Please use the attached assignment instructions to complete the 3 assignments in it. 

The attached document has 3 different assignments. Please submit each individually, and use references within the 5 years ONLY

Assignment 1: 3- Discussion Questions  

Assignment 2:

Develop a 3,000 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

Assignment 3:

Professional Capstone and Practicum Reflective Journal




CAT: Christian World View

What have you done this week to feel like you have contributed to something important whether at work or at home or in the community?
(150 Words).

CAT: Class, sometimes it can be confusing to determine what your variables are. Here is a site that is helpful:
(150 Words).

CAT: Clinical and Statistical Significance

Here is some information on clinical and statistical significance. When you read an article and the authors report that the study was not statistically significant, there can be parts of it that made a difference making it clinically significant.


Capstone Change Project Evaluation Plan

Benchmark – Capstone Project Change Proposal

Assessment Description


Please see the attached

A. PICOT Question Paper

B. Literature Review.

In this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice.

Develop a 3,000 written project that includes the following information as it applies to the proble

PICOT Question: In older adults receiving home healthcare, does implementing a multifaceted intervention (including individualized medication education, family engagement, medication reminder tools, coordination with healthcare providers, and affordable medication) compared to standard care increase medication adherence and improve health outcomes?

Population: Older Adults Receiving Home Healthcare. It involves the populace that nursing staff are directly working with.

Intervention: A multifaceted intervention including individualized medication education, family engagement, medication reminder tools, coordination with healthcare providers, and affordable medication

Comparison: Standard care. A systematic approach of successful comparison of intervention methods that entails contrasting the implementation of a multifaceted intervention with standard care.

Outcome: Improved medication adherence and health outcomes. This approach will be used to forecast or predict the intervention been used as compared to the current one been used. Estimated outcome should lead to increased medication adherence and improve health outcom
Time: 6 months. This stage would measure how long it takes the intervention to take effect. In addition, it is expected that the time should take between six-month for the analysis to be implemented.

The PICOT question is an essential part of research since it aids in determining the research topic, elaborating on the scope of the study, and laying down the foundation for the research design. When applied to older persons receiving home healthcare, the PICOT question seeks to examine the efficacy of an intervention to increase drug adherence and better health outcomes (Marcum et al., 2017). Medication education, family involvement, medication reminder aids, healthcare provider coordination, medication cost reduction, and drug accessibility are all part of the initiative (Ryan et al., 2014). knowledge, attitudes and beliefs influence perceptions and adherence.( Myers et al., 2020). The comparison is standard care, and the outcome measures include medication adherence and health outcomes.

The PICOT question is precise, quantifiable, and pertinent to the researched population, the intervention under consideration, and the results being assessed. Non-adherence to medicine prescriptions is a serious concern for older persons in the home healthcare context and may result in adverse outcomes, including hospitalization and death, which highlight the significance of the topic (Christopher et al., 2022). Finding an effective strategy to increase drug adherence is essential to enhance health outcomes and reduce healthcare costs. The PICOT question can be made more particular by identifying the kind of drug and the precise medical professionals working on the coordinati



Atinuke Domingo

Grand Canyon University

NRS-493- Professional Capstone & Practicum

Dr. Stacey Hannah

April 24, 2023.

Literature Review

Multifaceted Intervention to Improve Medication Adherence and Health Outcomes in Older Adults Receiving Home Healthcare


One major issue with home healthcare for older people is drug non-adherence. This may result from negative health outcomes, hospitalizations, and increased healthcare expenses. A comprehensive intervention has been proposed to enhance medication compliance and health outcomes. This literature review aims to assess the present state of knowledge about the efficacy of a comprehensive intervention for enhancing medication adherence and health outcomes in home healthcare recipients aged 65 and above.

Comparison of Research Questions

The literature review scrutinizes research inquiries that center on the efficacy of a multifaceted intervention aimed at enhancing medication adherence and health outcomes in elderly individuals who are receiving home healthcare services. Nevertheless, the investigations exhibit variations in their particular research inquiries and suppositions.

In a study conducted by Ryan et al. (2014), a randomized controlled trial was carried out on a sample of 115 older adults who were receiving home healthcare. The study involved the categorization of participants into two distinct groups, namely the intervention group and the control group. The group that underwent the intervention was provided with a multifaceted approach that encompassed medication education, engagement of family members, employment of medication reminder tools, coordination with healthcare providers, and access to affordable medication. The group designated as the control received standard or routine care. The research revealed that the group that received the intervention exhibited a noteworthy enhancement in adhering to medication as compared to the group that did not receive any intervention. The group receiving the intervention exhibited a decrease in hospitalizations and visits to the emergency department, which suggests an enhancement in health outcomes. The research emphasizes the significance of implementing a comprehensive strategy to enhance medication adherence and health consequences among elderly individuals receiving home-based medical care. The statement posits that a successful intervention requires the inclusion of critical components such

Literature Evaluation Table 

Student Name:  Atinuke A. Domingo

Change Topic (2-3 sentences): Does implementing a multifaceted intervention versus standard care increase medication adherence and improve health outcomes in older adults receiving home healthcare


Article 1 

Article 2 

Article 3 

Article 4 

Author, Journal (Peer-Reviewed), and  

Permalink or Working Link to Access Article 



 Christopher, C., Kc, B., Shrestha, S., Blebil, A. Q., Alex, D., Mohamed Ibrahim, M. I., & Ismail, N.  
Aging Medicine.

Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., … & Wakefield, B. J

Manias, E., Bucknall, T., Hughes, C., Jorm, C., & Woodward-Kron, R.
BMC geriatric.

Correia, J. C., Lachat, S., Lagger, G., Chappuis, F., Golay, A., & Beran, D
BMC Public Health. 

Article Title and Year Published 


 Medication use problems among older adults at primary care: A narrative of literature review. 2022

Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension. 2020 

Family involvement in managing medications of older patients across transitions of care: a systematic review.. 2019 

Interventions targeting hypertension and diabetes mellitus at community and primary healthcare level in low-and middle-income countries: a scoping review. 2019

Research Questions (Qualitative)/Hypothesis (Quantitative)  


 What are the medication use issues amongst older patients in primary care?

 What are clinical usefulness and applicati



Atinuke Domingo

Grand Canyon University

NRS-493- Professional Capstone & Practicum

Dr. Stacey Hannah

April 8, 2023.

Objectives for the proposed intervention

Cultural assessment is an essential component of any change project, especially in healthcare. It helps to identify the cultural values, beliefs, and practices of the population under study and the nursing staff working with them. In the case of older adults receiving home healthcare, cultural factors such as language barriers, social isolation, and mistrust of healthcare providers may contribute to medication non-adherence. It is therefore crucial to consider these factors when designing the intervention to improve medication adherence and health outcomes.


1. Increase medication adherence in older adults receiving home healthcare by 50% within 6 months.

Rationale: Medication non-adherence is a prevalent problem in this population, leading to adverse health outcomes and increased healthcare costs (Gerland & Prell, 2021). The multifaceted intervention proposed in the PICOT question aims to address this issue by providing individualized medication education, family engagement, medication reminder tools, coordination with healthcare providers, and affordable medication.

2. Improve communication between nursing staff and older adults receiving home healthcare to enhance trust and reduce social isolation.

Rationale: Trust is a critical factor in healthcare, and older adults receiving home healthcare may feel isolated and mistrustful of their nursing staff. Improving communication between nursing staff and patients can help to establish trust, improve medication adherence, and enhance health outcomes (Khan & Socha-Dietrich 2018).

3. Increase family involvement in medication management for older adults receiving home healthcare.

Rationale: Family members play a significant role in medication management for older adults receiving home healthcare. They can help to remind patients to take their medication, monitor side effects, and communicate with healthcare providers. Increasing family involvement can, therefore, improve medication adherence and enhance health outcomes.

4. Provide affordable medication options for older adults receiving home healthcare.

Rationale: Medication cost is a significant barrier to medication adherence, especially for older adults receiving home healthcare. Providing affordable medication options can help to reduce this barrier and improve medication adherence.

5. Monitor medication adherence



Atinuke Domingo

Grand Canyon University

NRS-493- Professional Capstone & Practicum

Dr. Stacey Hannah

April 17, 2023.

Strategic Plan Summary

Leadership support is crucial for successfully implementing nursing practice interventions (Mick and Ackerman, 2016). A culture of collaboration, teamwork, and open communication are also important factors in facilitating change (Snyder et al., 2020). Adequate resource availability, including staffing, equipment, and technology, is necessary for successful implementation (Hutchinson and Jackson, 2019). Additionally, staff resistance to change can significantly challenge the implementation of nursing practice interventions (Proctor et al., 2011).

Based on my assessment of the clinical site’s organization’s culture, I can develop a strategic plan for implementing nursing practice interventions in my capstone project change proposal. My plan would address any potential challenges identified in the assessment and include specific steps for implementation, like; identifying key stakeholders and securing their support, developing clear communication strategies, and providing education and training to staff on the new intervention (Proctor et al., 2011). I would also monitor and evaluate the implementation to assess its effectiveness and identify areas for improvement (Hutchinson and Jackson, 2019).

Overall, my strategic plan would be adapted to the unique requirements and culture of my organization and contain evidence-based solutions to any problems that can arise when putting nurse practice interventions into practice.


Hutchinson, M., & Jackson, D. (2019). Transformational leadership in nursing: towards a more critical interpretation. Nursing Inquiry, 26(2), e12296.

Mick, J. W., & Ackerman, M. H. (2016). Organizational culture and supportive infrastructures for evidence-based practice. Journal of Nursing Administration, 46(4), 221-225.

Proctor, E., Silmere, H., Raghavan, R., Hovmand, P., Aarons, G., Bunger, A., … & Hensley, M. (2011). Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health and Mental Health Services Research, 38(2), 65-76.

Snyder, C. R., Staggers, N., & Hardin, S. R. (2020). Cultivating a culture of innovation: The role of nursing leaders. Journal of Nursing Administration, 50(1), 9-12.