Date of Award

Spring 2023

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chairperson

Veronica Wilbur, PhD, APRN-FNP, CNE, FAANP

Committee Member

Jacqueline Owens, DNP, RN, FNP-BC

Committee Member

Marguerite Ambrose, PhD, RN, ACNS, BC, CNE

Committee Member

Cheryl Schlamb, DNP, CRNP

Abstract

Atrial fibrillation is a chronic disease managed through rate control, rhythm control, and anticoagulation. Anticoagulation compliance must be verified when a patient needs a cardioversion to convert to normal sinus rhythm. If a patient has missed a dose within the last four weeks, a Transesophageal Echocardiogram (TEE) is required to confirm that a clot has not formed in the heart. Medication noncompliance plagues the healthcare industry, costing millions of preventable healthcare dollars. The literature review shows that educational and behavioral interventions effectively increased medication compliance. Educational material was created, and a verified medication compliance survey was utilized to evaluate anticoagulation compliance. A qualitative data analysis and retrospective chart review from 31 patients was conducted on atrial fibrillation patients who were scheduled for a cardioversion during a three-month time period. Patients were emailed an educational packet and a medication compliance survey. The TEE rates were also tracked pre-and post-intervention. Results: Questions from the survey identifying purposeful or consciously choosing not to take medication was 100% compliance. Questions identifying carelessness or forgetfulness showed between 93% and 99% compliance. TEE results could not be analyzed due to the inability to extract cardioversion data.

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