TOPIC: – Improving Medication Adherence among Type II Home Healthcare Diabetic Patients
1. I need this research project done as if conducting training with 5 five nurses in Home Health Setting on Improving Medication Adherence among Type II Home Healthcare Diabetic Patients.
2. I need responses from the nurses.
3. Sample questions are included, using Medication Adherence Project (MAP) Tools/Resources. These are just SAMPLES. Please come up with real Questions and Responses.
4. The Medication Adherence Project (MAP) Tools/Resources can be downloaded from http://www.nyc.gov/heartworks.
Please see the attached 10 Strategic Points for guidance
1. Problem Statement:
It is not known if or to what degree the implementation of the New York City Department of Health and Mental Hygiene Medication Adherence Project (MAP) resources, which include (1) the questions to ask poster, (2) adherence assessment pad, and (3) my medications list, impact patient medication adherence rates when compared to current practice among Type II diabetic home healthcare patients, ages 35 to 64 of a home healthcare organization located in urban Texas.
2. Clinical/PICOT Questions:
To what degree does the implementation of Medication Adherence Project resources, which include the Questions to Ask Pad, the Questions to Ask Poster, an Adherence Assessment Pad, and the My Medications List impact medication adherence among Type II diabetic home healthcare patients, ages 35 to 64, of a home healthcare organization located in urban Texas over a period of four weeks? The following clinical question will guide this quantitative project:
Q1: Does using the MAP resources improve medication adherence among home health diabetic patients?
3. Sample (and Location):
a. Location: The location of this project is in urban Texas. The project site provides a larger percentage of patients with healthcare services who reside in the urban area as compared to the rural area.
b. At the selected project site, approximately 30 patients have been diagnosed with type II diabetes, though this census changes each month. Patients between the ages of 35 to 64, with no cognitive limitation, who speak English, will be invited to participate in this project.
c. Inclusion Criteria
i. 35 to 64 years of age
ii. Type II diabetes diagnosis
iii. English speakers
iv. Cognitively abled
d. Exclusion Criteria
▪ Younger than 35 and older than 64 years of age
▪ Not diagnosed with type II diabetes
▪ Non-English speakers
Cognitively disabled/delayed
4. Define Variables and Level of Measurement:
Intervention: Use of the MAP resources, by nursing staff members, which will be implemented upon the completion of an educational training session. Starr and Sacks’s (2010) MAP Toolkit and Training Guide resources, include: (1) the Questions to Ask Poster, (2) an Adherence Assessment Pad, and (3) the My Medications List.
Outcome: Enhanced medication adherence.
Variables: Medication adherence, which is the dependent variable explored in this project, will be measured using data attained through the project site’s EHR. The MAP resources, which serve as the independent variables explored in this project, include (1) the Questions to Ask Poster, (2) an Adherence Assessment Pad, and (3) the My Medications List.
5. Methodology and Design:
A quantitative methodology, which employs a quasi-experimental design, will be used to examine medication adherence rates pre-project implementation and post-project implementation. Statistical analyses will be used to compare pre-and post-project data. Demographic data will be collected because the prevalence of non-adherence is often high among certain groups (e.g., impacted by socioeconomic status, gender, age, etc.).
6. Purpose Statement:
The purpose of this quantitative quasi-experimental project is to determine if or to what degree the implementation of the New York City Department of Health and Mental Hygiene Medication Adherence Project (MAP) resources, which include (1) the questions to ask poster, (2) adherence assessment pad, and (3) my medications list, impact patient medication adherence rates when compared to current practice among Type II diabetic home healthcare patients, ages 35 to 64 of a home healthcare organization located in urban Texas.
Demographic Survey of the Patients
What is your age?
· 25-34 years old
· 35-44 years old
· 45-54 years old
· 55-64 years old
· Over 65 years old
How would you describe yourself?
· American Indian or Alaska Native
· Asian
· Black or African American
· Native Hawaiian or Other Pacific Islander
· White
What is your gender?
· Male
· Female
What is your highest level of education?
· High school or GED
· Some college
· Associate degree
· Bachelor’s degree
· Master’s degree
· Doctorate or PhD
· Professional degree (MD, JD. Etc.)
Years diagnosed with Type II diabetes. (Oral medication or insulin)
· Less than one year
· One to three years
· Four to six years
· Seven years and above
SAMPLE QUESTIONS
-To the Nurses Participating in the Research
What are the common patient barriers faced by nurses in Medication Adherence?
Provider Barriers
i. ———————–
ii. ———————–
iii. ———————–
iv. ———————-
v. ———————-
Pharmacist Barriers
i. ———————–
ii. ———————–
iii. ———————–
iv. ———————-
v. ———————-
Patient Barriers
vi. ———————–
vii. ———————–
viii. ———————–
ix. ———————-
x. ———————-
Patients Perspectives
i. ———————–
ii. ———————–
iii. ———————–
iv. ———————-
v. ———————-
What are your suggested solutions to Improve Medication Adherence?
i. ———————–
ii. ———————–
iii. ———————–
iv. ———————-
v. ———————-
Describe Experience & Patient Response
Questions
· How many patients did you use this tool with?
· How did you integrate the tool into the visit?
· Describe the experience
· Characterize the patient response in general * provide specific example
Adherence Assessment
· How many patients did you use this tool with?
· How did you integrate the tool into the visit?
· Describe the experience
· Characterize the patient response in general * provide specific example
Medication List
· How many patients did you use this tool with?
· How did you integrate the tool into the visit?
· Describe the experience
· Characterize the patient response in general * provide specific example
Pocket Guide
· How many patients did you use this tool with?
· How did you integrate the tool into the visit?
· Describe the experience
· Characterize the patient response in general * provide specific example
Which tool was the easiest to use? Why?
Which tools were more challenging to work into the visit? Why? What are some ways that you could get around these obstacles?
Think about patients’ overall responses to the tools. How would you characterize the response?
Describe the difference in your experience this week, as compared to last week.
Which staff members did you involve in testing out the tools? Characterize the experience overall.
Which staff members would you like to involve in testing the tools? How do you envision their roles?
What are your next steps to making the tools a regular part of practice?
How will MAP lighten your workload?
How will extra work increase the job satisfaction of other team members?
How will the MAP tools help to improve patient outcome?
How do you not “step on any toes”?
How will MAP improve the quality of care?
How can MAP be integrated into other Quality Improvement Initiatives that are already underway?
Do you have any concrete example of how the tools have improved patient care?
Why should we dedicate training time to make MAP practice-wide?
How much will MAP cost?
Reference
http://www.nyc.gov/heartworks.
