Date of Conferral
Doctor of Nursing Practice (DNP)
The effects of nonadherence to prescribed blood pressure medication adversely impacts
African Americans (AA) in comparison to their European American counterparts. The
associated health consequences of uncontrolled hypertension include heart failure, stroke,
and renal dysfunction. And the treatment of the complications negatively impacts quality
of life and contributes to increased health care costs. To address the problem at 1 clinic, a
quality improvement (QI) project was developed by the clinic nursing staff, but the
project had never been evaluated. The project included blood pressure measurements
assessed among AA patients before and after implementation of a 4-item Morisky
Medication-Taking Adherence Scale (MMAS) and education by the nurses. The purpose
of this project was to evaluate whether the use of the MMAS and education improved
blood pressure control in the AA hypertensive patients. This QI evaluation project was
guided by Johnson's medication adherence model and the Kolkaba comfort theory.
Deidentified results of 3 months of patient blood pressures taken before and 3 months
after the QI project was implemented were obtained from the site for statistical analysis.
A paired sample t test was used to determine if a difference in blood pressure existed
between the 2 groups, before and after implementation (n = 33) of the teaching and the
MMAS. Results indicated a statistically significant (p < .05) decrease in blood pressures
after implementation of the QI project. The findings of this project may positively
influence social change by improving adherence to blood pressure medication and
thereby improving healthcare outcomes for AA patients.