Looking for a scholarly opinion on the 2 topics below with 2 scholarly references to support your opinion, please.

Question Looking for a scholarly opinion on the 2 topics below with 2 scholarly references to support your opinion, please. LUZIntroduce Chapter Two: The overall purpose of this quality improvement project is to implement a research- based intervention as a tool that can convey information or educate a target population with specific conditions. This chapter will discuss a synthesis of literatures on what is known and not known about the research- based intervention and how it can promote patient positive outcomes. The literature review was obtained from previous research such as scholarly articles, empirical research studies, academic books, clinical manuals, and other resources.Uncontrolled hypertension is consistently a major health problem in the country. In particular, the complications of hypertension may result to disabling diseases that affects the physical, emotional, psychological, and social wellbeing of the patient. The cost required to manage chronic disease creates a burden on the patient, family, community, and societal economic position. Hypertension management improves the health status. Having the patient adhere to hypertensive medication controls the symptoms, prevents complications, and increases the quality of life and decrease the cost of unmanaged hypertension. Several community resources are available to manage hypertension. However, medication nonadherence in hypertension remains to be a problem.The trajectory of medication nonadherence in patients with hypertension is going to an upward direction based on current studies. Urgent attention is needed on medication adherence in chronic disease such as hypertension as it continue to be a global concern (Lemstra, Nwanko, Bird, & Moraros, 2018).Theoretical Framework: Nursing models and theories were developed to explain and improve nursing and clinical practice. The purpose of these models and theories is to communicate a clearer perspective of nursing practice. The conceptualization of the nursing theories and models facilitates the process of describing, explaining, and even predicting an innovative new nursing practice. Further, the theories and models add value to the promotion of modern nursing. Nursing theory-guided practice helps improve the quality of nursing care because it allows nurses to articulate what they do for patients and why they do it (Younas & Quennell, 2019). A nursing- theory guided practice change is needed to successfully implement a particular clinical practice. The theories and model integrated in this quality improvement project will provide a robust framework to make the implementation a success.The nursing theory that will be applied to the DPI project is Jean Watson’s theory of human caring. The theory of human caring and healing change the direction of health care to a time of connectivity (Watson, 1988). This theory will be utilized to increase awareness on the nurses’ conscious role in promoting and maintaining health and preventing illness in the patient population.Medication Adherence: “Non-adherence negatively affects the efficacy, safety and costs of therapies. Especially in chronic conditions with long-term therapies, adherence is important to achieve target outcomes” (Gast & Mathes, 2019).Hypertension management and patient’s perception. The success of therapy in patients with chronic disease is adherence. Pill consumption is not the sole predictor of medication adherence, but also a reflection of healthy behavior (Vrijens et al., 2017).Attitude and beliefs toward medication adherence. Personal goals and values lead a patient’s decisions for adherence or nonadherence to medications for CHF. However, studies have found nurses to have the potential to promote adherence to medications for by implementing care that is patient focused and nonjudgmental (Meraz, 2017).Importance of medication adherence. Complete adherence to prescribed medication is vital in assisting clinicians to provide supervised evidence-based treatment of patients (Omotosho & Ayegba, 2019).Significance of the Project: This quality improvement project aims to explore the effect of text messaging reminders on medication adherence of patients with hypertension. The outcome measure of this DPI project is to measure self- report medication adherence for participants who will receive text message reminders compared to current practice of the clinic. Increase in medication adherence post intervention will reflect the clinical significance of this project. This outcome