeat instructions to them in their own words verbally, was very effective for stroke patients with cognitive impairments. Informational personalization of the patient's level of functioning is one of the strongest points of nurse-initiated interventions. By using everyday language, visual aids, and interactive teaching modalities, nurses ensure maximum knowledge retention in patients with cognitive impairments. Second, follow-up frequently helps strengthen learning and enforces accountability. Combined, these steps turn information into action plans that patients can uphold outside the clinical setting.
Technology-enabled nurse interventions were also seen as promising. Zhang et al. (2024) compared several randomized controlled trials of eHealth programs delivered by nurses and registered a 50% reduction in missed doses using digital reminders and virtual follow-up. These programs increased adherence and functional recovery by engaging the patients in the rehabilitation program. Kumar et al. (2024) also demonstrated that structured nurse involvement in stroke care teams led to decreased treatment intervals and higher medication adherence rates, notably risky medication like anticoagulants. Their meta-analysis reported that nurse-led protocols reduced door-to-needle times by nearly 20 minutes and enhanced functional outcomes at three months in the same breath. Online platforms enable nurses to monitor compliance in real-time and initiate timely interventions as required. These systems also engage patients with reminders and progress feedback, enhancing a more incredible feeling of control. Of equal importance is the reality that virtual programs led by nurses remove the burden of transport and scheduling inconvenience, particularly for stroke survivors who have limited mobility. This accessibility ensures that more patients receive organized, ongoing care.
The interventions work because nurses' unique role is to provide uninterrupted, patient-centered care. By combining education with evidence-based support interventions such as simplified dosing regimens, reminding, and motivational interviewing, the practical and psychological barriers to adherence can be overcome by nurses (Berardinelli et al., 2024). This integrated approach is particularly vital for stroke patients who have complex medication schedules to add to their cognitive and physical impairment. The literature consistently supports nurse-implemented interventions to reduce preventable complications and improve long-term outcomes in this high-risk population.
**Conclusion**
Medication nonadherence among stroke patients is a highly complex issue of life-and-death consequences. Nurses with evidence-based practice measures like customized education are the best professionals to address this issue. In the literature review, the efficacy of nurse-implemented interventions for improving adherence, reducing the number of stroke recurrences, and enhancing the quality of life in patients is promoted. With the application of these interventions, nurses can implement research into practice and assist patients in receiving the support they need to manage their medications effectively.
References
Arkan, G., Ordin, Y. S., Ozturk, V., & Ala, R. T. (2022). Investigation of medication adherence and factors affecting it in patients with stroke.
_Journal of Neuroscience Nursing_,
_54_(1), 35-41.
[https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx](https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx)
Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024, November). Nurse-Led Interventions for Improving Medication Adherence in Chronic Diseases: A Systematic Review. In
_Healthcare_ (Vol. 12, No. 23, p. 2337). MDPI.
[https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/](https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/)
Kumar, A., Kumar, M., Verma, P., Pal, R., Nagi, M., Mahesh, K. V., … & Khurana, D. (2024). Effects of stroke nurse-led acute stroke management on treatment time benchmarks, intravenous thrombolysis rates, and patient outcomes: A systematic review and meta-analysis.
_Journal of Stroke and Cerebrovascular Diseases_, 108216.
[https://www.sciencedirect.com/science/article/pii/S1052305724006591](https://www.sciencedirect.com/science/article/pii/S1052305724006591)
Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led health program 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/full](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/full)
**## Unit6-KTAPart2Template.docx**
**Knowledge-to-Action: Intervention SWOT Analysis**
Student Name
Herzing University
NU 700: Knowledge for Nursing Practice
Nancy Delmont DNP, RN, CNE
Month Date, Year
1
8
**Knowledge-to-Action: Intervention SWOT Analysis**
It is always good to start a paper with a grabbing statistic (with citation) 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 for implementation of an improvement project. 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 the clinical practice problem of hospital acquired infections and provide a strengths, weaknesses, opportunities, and threats (SWOT) analysis of evidence-based intervention to address a clinical practice problem in YOUR practice setting
*TIP: (be more
**specific** using the problem, practice setting, and intervention you have identified 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.
**Implementation**
Provide a few sentences to explain the intervention you selected from the Unit 5 paper and why it was the best for YOUR practice (don’t forget to state the practice setting) as a lead into the Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis. Refer the reader to Table 1.
