Consider you are an expert in the field of journalism field.  You are an expert in journalism analysis. Ensure your writing reflects your expertise and is tailored for an audience that consists of other experts in the field. You need to provide advanced arguments that support your stateament. Use a formal and academic tone appropriate for advanced readers, constructing your content with sophisticated arguments that would meet the standards of a peer-reviewed journal. Avoid figures of speech, poetic language, and enumerations. Write in full sentences and paragraphs, employing the active voice, and minimize the use of terms such as "that," "overall," and "in conclusion." You are not allowed to use enumerations as in recounting/ the act or process of making or stating a list of things one after another not allowd) at all. Remember, your writing should be humanized and engaging while still demonstrating your expertise. Provide expert arguments. I am not interested in filling sentences that are irrelevant. Your output should be 1200 words. Keep in mind the general rules and make sure you adhere to them.. Also, provide a title for this work . Be specific, don't fill with irrelevant information. Be advanced, not basic generalized answers. Identify the key information needed to answer the question you selected before starting to write. Be systematic, precise, and succinct. The information and analysis must use the sources provided below which msut be cited as in text citations (the sources are provided below). Make sure you are coherent and build information between articles, your analysis of the articles and understanding of the topic. This is not a summary of the articles. All the sources must be used coherently. Don’t miss any source. 
1) Use active voice as much as possible, but make sure that the text is coherent.
 2) Coherency is very important, yet the text must seem like it was written by a human with expertise in the field, not by a robot 
3) You are not allowed to use figures of styles. Avoid using adverse
 4) DO NOT USE enumeration. This act or process of making or stating a list of things one after another not allowed. This is very important; enumerations are not allowed at all, so make sure the work does not contain enumerations 
5) Ensure a diversity of length and sentence structure between sentences in order to imitate a human style of writing. When it comes to writing content, two factors are crucial, "perplexity" and "burstiness." Perplexity measures the complexity of text. Separately, burstiness compares the variations of sentences. Humans tend to write with greater burstiness, for example, with some longer or complex sentences alongside shorter ones. AI sentences tend to be more uniform. Therefore, when writing the following content I am going to ask you to create, I need it to have a good amount of perplexity and burstiness 

Don’t forget to not be shorter than 1300 and use all the headings and answer as below. 

Prompt and headings that you will use:
The purpose of this assignment is to explore the Doctor of Nursing Practice (DNP) Repository, identify three DNP Projects related to a topic of interest, analyze each manuscript, and discuss their relevance to potential DNP projects. Additionally, students will evaluate the rigor of each project and the quality of the written manuscripts. 
MY DNP project : A Quality Improvement Project to Improve Medication Adherence and appointment compliance after discharge and reduce re-admission rate for Adults in a Psychiatric Clinic Setting.
1.	Topic of Interest 
o	Potential Setting & Population
1.	Manuscript Summary
o	For each selected DNP Project, write a concise summary. Include:
	Purpose of the project
	Methodology employed.
	Key findings or outcomes
	Implications for practice
	Provide the titles and authors of the selected projects.
1.	Relating to Your Potential DNP Project
o	Discuss how each of the three DNP Projects could inform or inspire potential DNP projects for you.
o	Highlight the aspects of each project that resonate with your interests and how they align with your envisioned DNP project.
1.	Evaluation of Rigor
o	Assess the rigor of each DNP Project. Consider the research design, data collection methods, analysis, and interpretation.
o	Discuss any strengths or limitations identified in the manuscripts.
o	Evaluate the quality of the written manuscripts. Consider clarity, organization, and adherence to scholarly writing standards.
1.	Reflection on Learning
o	Reflect on what you have learned from reviewing these DNP Projects. Consider how this exploration has shaped your understanding of potential DNP projects and the importance of rigorous scholarly writing. In this part you will also write 2 detailed paragraphs with statistics reflecting the importance of your DNP project and potential impact.(must contain generalized nformation too supported with arguments).