is meaningful for the participants because improved medication adherence promotes positive outcomes, decreases morbidity, and mortality rate, and minimizes hospitalizations. The projected measurable patient outcome will represent clinical significance.Project Methodology: Quantitative methodology and quasi-experimental design are used to identify causal relationships between the independent and dependent variables after an intervention is implemented without randomization (Jones and Bartlett Learning, 2017). Since the goal of this project is to gain best use of evidence practice to improve medication adherence, the methodology that will be used is quantitative while quasi- experimental for the design. The research method and design will identify the relationship between the use of mobile telephone text messaging and medication adherence in patients with hypertension as evidenced by blood pressure control.This is an appropriate project design because it will establish the cause- effect relationships among the variables.Project Design: The research design that will be employed on this quality improvement project is quasi-experimental. This is the appropriate design because it will appraise the effect of the intervention applied on the identified population. Gopalan, Rosinger, & Ahn (2020) stated that quasi-experimental research designs, as the term implies is non-researcher- induced or nonexperimental study which focuses on identifying the effect the main independent variable of interest to the dependent variable. Providing the rationale for the selected project design and includes a discussion of why the selected design is the best one to collect the data needed. References:Gast, A. & Mathes, T. (2019). Medication adherence influencing factors—an (updated) overview of systematic reviews. Systematic Reviews, 112. https://doi.org/10.1186/s13643-019-1014-8Gopalan, M., Rosinger, K., & Ahn, J. B. (2020). Use of quasi-experimental research designs in education research: Growth, promise, and challenges. SAGE Journals. https://doi.org/10.3102/0091732X20903302Jones and Bartlett Learning. (2017). Quantitative research designs: Experimental, quasi-experimental and descriptive. http://samples.jblearning.com/9781284101539/9781284101539_CH06_Drummond.pdfLemstra, M., Nwanko, C., Bird, Y., & Moraros, J. (2018). Primary nonadherence to chronic disease medications: a meta-analysis. Patient Prefer Adherence, 12, 721-731. https://www. doi: 10.2147/PPA.S161151Meraz, R. (2017). Making medication adherence decisions: Stories from older adults taking medications for congestive heart failure. [Doctoral Dissertation, Texas Woman’s University]. ProQuest. https://www.proquest.com/openview/e18ab02e8cad048c2d5924448efed2f0/1?pq-origsite=gscholar&cbl=18750Vrijens, B, Antoniou, S., Burnier, M., de la Sierra, A., & Volpe, M. (2017). Current situation of medication in hypertension. Front Pharmacology. https://doi.org/10.3389/fphar.2017.00100Watson, J. (1998). New dimensions of human caring theory. SAGE Journals. https://doi.org/10.1177/089431848800100411Younas,. & Quennell, S. (2019). Usefulness of nursing theory-guided practice: an integrative review. Scandinavian Journal of Caring Sciences, 33(3), 540-555. https://doi.org/10.1111/scs.12670Post the following statement to this topic’s discussion forum after your references:CANDYIntroduce Chapter Two:In the enclosed chapter 2, the review of the literature provides insight into the current use of SMS and relationships to improving veteran outcomes. The project administrator will begin with a theoretical foundation as a guide to the DPI project. There will be a review of current literature that is organized by three main themes. Under each theme, there will be subthemes that are related to the theme. Each main theme will have an introduction initially with a summary at the end. At the end of the literature, review gaps will be identified. The conclusion of Chapter 2 will have key points for the current literature that will give evidence for a solid foundation for the DPI project.The purpose of this quantitative quasi-experimental direct practice improvement project is to determine if or to what degree an automated short messaging system (SMS), would impact the colonoscopy screening rate by decreasing the cancelation rate for colonoscopy procedures when compared to current standard practice among veterans in an outpatient setting in Colorado over four weeks. The intervention aimed to equip the nursing staff to improve colonoscopy screening rates is the implementation of ASMS to begin four days prior to a scheduled colonoscopy in the