**Table 1**
_SWOT Analysis Chart_
| | |
| — | — |
| Strengths<br>· Use bullet points to list 3 <br>**Strengths** of YOUR <br>**practice** that would <br>**support** change were you to implement the selected intervention | Weaknesses<br>· Use bullet points to list 3 <br>**Weaknesses** of YOUR <br>**practice** that would <br>**resist** change were you to implement the selected intervention |
| Opportunities<br>· Use bullet points to list 3 <br>**Opportunities** that a change might <br>**result in** were you to implement the selected intervention | Threats<br>· Use bullet points to list 3 <br>**Threats** that represent an <br>**actual or potential**<br>**barrier** were you to implement the selected intervention. |
*TIP-Strengths and Weaknesses are internal to the practice; Opportunities and Threats are external in relation to the practice. Provide citations & references as applicable to your organization and/or other sources in the narrative content, particularly opportunities and threats.
Strengths
Provide a narrative discussion of the
**strengths of YOUR practice** (internal) that would support change were you to implement the selected intervention
**.**(Ex: healthcare team)
**Weaknesses**
Provide a narrative discussion of the
**weaknesses of YOUR practice** (internal) that would resist change were you to implement the selected intervention. (Ex: existing technology (EPIC)
**Opportunities**
A narrative discussion of
**opportunities that a change might result in** (external) were you to implement the selected intervention
**.**(Ex: competitive advantage).
**Threats**
A narrative discussion of
**Threats** that represent an
**actual or potential**
**barrier (external)** were you to implement the selected intervention. (Ex: New Legislation).
**TIP: The narrative should elaborate on each bullet listed. The narrative is not about the intervention itself, rather, it is the analysis of the feasibility to
**implement** the intervention & sustain it.
**Conclusion**
Bring the reader back to the main topic of this paper which is the practice problem and the professional nurses’ role for implementation of an improvement project. 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)?
**TIP: Notice the Conclusion is a Level 1 Header, centered, and bolded. A conclusion section should be included in all scholarly papers as a place to summarize the paper. It is normally one paragraph in length, succinct, and restates the main points of your paper. If you need to add cited information, move that information to a previous section of your paper.
***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.
**While there is no minimum number of references, scholarly writing for this course is best when supported by no less than 3 current journal articles.
**Module51.docx**
This file is too large to display. [View in new window](https://www.sweetstudy.com/files/module51-docx-10256275)
**## TheCriticalRoleofNursesinImprovingMedicationAdherence111.docx**
2
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
Beverly Jordan
Herzing University
NU700 Knowledge for Nursing Practice
Module 4 Resubmission
Dr. Jessica Clark
04/08/2025
**The Critical Role of Nurses in Improving Medication Adherence for Stroke Patients**
**Introduction**
Medication nonadherence in stroke survivors is a significant public health issue, and studies suggest that 30-50% of patients do not follow prescribed regimens, resulting in avoidable complications (Arkan et al., 2022). This is a critical concern since the secondary risk for stroke significantly increases when drugs like antihypertensives and anticoagulants are not appropriately taken. Nurses, the first point of contact in health care, have a unique chance to act on this threat through systematic action. Ongoing patient interaction provides real-time evaluation of challenges such as cognitive impairment, budget constraints, and literacy levels (Berardinelli et al., 2024). Targeted education with follow-up enables nurses to act at the right moment to reduce the risk of nonadherence. Medication nonadherence undermines not only individual patient outcomes but also overburdens the health systems with recurrent hospitalization and prolonged recovery. Nurses have excellent chances to detect signs of nonadherence early in their routine care interactions. By detecting it early, they can decrease readmission and healthcare costs. Their ability to visualize the cycle of patient needs enables them to develop tailored approaches that bridge knowledge gaps and improve long-term adherence.
