Enhancing Medication Adherence in Home-Based Hypertension Care Through Targeted Staff Education

Summary In this practice-based, quality improvement project, I incorporated a one-group, pre-/posttest design with the aim to evaluate a staff education intervention, reflecting on key principles in improving practice, including continuous evaluation and informing locally based change. This Doctor of Nursing Practice (DNP) project addressed the issue of inconsistent adherence to medication and the lack of staff skills in home-based hypertension management. Notably, the nurse plays an important role in medication adherence to care and in the consistent, evidence-based care with chronic diseases. The practice-focused question was: For home health staff, how does participation in an evidence-based medication adherence education program affect staff knowledge and confidence, as measured by pre- and posttest scores? In this doctoral study, I designed and tested an intervention for increasing the staff’s knowledge, confidence, and performance levels for assessing and documenting the levels of medications taken for home management of hypertension. Descriptive statistics assessed nurses' knowledge. I measured pre- and post-intervention performance using mean, minimum, and maximum values. Learning gains were calculated using the normalized learning gain (NLG) method. Staff knowledge improved, with a 55.2% NLG, demonstrating the effectiveness of targeted staff education. I recommended to maintain staff education and use checklist-generated data to improve quality and evidence-based, inclusive nursing practice to close health gaps. Sound, accurate, and equitable hypertension care is an essential element vital for bringing positive social change and contributing to the reduction of health inequities among diverse populations in home based settings.