NUR 550 Summary of Current Course Content Knowledge

Sample Answer for NUR 550 Summary of Current Course Content Knowledge

Which weekly objectives do you have prior knowledge of, and to what extent?

I have prior knowledge of some of the objectives of Topic 1, which is differentiating translational research from evidence-based practice (EBP). Chan et al. (2023) explain the difference between translational and evidence-based practice. The authors explain that EBP is the implementation of evidence in practice, whereas translation research entails the adoption of interventions, factors and contextual variables that influence knowledge use. However, I have minimal knowledge concerning the evaluation of sources of translational research. In nursing, the models of translation research, which include T-phases, the theoretical framework and phases of TR, can be used to evaluate the translational research sources (Jayakumar & Savarimuthu, 2019). I also have prior knowledge of the role of epidemiology in addressing population health challenges. Fairchild et al. (2018) assert that epidemiology can be utilized to gain more insights into population-level disease progression. These are some of the objectives I have prior knowledge of.

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Which weekly objectives do you have no prior knowledge of?

There are various weekly objectives I lack prior knowledge of. The first objective is the legal considerations concerning translating research into practice. I, however, have knowledge of the ethical requirements. Gupta (2022) explains that the ethical considerations include informed consent, clinical equipoise and therapeutic misconception. The second objective is to explain how translational research can be utilized for safety and quality enhancement initiatives concerning improving population health. Shah et al. (2023) explain that the iterative, slow process of this approach results in improved solutions for increased safety and quality. These are some of the objectives I lack prior knowledge of.

What course-related topics would you like to discuss with your instructor and classmates? What questions or concerns do you have about this course?

There are various course-related topics I look forward to discussing with my instructor and classmates. One of the topics is how translational research can be used to develop safe and quality interventions. For instance, I would like to understand how translational research could have made the prevention of the COVID-19 pandemic easier. Another topic is how nurses can be involved in appropriate translational research practices to enhance quality and safety.

References

Chan, R. J., Knowles, R., Hunter, S., Conroy, T., Tieu, M., & Kitson, A. (2023). From evidence-based practice to knowledge translation: What is the difference? what are the roles of nurse leaders? Seminars in Oncology Nursing, 39(1), 151363. https://doi.org/10.1016/j.soncn.2022.151363

Fairchild, G., Tasseff, B., Khalsa, H., Generous, N., Daughton, A. R., Velappan, N., Priedhorsky, R., & Deshpande, A. (2018). Epidemiological Data Challenges: Planning for a more robust future through data standards. Frontiers in Public Health, 6. https://doi.org/10.3389/fpubh.2018.00336

Gupta, N. (2022). Ethical considerations in Translational Research. Perioperative Neuroscience, 215–228. https://doi.org/10.1016/b978-0-323-91003-3.00004-0

Jayakumar, J., & Savarimuthu, R. (2019). Translational research. Indian Journal of Continuing Nursing Education, 20(1), 7. https://doi.org/10.4103/ijcn.ijcn_9_19

Shah, R. C., Hoyo, V., Moussatche, P., & Volkov, B. B. (2023). Improving quality and efficiency of translational research: Environmental scan of adaptive capacity and preparedness of Clinical and Translational Science Award Program hubs. Journal of Clinical and Translational Science, 7(1). https://doi.org/10.1017/cts.2022.423

Benchmark_Part_A_Population_Health_Research NUR 550

Benchmark- Part A: Population Health Research and PICOT Statement 

The healthcare environment in the modern world is characterized by emerging health problems that increase the need for complex interventions to address them. Health care organizations are forced to explore interventions that would not only promote the efficiency in the use of resources but also optimum health of the population. Achieving these outcomes is highly dependent on the collaborative efforts between different healthcare stakeholders such as the patients, healthcare providers, and management teams of the health organizations. For instance, patients should be willing to adhere to the given regimes for managing their conditions. Healthcare providers should be dedicated to ensure that innovative interventions are used to promote quality and safety in healthcare. Therefore, this paper explores the issue of non-adherence to medication among diabetic African-American patients and proposes a PICOT statement that can guide the adoption of interventions to address it.  

Description of Population 

African-Americans constitute a significant proportion of the population in America. According to statistics, there are approximately 40 million Africa-Americans in the US. This implies that they constitute about 13% of the population in America. Unlike other ethnicities, people from African-American origin are disproportionately affected by health problems (Iceland, 2017). The disease burden of great focus in this research paper is the poor or lack of adherence to medication among patients of this ethnicity. According to Canedo et al. (2018), African-Americans comprise of an ethnic minority group that have a high burden of diabetes and its prevalence when compared to the whites in the state. There is also the existence of significant medical disparities among this population in terms of access to and utilization of healthcare. This is despite the advances in access to care and medical technologies that aim at reducing the disease burden among them (https://clinical.diabetesjournals.org/content/30/3/130Canedo et al., 2018). The severity of the disparities can be seen in the report by the CDC where the age-adjusted prevalence of undiagnosed and diagnosed diabetes was high in African-American population when compared to non-Hispanic whites (American Diabetes Association, 2017).  

Lack of or poor adherence to diabetes medication is among the factors contributing to the high burden of the disease among African-Americans in the US (Elsous et al., 2017). According to Burnier (2018), adherence refers to the level in which an individual’s behavior such as following a prescribed diet, taking medication, and embracing lifestyle changes aligns with the recommendations from the healthcare provider. Evidence has shown that there is low level of adherence among individuals diagnosed with chronic conditions in developed countries. Accordingly, the level of adherence is approximately 50% in these countries while it is lower in developing nations. It is estimated that 33-69% of hospital admissions in America are attributed to poor adherence to medications. The consequences of the low adherence include worsening of health conditions, increased rates of mortalities, and financial costs incurred by the patients, health care organizations, and the state as a whole (Alqarni et al., 2019). Often, the lack of or poor adherence to treatment among patients with diabetes is attributed to factors such as patient-centered, therapy related, social and economic, disease related, and health care system-related factors (Elsous et al., 2017). Therefore, it is important that interventions that aim at raising the level of adherence to medication among African-American patients with diabetes be embraced to improve their health and wellbeing.  