**Practice Problem Overview**
Medication nonadherence among stroke patients is a complex problem driven by medical, psychological, and socioeconomic determinants. Arkan et al. (2022) established that merely 33.9% of stroke patients showed high adherence, and fear of side effects and lack of confidence in medication overuse were the main discourages. Post-stroke cognitive impairments further complicate compliance by disrupting memories regarding dosing or treatment needs. In addition, cumbersome multidrug regimens on a frequent schedule—a frequent regimen in stroke—induce more confusion and omissions (Kumar et al., 2024). A crossover between supervised medication is a sensitive, vulnerable point during in-hospital treatments. In the absence of proper support, there is a high risk of recurrence, disability, and death, which further provides a rationale for consistent nursing interventions. Most patients are sent home without sufficient support systems, and this heightens the likelihood of missing medication or abandoning it altogether. Most stroke survivors battle depression or anxiety, which also influences motivation to adhere to multifaceted regimens. Without structured guidance, even patients with good intentions will default on treatment. This fact highlights the importance of nurses acting as continued contact points for medication management after discharge.
**Literature Review: Potential Intervention**
Evidence indicates that interventions by nurses are highly effective at encouraging medication compliance among stroke survivors. Interventions typically integrate patient education, regimen simplification, and technological support to overcome multifactorial barriers to adherence. Berardinelli et al. (2024) conducted a systematic review of patients with chronic diseases, noting that patient education by a nurse in the face-to-face format significantly improved adherence, with particularly robust increases in patients with stroke and cardiovascular diseases. They recognized that nurses' ability to deliver personalized education on medication aims, potential side effects, and dosing time helped to moderate patients' misconceptions and concerns, which are crucial risk factors for nonadherence (Arkan et al., 2022). The teach-back method, under which patients repeat instructions to them in their own words verbally, was very effective for stroke patients with cognitive impairments. Informational personalization of the patient's level of functioning is one of the strongest points of nurse-initiated interventions. By using everyday language, visual aids, and interactive teaching modalities, nurses ensure maximum knowledge retention in patients with cognitive impairments. Second, follow-up frequently helps strengthen learning and enforces accountability. Combined, these steps turn information into action plans that patients can uphold outside the clinical setting.
Technology-enabled nurse interventions were also seen as promising. Zhang et al. (2024) compared several randomized controlled trials of eHealth programs delivered by nurses and registered a 50% reduction in missed doses using digital reminders and virtual follow-up. These programs increased adherence and functional recovery by engaging the patients in the rehabilitation program. Kumar et al. (2024) also demonstrated that structured nurse involvement in stroke care teams led to decreased treatment intervals and higher medication adherence rates, notably risky medication like anticoagulants. Their meta-analysis reported that nurse-led protocols reduced door-to-needle times by nearly 20 minutes and enhanced functional outcomes at three months in the same breath. Online platforms enable nurses to monitor compliance in real-time and initiate timely interventions as required. These systems also engage patients with reminders and progress feedback, enhancing a more incredible feeling of control. Of equal importance is the reality that virtual programs led by nurses remove the burden of transport and scheduling inconvenience, particularly for stroke survivors who have limited mobility. This accessibility ensures that more patients receive organized, ongoing care.
The interventions work because nurses' unique role is to provide uninterrupted, patient-centered care. By combining education with evidence-based support interventions such as simplified dosing regimens, reminding, and motivational interviewing, the practical and psychological barriers to adherence can be overcome by nurses (Berardinelli et al., 2024). This integrated approach is particularly vital for stroke patients who have complex medication schedules to add to their cognitive and physical impairment. The literature consistently supports nurse-implemented interventions to reduce preventable complications and improve long-term outcomes in this high-risk population.
**Conclusion**
Medication nonadherence among stroke patients is a highly complex issue of life-and-death consequences. Nurses with evidence-based practice measures like customized education are the best professionals to address this issue. In the literature review, the efficacy of nurse-implemented interventions for improving adherence, reducing the number of stroke recurrences, and enhancing the quality of life in patients is promoted. With the application of these interventions, nurses can implement research into practice and assist patients in receiving the support they need to manage their medications effectively.
References
Arkan, G., Ordin, Y. S., Ozturk, V., & Ala, R. T. (2022). Investigation of medication adherence and factors affecting it in patients with stroke.
_Journal of Neuroscience Nursing_,
_54_(1), 35-41.
[https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx](https://journals.lww.com/jnnonline/fulltext/2022/02000/investigation_of_medication_adherence_and_factors.8.aspx)
Berardinelli, D., Conti, A., Hasnaoui, A., Casabona, E., Martin, B., Campagna, S., & Dimonte, V. (2024, November). Nurse-Led Interventions for Improving Medication Adherence in Chronic Diseases: A Systematic Review. In
_Healthcare_ (Vol. 12, No. 23, p. 2337). MDPI.
