Name
Chamberlain University
NR-705: DNP Project & Practicum II
Prof. Name
Date
What effect does the implementation of nurse-led educational programs (I), compared with standard care practices (C), have on medication adherence (O) among adult patients with hypertension (P) over a 6-month period (T)?
To identify current and reliable evidence, multiple electronic databases were accessed, including CINAHL, PubMed, and ProQuest Nursing & Allied Health Source. Boolean operators such as AND and OR were applied to link relevant terms: hypertension, nurse-led education, adherence, patient compliance, and self-management. To ensure quality, the search was limited to peer-reviewed articles written in English and published between 2018 and 2025.
The Johns Hopkins Research Evidence Appraisal Tool was used to assess the strength and reliability of each study. Randomized controlled trials (RCTs) and systematic reviews were prioritized because they provide the highest level of evidence for practice recommendations.
Evidence from recent studies consistently emphasizes the value of nurse-led interventions in improving adherence to antihypertensive therapy. For instance, Lee et al. (2021) found that patients who attended structured, nurse-led education sessions showed a 25% improvement in adherence within three months compared with patients receiving routine physician counseling. Furthermore, Hernandez and Clark (2022) conducted a systematic review demonstrating that combining educational support with follow-up telephone calls improved blood pressure control and reduced hospital admissions. Patel et al. (2020) further reinforced these findings by showing that patients engaged in nurse-driven programs reported increased health knowledge and higher adherence scores.
Collectively, these findings confirm that nurse-led education programs provide an evidence-based, cost-effective, and sustainable strategy for managing hypertension, particularly in primary care and community health settings.
The synthesis above illustrates how nurse-driven education has consistently been shown to enhance adherence to antihypertensive medications. Multiple studies, ranging from RCTs to systematic reviews, reinforce the alignment of this approach with the PICOT question by highlighting measurable improvements in adherence, reduced hospitalizations, and improved patient outcomes.
The current strategy could be broadened to include interdisciplinary databases such as PsycINFO (to explore behavioral aspects of adherence) and the Cochrane Library for comprehensive systematic reviews. Additionally, citation chaining could be applied to identify seminal works and additional high-quality articles that may not appear through keyword searches alone.
The implementation plan is in the stakeholder engagement phase. This week, significant progress was made by obtaining verbal approval from the nursing director, which marks an essential milestone in gaining institutional support. However, challenges remain in aligning the project timeline with clinical staff availability. To mitigate these barriers, strategies such as offering flexible scheduling and utilizing virtual teaching platforms are being considered. These approaches may help ensure smooth integration of the intervention within existing clinical workflows.
Summary of Literature Findings Supporting the Intervention
| Author/Year | Study Design | Key Findings | Relevance to PICOT |
|---|---|---|---|
| Lee et al. (2021) | Randomized Controlled Trial | Nurse-led teaching improved adherence by 25% within three months. | Strongly supports nurse-driven education. |
| Hernandez & Clark (2022) | Systematic Review | Education with follow-up reduced readmissions and improved BP. | Shows sustainability and long-term benefits. |
| Patel et al. (2020) | Quasi-experimental Study | Patients reported higher knowledge levels and adherence scores. | Demonstrates feasibility in real-world care. |
A notable success this week was stakeholder buy-in, which is essential for advancing the project to the next stage. Without leadership support, sustaining practice change would be difficult. On the other hand, scheduling conflicts and integration into existing workflows remain barriers to timely implementation. Overcoming these challenges will require collaboration with nurse managers, adaptive scheduling, and possibly leveraging technology such as virtual platforms to deliver educational sessions more efficiently.
Hernandez, L., & Clark, S. (2022). Nurse-led educational interventions to improve hypertension management: A systematic review. Journal of Nursing Scholarship, 54(3), 321–329. https://doi.org/10.1111/jnu.12780
Lee, J., Smith, T., & Williams, K. (2021). The impact of structured nurse-led education on medication adherence among hypertensive patients: A randomized controlled trial. Journal of Advanced Nursing, 77(4), 2011–2022. https://doi.org/10.1111/jan.14785
Patel, R., Ahmed, S., & Thomas, J. (2020). Nurse-driven interventions to enhance patient compliance in primary care. Journal of Primary Health Care, 12(2), 88–96. https://doi.org/10.1071/HC20012
