Research Utilization Paper An Intervention Study to Enhance Medication Compliance in Community-Dwelling Elderly Individuals Chris Elmer HSCI 401 Fall 2001 My research study was to determine whether daily videotelephone or regular telephone reminders would increase the quantity of prescribed cardiac medication taken in a sample of elderly individuals who have congestive heart failure (CHF) (Peteva, 2001).
Within this research I would disseminate the new scientific knowledge with the help of the pharmaceutical company that makes the congestive heart failure medication. With the help and support of the pharmaceutical maker, I would provide a full in-service to the nursing staff of hospitals and doctor’s offices alike. In doing this, this would provide a friendly and educational atmosphere in a nursing practice setting to get complete understanding of the research findings and how they as nurses can make a difference in the consumption of prescribed medication. Secondly, I would write a journal article and have it published in the pharmaceutical’s bulletin to include a well-known nursing journal. These journal articles would contain the findings of the research and suggestions on how the nursing staff can help the patients improve the compliance of taking prescribed medication. Once the information is disseminated into the medical public, the nurses will apply the learned knowledge to their practice for the elderly patients who are taking congestive heart failure medication.
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Congestive Heart Failure is not a disease, but a condition in which the heart is unable to pump enough blood needed to meet the cardiac demands of the body and facilitate systemic circulation. Congestive Heart Failure can be right or left-sided, and is mainly a fluid issue, in which there is a decreased amount of blood to the kidneys. In children, CHF can be long term and is most common in ...
First, the nurse will collect all the patients that are currently taking congestive heart failure medication and explain to them on a one-on-one basis the benefits of having reminders to comply with taking prescribed medications. Then nurse would also explain the pros and cons of the reminders and that the videotelephone reminders would be provided at no cost to the patient. If the patient agrees to utilize the videotelephone reminder, the patient would sign a patient confidentiality agreement and liability agreement for legal reasons. What the agreements would stand for is a “need to know basis,” meaning that the patients information is strictly confidential and those who are on a need to know basis would have access to the patients information. The liability agreement is so that the patient could not sue the pharmaceutical company or the medical facility where they are being treated if a complaint involved only the videotelephone reminder program. Once the videotelephone reminder program is implemented the pharmaceutical company and myself would provide quarterly visits to the medical site to collect data on the progress of the program.
We would talk to the nursing staff and inquire about their feelings for the program and weather or not this program has helped in the decline of repeat hospitalizations for patients with CHF. We would also review the nursing notes from when each call was made to the patient. When each reminder call is made the nurse is to ask the patient how they like the program and if the patient would like to continue with the reminder calls. From these notes we can determine the feelings about the program from the patient without making another call or interrupting the patients daily routine. Being that the pharmaceutical company is the current sponsor and has taken a vital interest in the program, the pharmaceutical company covers resource utilization and cost for the videotelephone reminder program at 100%. This particular pharmaceutical company is ranked number two in the United States and they feel with their help and support to the medical community there may be an increase in sales of the CHF medication due to the benefit that is offered to the elderly population.
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The pharmaceutical company feels that more physicians would use their medication and promote their company to other physicians by word of mouth, therefore, creating a win-win situation for both the medical community as well as the growth of the pharmaceutical sales. This research utilization has been undertaken from an individual perspective (Nursing Research, 1998).
These nurses that work with the elderly population have read, synthesized the research and are using the information in their practice. The impact of these nurses by using the research information in their practice has a great influence on the way their patients think and act in regards to taking prescribe medication for CHF. This is an example of conceptual utilization. This also included the way that the nurses may feel in terms of the importance of their role in the health and well being of their patients.
In order to implement a change I would use the “core group” approach. (Nursing Research, 1998).
I would identify several staff members to assist with the change of the videotelephone reminders. This group would become knowledgeable about the scientific basis for enhancing medication compliance with elderly individuals through videotelephone communication. The group would assist in the dissemination of the research-based information to other staff members and in-turn would educate their patients and enhance the compliance of consuming prescribed medication for patients diagnosed with CHF, the change would be reinforced on a daily basis. The core group would be responsible for their assigned elderly patients that are currently taking medication for CHF. The core group members would provide positive feedback to their assigned staff who is implementing the change of utilizing the videotelephone reminder calls. The staff will be educated about the changes with regards to the knowledge and skills needed to make the practice changes.
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“Research on police officers and the duties associated with being a law enforcement officer has demonstrated that high levels of stress, continually subjected to dangerous working conditions, and behavioral changes occur as a result of this occupation (Ellison & Genz, 1983 pg.60).” This research data paper will include the following statements, the satisfaction or job hazards. What is the goal ...
Once the change has been implemented and staff members are aware of the program, I would give them ribbons or pins as a visible identifier for those who have learned the information. I would hope that this would stimulate the interest of other who may not be aware of the program and would promote questions that would possibly lead to the implementation of this program in their department. The changes that are made would be evaluated by first identifying the process and outcome of the elderly patients that have been diagnosed with CHF and enhancing their medication compliance by videotelephone reminders. The outcome would be an increase of medication compliance in elderly patients diagnosed with CHF. Secondly, I would determine the methods and frequency of data collection. Thirdly, I would determine the baseline and follow-up sample sizes. I would then design data collection forms, for example, when each call is made to a patient with CHF, the patient would be asked if they have taken their medication and if this program helps them to remember to take the medication. The outcome form would show whether or not the patient is in compliance with taking or not taking their medication.
These data collection forms would be user friendly, short, concise, easy to complete and have content validity. From this form, I would establish the content validity and would train data collectors with the information that is provided. Next, I would assess interrater reliability of data collectors and collect data at specified intervals. I would collect the data monthly to mark the progress of the program. After the data is collected there would be an on-sight feedback for staff regarding the progress in the implementation of the videotelephone reminder calls for the elderly patients with CHF. During the feedback, the problem solve issues would be addressed and then feedback of analyzed data staff would be provided.
Lastly, the data that is obtained from the implementation of the videotelphone reminder calls will be used to help staff in the integration of the research based practice change in promoting videotelephone reminder calls for the elderly patients diagnosed with CHF (Nursing Research, 1998).
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