form of three messages as previously performed by (Walter et al., 2016). The use of SMS has been shown to increase quality and efficacy in an outpatient setting by increasing colonoscopy screening procedures, decreasing cancellations, and improving the quality of bowel preparation (Solonowicz et al., 2021).Screening colonoscopy is a routine exam that everyone should have around the age of fifty. Cancellations and no-shows increase the risk of colon cancer due to a missed screening opportunity (Solonowicz et al., 2021). There is an increasing burden of colon cancer on the health care system that is expected to be a million new cases by 2030 (Wu et al., 2019). Every day there are canceled endoscopy appointments which are problematic for outpatient settings around the world (Alnasser et al., 2020). Screening for colon cancer takes on several forms but the optimal way to find and remove colon cancer is with a colonoscopy. There are colorectal cancer screening initiatives all around the world that are backed by NIH and AHQR. A statewide study performed in New Hampshire in conjunction with the CDC demonstrated a successful ninety-seven percent screening rate and less than one percent cancellation rate (DeGroff et al., 2019).Theoretical Framework:The goal of this quality improvement (QI) project is to improve colonoscopy screening rates for veterans by decreasing cancellations. A theoretical foundation is needed to solidify and guide the project in a successful manner. The two theories of choice to guide the project are the nursing theory by Nola Pender (1982), and Kurt Lewin (1940). There will be added value to theorists chosen for this DPI project to guide its success. The role of each respective theorist will be given as it applies to the DPI. Pender’s theory of health promotion and wellness is the basic foundation for the DPI project. Nursing seeks to understand the patient and meet them where they are in order to get them to where they need to be for their best health and wellness potential. Pender’s theory of health promotion and wellness can identify patient factors and behaviors which can lead to needed action to be implemented by nursing to change unhealthy behaviors (Pender, 1990). Lewin’s change stages will allow for the intervention to get to the next level and ease acceptance for sustainment.Theme 1: Short Messaging Service (SMS), with twenty-four subthemes.Digital navigation improves no-show rates and bowel preparation quality for patientsundergoing colonoscopy (Solonowicz et al., 2021).Improves no show rate for outpatient colonoscopy (Mahmud et al., 2019).Development and testing of an automated 4-day text messaging guidance as an aid forimproving colonoscopy preparation (Walter et al., 2018).The SMS technology has exhaustive potential for utilization in health care as reviewed in the extensive literature contained. SMS is a soft form of contact to gently remind patients of important commitments. It is automated and will save time, money and overall improve quality and efficiency for utilization. The accessibility for patients creates easy access in a convenient manner. A large majority of the general population has digital capacity on a cellular device with improves creates efficient timely delivery.Theme 2: Cancellations, with ten subthemes.Inadequate bowel preparation may lead to missed precancerous polyps. (Chang et al., 2018).Inadequate bowel preparation can mean missed polyps which can increase the risk of colon cancer (Kluge et al., 2018).Attendance rates improved with automated short messaging system (Mahmud et al., 2021).Social vs practical problems in attaining a colonoscopy: different patient profiles colonoscopy(Curbow et al., 2019).There can be many barriers to timely colonoscopy completion. Colonoscopy procedure cancellations affect individual health promotion and wellness. Colon cancer often has no symptoms, and routine screening can improve morbidity. For a DPI site, a no-show or cancellation affects revenue, quality, and efficiency.Theme 3: Bowel Preparation, with sixteen subthemes.Improves Boston Bowel Preparation Scale score (Walter et al., 2019), and improves the quality of bowel preparation which is a national quality indicator (Ozkan et al., 2020).Improved bowel preparation quality, bowel cleanliness determines effectiveness of bowel preparation (Gausman et al., 2020).Prediction of inadequate bowel preparation using total segmental colon transit time inpatients with chronic constipation: some different outcomes (Zhai et al., 2019). There are many barriers to performing a bowel preparation properly like constipation or