[https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/](https://pmc.ncbi.nlm.nih.gov/articles/PMC11641167/)
Kumar, A., Kumar, M., Verma, P., Pal, R., Nagi, M., Mahesh, K. V., … & Khurana, D. (2024). Effects of stroke nurse-led acute stroke management on treatment time benchmarks, intravenous thrombolysis rates, and patient outcomes: A systematic review and meta-analysis.
_Journal of Stroke and Cerebrovascular Diseases_, 108216.
[https://www.sciencedirect.com/science/article/pii/S1052305724006591](https://www.sciencedirect.com/science/article/pii/S1052305724006591)
Zhang, W., Mei, Z., Feng, Z., & Li, B. (2024). Effects of a nurse-led health program 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/full](https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1395270/full)
**## Unit6-KTAPart2Template.docx**
**Knowledge-to-Action: Intervention SWOT Analysis**
Student Name
Herzing University
NU 700: Knowledge for Nursing Practice
Nancy Delmont DNP, RN, CNE
Month Date, Year
1
8
**Knowledge-to-Action: Intervention SWOT Analysis**
It is always good to start a paper with a grabbing statistic (with citation) 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 for implementation of an improvement project. 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 the clinical practice problem of hospital acquired infections and provide a strengths, weaknesses, opportunities, and threats (SWOT) analysis of evidence-based intervention to address a clinical practice problem in YOUR practice setting
*TIP: (be more
**specific** using the problem, practice setting, and intervention you have identified 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.
**Implementation**
Provide a few sentences to explain the intervention you selected from the Unit 5 paper and why it was the best for YOUR practice (don’t forget to state the practice setting) as a lead into the Strengths, Weaknesses, Opportunities, and Threats (SWOT) Analysis. Refer the reader to Table 1.
**Table 1**
_SWOT Analysis Chart_
| | |
| — | — |
| Strengths<br>· Use bullet points to list 3 <br>**Strengths** of YOUR <br>**practice** that would <br>**support** change were you to implement the selected intervention | Weaknesses<br>· Use bullet points to list 3 <br>**Weaknesses** of YOUR <br>**practice** that would <br>**resist** change were you to implement the selected intervention |
| Opportunities<br>· Use bullet points to list 3 <br>**Opportunities** that a change might <br>**result in** were you to implement the selected intervention | Threats<br>· Use bullet points to list 3 <br>**Threats** that represent an <br>**actual or potential**<br>**barrier** were you to implement the selected intervention. |
*TIP-Strengths and Weaknesses are internal to the practice; Opportunities and Threats are external in relation to the practice. Provide citations & references as applicable to your organization and/or other sources in the narrative content, particularly opportunities and threats.
Strengths
Provide a narrative discussion of the
**strengths of YOUR practice** (internal) that would support change were you to implement the selected intervention
**.**(Ex: healthcare team)
**Weaknesses**
Provide a narrative discussion of the
**weaknesses of YOUR practice** (internal) that would resist change were you to implement the selected intervention. (Ex: existing technology (EPIC)
**Opportunities**
A narrative discussion of
**opportunities that a change might result in** (external) were you to implement the selected intervention
**.**(Ex: competitive advantage).
**Threats**
A narrative discussion of
**Threats** that represent an
**actual or potential**
**barrier (external)** were you to implement the selected intervention. (Ex: New Legislation).
**TIP: The narrative should elaborate on each bullet listed. The narrative is not about the intervention itself, rather, it is the analysis of the feasibility to
**implement** the intervention & sustain it.
**Conclusion**
Bring the reader back to the main topic of this paper which is the practice problem and the professional nurses’ role for implementation of an improvement project. 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)?
**TIP: Notice the Conclusion is a Level 1 Header, centered, and bolded. A conclusion section should be included in all scholarly papers as a place to summarize the paper. It is normally one paragraph in length, succinct, and restates the main points of your paper. If you need to add cited information, move that information to a previous section of your paper.
***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.
**While there is no minimum number of references, scholarly writing for this course is best when supported by no less than 3 current journal articles.
**Module51.docx**
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