NR 705 Week 2 Literature Synthesis

NR 705 Week 2 Literature Synthesis

Student Name

Chamberlain University

NR-705: DNP Project & Practicum II

Prof. Name

Date

Week 2: The DNP Project – Literature Synthesis

PICOT Question

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)?

Literature Search Strategy

To obtain current and reliable evidence, multiple electronic databases were utilized, including CINAHL, PubMed, and ProQuest Nursing & Allied Health Source. Boolean operators such as AND and OR were applied to connect relevant terms, including hypertension, nurse-led education, adherence, patient compliance, and self-management. The search was refined to include only peer-reviewed articles published in English between 2018 and 2025 to ensure recency and quality.

The Johns Hopkins Research Evidence Appraisal Tool was employed to evaluate the strength and reliability of each study. Priority was given to randomized controlled trials (RCTs) and systematic reviews, as these designs provide the highest levels of evidence for clinical practice recommendations.

Example of Literature Synthesis

Recent evidence consistently underscores the effectiveness of nurse-led interventions in enhancing adherence to antihypertensive medication. Lee et al. (2021) demonstrated that patients participating in structured, nurse-led education sessions exhibited a 25% improvement in medication adherence within three months compared to those receiving standard physician counseling. Similarly, Hernandez and Clark (2022) conducted a systematic review revealing that combining educational support with follow-up telephone calls led to improved blood pressure control and fewer hospital admissions. In alignment with these findings, Patel et al. (2020) observed that patients involved in nurse-driven educational programs displayed increased health literacy and higher adherence scores.

Collectively, these studies highlight that nurse-led educational programs represent an evidence-based, cost-effective, and sustainable strategy for managing hypertension—particularly within primary care and community-based health settings.

Weekly Discussion Questions

1. Provide an example of your literature synthesis

The synthesis above exemplifies how nurse-led education consistently enhances adherence to antihypertensive medications. A variety of studies, ranging from randomized controlled trials to systematic reviews, align with the PICOT question by illustrating measurable improvements in medication adherence, reduced hospitalizations, and improved patient outcomes.

2. How could your literature search strategy be improved?

The current literature search strategy could be strengthened by including interdisciplinary databases such as PsycINFO, which could provide insights into the behavioral and psychological aspects of medication adherence. Additionally, incorporating the Cochrane Library would enhance access to comprehensive systematic reviews. Implementing citation chaining could further identify seminal studies and other relevant high-quality articles not captured through initial keyword searches.

3. What is your update on implementation plans for your DNP Project?

The project is currently in the stakeholder engagement phase. This week, verbal approval was obtained from the nursing director, marking a critical milestone in securing institutional support. However, some challenges remain, particularly regarding alignment of project timelines with clinical staff availability. To address these barriers, flexible scheduling options and the integration of virtual teaching platforms are being explored. These adaptive strategies aim to facilitate smooth implementation while minimizing disruptions to clinical workflows.

Table 1

Summary of Literature Findings Supporting the Intervention

Reflection on Barriers and Successes

A major success achieved this week was stakeholder buy-in, a crucial component for advancing the project. Without leadership support, sustaining any long-term practice change would be challenging. Nevertheless, scheduling conflicts and workflow integration issues continue to pose barriers to timely implementation. Addressing these challenges will require close collaboration with nurse managers, adaptive scheduling methods, and the use of technology-based education platforms. Such strategies will enhance feasibility, reduce resistance, and promote the effective incorporation of the intervention into daily practice.

References

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

NR 705 Week 2 Literature Synthesis

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