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Educating Patients about Atrial Fibrillation. EBP Research Project Auburn University/Auburn Montgomery Location: Thomasville Internal Medicine Tonya Anderson, BSN, RN, Graduate Student, PCNP. Outline . PICO Question Purpose Significance Summary of Evidence Method Sample Findings
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Educating Patients about Atrial Fibrillation EBP Research Project Auburn University/Auburn Montgomery Location: Thomasville Internal Medicine Tonya Anderson, BSN, RN, Graduate Student, PCNP
Outline • PICO Question • Purpose • Significance • Summary of Evidence • Method • Sample • Findings • Summary
PICO Question In patients with atrial fibrillation, how does individualized education rather than generalized education affect the patient ability to adhere to medication?
Purpose • Evaluate and increase medication adherence • Educate • Increase follow-up • Increase the self-management of AF • Decrease hospital stays
Significance • Atrial Fibrillation(AF) is the most common cardiac arrhythmia in the United States (Shea and Sears, 2011) • AF has significant complications if not managed • Stroke • Dementia • Heart Failure • Death • Anticoagulant has serious complications if not properly regulated. • Patient knowledge and participation in AF management leads to fewer hospital stays and decrease healthcare costs.
Summary of Evidence • Databases: CINHAL, ERIC, HeathSource, Medline, PsycInfo, and PsycArticles. • Six studies found • Review of research shows a lack of knowledge in patients with Atrial Fibrillation, medication, and treatment. • Research suggests that improved outcomes are guided by education and involvement in care.
Method • Thomasville Internal Medicine. • Consents for eight patients. • Morisky Medication Adherence Scale given prior to education and by follow-up phone call. • Data collected- Age, gender, and race. • Education received: Atrial Fibrillation, risks of uncontrolled HR, Coumadin, and rate control medications. • All data was compiled and analyzed.
Sample • Eight participants • Diagnosis of atrial fibrillation • Take Coumadin and a rate control medication
Findings: Questionnaire -- The lower the number, the higher the compliance. -- Results may range from 0 to 11.
Findings • The Morisky Medication Adherence Scale (Morisky, Krousel-Wood, & Ward, 2008)
Summary • Findings suggest: • -Although the participants reported high medication compliance at baseline, improvement was noted. • -The improvement was not statistically significant. • - A larger sample size is warranted with a longer evaluation period is needed to evaluate the significance of education in atrial fibrillation patients.
References Kring, D.L. (2008). Clinical nurse specialist practice domains and evidence-based practice competencies. Clinical Nurse Specialist, 22(4), 179-183. Morsiky, A., Krousel-Wood, M. Ward, H. (2008). Predictive validity of a medication adherence measure for hypertension control. Journal of Clinical Hypertension 10(5), 348-354. Shea, J., & Sears, S. (2008). A patient’s guide to living with atrial fibrillation. Circulation 11, e340-e343. doi: 10.1161/CIRCULATIONAHA.108.780577