Nursing Science and Determinants of Health 

Nurses play an important role in ensuring that medical adherence among African-American diabetic patients is achieved. They utilize their knowledge in the art and science of nursing in exploring the critical determinants of health among them. It is increasingly becoming evident that African-American patients with diabetes have poor health outcomes due to their backgrounds. Factors such as low level of education, unemployment, and lack of medical insurance cover predispose them to problems related to access to healthcare. Therefore, nurses need to utilize their knowledge and skills to ensure that the existing barriers affecting the health of this population are eliminated. Further, they need to embrace interventions that will raise the level of awareness in this population on the importance of medical adherence. The nurses also have to explore the ways in which the lifestyle behaviors of the African-American patients affected by diabetes can be transformed to enhance their health outcomes (Canedo et al., 2018). Through these interventions, it is anticipated that the disease burden among African-American patients with diabetes will be reduced with enhanced adherence to medication.  

Potential Solution and PICOT Statement 

The management of diabetes is largely dependent on the use of pharmacological and non-pharmacological interventions. While these interventions have proven effective in the management of diabetes, it is critical that patients adhere to their prescribed medical management of the disease. Several interventions have been embraced to enhance adherence to treatment by patients suffering from diabetes. One of them is the use of health information technologies to enhance the adherence of African-American patients with diabetes to treatment. According to Conway and Kelechi (2017), health technologies such as eHealth and mHealth could improve the adherence of the patients to the treatment. They promote the outcomes by increasing the patient’s level of awareness and communication with their healthcare providers (Conway & Kelechi, 2017). A research conducted by Bailey et al. (2019) revealed that the use of Electronic Medication Complete Communication strategy increased patient satisfaction with care. The improvement reflected an increased rate of adherence among them to the treatment (Bailey et al., 2019). There was a significant reduction in the level of HbAc1c in the research by Yoshida et al. (2018) with the use of health information technology to promote adherence to treatment among diabetic patients. Based on this above evidence, this research proposes the use of health information technologies to promote adherence to treatment among African-American patients with diabetes. It will be guided by the following PICOT statement: 

In African-American patients with type 2 diabetes, will the use of health information technologies increase adherence to treatment when compared to no use within a period of six months?  

How it Incorporates Health Policies 

The provision of healthcare in the US currently focuses on performance metrics such as patient satisfaction with care and adherence to treatment. Health institutions are embracing policies that focus on patient-centeredness. The use of the intervention focuses on patient-centered care and empowerment, hence, aligning with institutional policies in most healthcare organizations. The above evidence has shown that African-American patients are disproportionately affected by disease burden of diabetes when compared to other ethnicities. Utilizing interventions that improve their health outcomes such as the proposed solution in this paper will address the inequalities in health experienced by this population (Canedo et al., 2018). Therefore, the solution promotes equity, equality, and improvement of healthcare policies targeting the health of the public.  

Conclusion 

In summary, African-American populations are highly vulnerable to health inequalities. They are largely affected by chronic conditions such as diabetes. The adherence to treatment among those diagnosed with diabetes is also low due to barriers affecting their access to healthcare. Their level of adherence can however be improved with the use of health care technologies. Therefore, this research will investigate the effectiveness of health information use in promoting adherence to treatment among African-American patients with diabetes type 2.  

References 

Alqarni, A. M., Alrahbeni, T., Al Qarni, A., & Al Qarni, H. M. (2019). Adherence to diabetes medication among diabetic patients in the Bisha governorate of saudi Arabia–a cross-sectional survey. Patient preference and adherence, 13, 63. 

American Diabetes Association. (2017). National diabetes statistics report, 2017. Estimates of diabetes and its burden in the United States.  

Bailey, S. C., Wallia, A., Wright, S., Wismer, G. A., Infanzon, A. C., Curtis, L. M., … & Hornbuckle, K. (2019). Electronic Health Record–Based Strategy to Promote Medication Adherence Among Patients With Diabetes: Longitudinal Observational Study. Journal of medical Internet research, 21(10), e13499. 

Burnier, M. (2018). Drug adherence in hypertension and cardiovascular protection. Cham: Springer.  

Canedo, J. R., Miller, S. T., Schlundt, D., Fadden, M. K., & Sanderson, M. (2018). Racial/ethnic disparities in diabetes quality of care: the role of healthcare access and socioeconomic status. Journal of racial and ethnic health disparities, 5(1), 7-14. 

Conway, C. M., & Kelechi, T. J. (2017). Digital health for medication adherence in adult diabetes or hypertension: an integrative review. JMIR diabetes, 2(2), e20. 

Elsous, A., Radwan, M., Al-Sharif, H., & Abu Mustafa, A. (2017). Medications adherence and associated factors among patients with type 2 diabetes mellitus in the Gaza Strip, Palestine. Frontiers in endocrinology, 8, 100. 

Iceland, J. (2017). Race and ethnicity in America. Oakland, California : University of California Press.  

Yoshida, Y., Boren, S. A., Soares, J., Popescu, M., Nielson, S. D., & Simoes, E. J. (2018). Effect of health information technologies on glycemic control among patients with type 2 diabetes. Current diabetes reports, 18(12), 130.