health literacy for example. Colon cleansing options are not optional and are chosen by provider preference. The literature review demonstrates a clear correlation to the utilization of SMS to improve bowel preparation adequacy, to improve colonoscopy screening rates, decrease no-shows and cancellations. All articles reviewed in the literature were reviewed for direct impact to the DPI. Significance of the Project:The DPI will improve colon cancer screening rates for veterans by decreasing colonoscopy procedure cancellations. In 2019 there was a twenty percent cancellation rate. In 2020 there was a fifteen percent cancellation with only forty percent of the expected volume due to COVID. Colon cancer is the second-highest reason for cancer in women and third for men globally (Wu et al., 2019). There is no current standard for pre colonoscopy instructions. However, current practice at the VA WCHCS is a handout and telephone call. Other modalities include video, text, face-to-face visits, or a link to one or each of these modalities (Gausman et al., 2020). The American Society of Gastroenterology accepts these practices for Gastrointestinal Endoscopy (ASGE).The proposed DPI project will contribute substantially to the literature by being performed on the veteran population for broad use in general and to be applied to veterans globally. Most veterans at the DPI site are over age fifty. The DPI site has a recommended screening age for initial screening colonoscopy at the age of fifty, and up to age seventy-five. The VA will likely decrease this to age forty-five for initial screening soon, as this would follow CDC guidelines. The implications for DPI outcomes for veterans could impact all veterans nationally and internationally. The SMS could be adopted at the VA hospital as an evidence-based practice to improve colorectal cancer screening, decrease cancelations and improve bowel preparation quality. The outcome of improved health and wellness for veterans and their family’s quality of life. A new best practice could impact all veterans. “Improving the quality of educational interventions for bowel preparation will overall impact the colonoscopy outcome” (Guo et al., 2020). Project MethodologyThe most practical method for the intended DPI is quantitative. The choice is reasonable and will provide a suitable, efficient way to process information for the DPI. The design will provide efficiency for accomplishing the project in the allotted four-week time frame and give real-time data to translate into evidenced-based outcomes for increased validity and reliability. The DPI quantitative analysis will add strength to interpret and support the significance of the findings. This will demonstrate a causal relationship between the outcome and the intervention applied (McLeod, 2017). Qualitative data has a subjective nature and more challenging to measure outcomes through statistical analysis. The quantitative method is objective, which will help to strengthen the project and give statistical analysis for application. The outcome data of the independent and dependent variables will be collected and compared to see if there is a relationship.Project DesignA quasi-experimental design is one of the relationships as a comparison between the variables. The entire sample will be taking part in the intervention for the DPI. There will not be random group assignment as this does not follow a quasi-experimental design. The design is the most suitable design to evaluate the intervention outcome concerning the variables. The intervention of SMS will show a clear result on screening colonoscopy rate improvement and a decrease in colonoscopy cancellations rates to demonstrate the intervention on the outcome. The quantitative design utilizes numerical data, and the qualitative design uses observation. Statistical analysis is applied to quantitative data, which does contribute to validity and reliability. A qualitative method is harder to duplicate based on the observation as that is subjective. Statistical analysis is complicated with qualitative data. Statistical analysis can be applied to quasi-experimental design. This design will have added value due to statistical analysis for evidenced-based practice outcomes (Smith, 2019).The first clinical question will be answered by giving precise numerical values to the screening colonoscopy rate at baseline before the DPI implementation compared to post DPI. The second clinical question will be answered by providing the actual numerical value of inadequate bowel preparations at baseline before the DPI compared to post DPI. The quasi-experimental design will allow a clear demonstration of cause and effect (Smith, 2019).References Alnasser, R., Alkhowaiter, S., Alhusaini, S. & Aljarallah, B. (2020). Factors associated with   missed and cancelled appointments on the endoscopy unit: descriptive study. Hepatology and   Gastroenterology. doi: 10.7759/cureos.7264Chang, J. Y., Moon, C. M., Lee, H. J., Yang, H. J., Jung, Y., & Kim, S. W. (2018).   Predictive factors for missed adenoma on repeat colonoscopy in patients with   suboptimal bowel preparation on initial colonoscopy. AKSID multicenter study.   PLos ONE, 13(4): e0195709. https://doi.org/10.137111/journal.pone0195709Curbow, B. A., King-Marshall, E. C., Mueller, N., Hyams, T., Sullan, S. & George Jr, T. J.   (2019) Social vs. practical problems in attaining a colonoscopy: different patient profiles?   Journal of Health Disparities Research & Practice, 12(1), 159-173.DeGroff, A., Gressare, L., Glover-Kudon, R., Rice, K., Tharpe, F. S., Escoffery, C., Gersten, J.   & Butterly. L. (2019). Assessing the implementation of a patient navigation intervention for   colonoscopy screening. BMC Health Services Research, 19(1), 1-11.   https://doi- org.lopes.idm.oclc.org/10.1186/s12913-019-4601-4Gausman, V., Quarta, G., Lee, M. H., Chtourmine, N., Ganotisi, C., Nanton-   Gonzales, F., Ng, C. L., Jun, J., Perez, L. Dominitz, J., Sherman, S. E., Poles, M.   A., & Liang, P. A. (2020). A theory-based educational pamphlet with low-   residue diet improves colonoscopy attendance and bowel preparation quality.   Journal of Gastroenterology, 54(2), 164-169.   https://doi.org/10.1097/MCG.0000000000001151Guo, X., Li, X., Wang, Z., Zhai, J., Liu, O., Ding, K. & Pan, Y. (2020). Reinforced education   improves the quality of bowel Preparation for colonoscopy: an updated meta-analysis of   randomized controlled trials. PLoS ONE, 15(4).   https://doi.org/10.1371/journal.pone.0231888Kluge, M. A., Williams, J. L., Wu, C. K., Jacobson, B. C., Schroy, P. C.,   Lieberman, D. A., & Calderwood, A. H. (2018). Inadequate Boston bowel   preparation Scale scores predict the risk of missed neoplasia on the next   colonoscopy. Gastrointestinal Endoscopy, 87(3), 744-751.   https://www.sciencedirect.com/science/article/abs/pii/S0016510717320357Mahmud, N., Doshi, S., Coniglio, M. S., Clermont, M., Bernard, D., Reitz, C., Khungar, V.,  Asch, D. A. & Mehta, S. (2019). An automated text message navigation program improves   the show rate for outpatient colonoscopy. Health Education & Behavior, 46(6), 942-946.   doi: 10.1177/1090198119869964McLeod, S. (2017). What’s the difference between qualitative and quantitative research? Retrieved from   https://www.simplypsychology.org/qualitative-quantitative.htmlOzkan, Z. K., Unver, S., Findik, U. Y., Albayrak, D. & Fidan, S. (2020). Effect of   short messaging service use on bowel preparation quality in patients undergoing   colonoscopy. ASGE, 43(1), 89-98. DOI: 10.1097/SGA.0000000000000405Pender, NJ. (1990). Expressing health through lifestyle patterns. Nursing Science Quarterly.   3(3): 115-122. doi:10.1177/089431849000300306Smith, H., Brunet, N., Tessier, A., Boushey, R. & Kuziemsky, C. (2020). Barriers to   colonoscopy in remote northern Canada: an analysis of cancellations. International Journal of   Circumpolar Health. https://doi.org/10.1080/22423982.2020.1816678Solonowicz, O., Stier, M., Kim, K., Kupfer, S., Tapper, E., & Sengupta, N. (2021).   Digital navigation improves no-show rates and bowel preparation quality for   patients undergoing colonoscopy. Journal of Clinical Gastroenterology.   doi:10.1097/MCG.0000000000001497Walter, B., Klare, P., Neu, B., Schmid, R. M. & von Delius. S. (2016). Development and testing   of an automated 4-day text messaging guidance as an aid for improving colonoscopy   preparation. JMIR Mhealth Uhealth, 4(2). doi: 10.2196/mhealth.5829Wu, Y., Liang, Y., Zhou, Q., Liu, H., Lin, G., Cai, W., Li, Y. & Gu, J. (2019). Effectiveness of a   short message service intervention to motivate people with positive results in preliminary   colorectal cancer screening to undergo colonoscopy: a randomized controlled trial. American   Cancer Society. https://doi.org/10.1002/cacr.32043Zhai, C., Huang, Q., Chai, N., Zhang, W. & Linghu, E. (2019). Prediction of inadequate bowel  preparation using total segmental colon transit time in patients with chronic constipation:   some different outcomes. Gastroenterology Research and Practice.https://doi.org/10.1155/2019/2328054  Health Science Science Nursing NURSING DNP 955 Share QuestionEmailCopy link Comments (0)

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