DNP project 1:
Baxter. (2022). A Quality Improvement Project to Improve Medication Adherence for Adults in a Psychiatric Clinic Setting. https://www.doctorsofnursingpractice.org/project-repository-details/
Non-adherence to medication among adult patients in a psychiatric clinic. ❑ Lack of access to psychiatric providers and care, leading to poor medication adherence. ❑ Non-adherence to the treatment lowers effectiveness by about 50 percent (Thakkar et al., 2016). ❑ A low therapeutic relationship has been associated with a high rate of non-adherence to medications❑ Non-adherence to medication is associated with increased suicide attempts, persistent symptoms, and relapse of psychosis (Thakkar et al., 2016). ❑ African Americans and Hispanic patients represent the largest ethnic groups with consistently poor medication adherence. ❑ Additionally, adults who lack family support contribute to medication non-adherence (Thakkar et al., 2016). ❑ Perceptions about medications and illness influence psychiatric medication adherence (Trezona et al., 2017). ❑ According to Conn and Ruppar (2017), a therapeutic alliance can increase medication adherence significantly❑ Improving drug adherence is key to treating psychiatric diseases, especially in adults. ❑ Non-adherence to prescriptions can be addressed by offering same-day appointments and walk-in services, among other techniques. ❑ This method seeks to build a therapeutic relationship, a vital tool in psychiatric clinics. ❑ The therapeutic relationship connects the health care professionals with the patient and familyAim To improve medication adherence in the adult population at a psychiatric clinic setting in Virginia Beach. Objectives ❑ To implement an Organizational Toolkit on Medication Adherence to increase medication compliance among patients. ❑ Educate RN, MA, Psychiatrist, and NP about the guidelines for medication adherence utilizing a PowerPoint presentation. ❑ Increase provider availability by offering walk-in services on Wednesdays and Thursdays from 2 pm- 4 pm. Objectives ➢ Show a 7% decrease in patient no shows to appointments by sending out appointment reminders using several different methods such as text messaging, email, and phone calls. ➢ Reminders were sent no more than three times about their appointments. ➢ Show improved medication adherence within four weeks of implementation. ➢ Evaluate medication adherence by using self-reporting questionnaires and reviewing pick-up/refills through the Rocopia medication system, verifying when medications were last filledPopulation of Interest ❑Twelve behavioral/mental health prescribers were trained on adherence guidelines. ❑Two front desk clerks, two medication assistants, a biller, and a lab technician assisted the mental health providers in completing their duties. ❑Adult patients ages 18-75 seeking services were the indirect population. Setting ❑An outpatient psychiatric clinic in Virginia Beach, VA ❑This clinic provides medication management, psychosocial and rehabilitative programs, and individual and family counseling to patients aged 18-75. Intervention ❑Week 1: Educate staff on medication adherence and toolkit use to promote patient compliance. ❑Weeks 2-4: Weekly chart reviews and implementation of the evidence-based toolkit ❑Week 5: Assess adherence by reviewing pick up/refills of the patients seen in Weeks 2-4 on the Azzly EHR. ❑ The EHR system was used to verify the last time medications were picked up from the pharmacy. Ethics/Human Subjects Protection ❑ Participation in the project was voluntary, and all participants were informed of the nature of the project and their rights as participants before participating. ❑ Confidentiality was ensured by assigning providers and patient numbers identifiersThe results showed that the intervention led to an 80% increase in medication adherence among adult patients in a psychiatric clinic. ❑Non-adherence is associated with a greater risk of readmission, increasing patient and provider prescription expenditures, relapse, symptom aggravation, rehospitalization, and death in people with a mental health condition. ❑The project strengthened the provider-patient therapeutic interaction, addressed non-medical adherence, and provided quality care for all patients. ❑This work is relevant to addressing the issue of non-adherence to medication among patients, especially those receiving care in outpatient psychiatric clinics. ❑The site can easily sustain cheap and effective intervention long term. Current and new psychiatric clinics should apply this project's quality improvement conclusions. ❑Future sample sizes should include more than 100 people. ❑Advanced data analysis should be used, such as correlation and regression.

Walsh, H. (2024). Improving Medication Adherence for Patients in a Psychiatric Out-Patient Setting Utilizing an Evidence-Based Protocol: A Quality Improvement Project. https://www.doctorsofnursingpractice.org/project-repository-details/
OSE AND HYPOTHESIS Problem • About 50% of patients are estimated to be non-adherent with taking their medications as prescribed (Eliasson et al, 2020). • Medication non-adherence in psychiatric mental health patients leads to a lower quality of life, shortened lives and higher health care costs. Background • The project site is a new out-patient psychiatric care group established in January 2022, which offers a parttime or intensive, out-patient hospitalization program, and a variety of outpatient programs for many mental health needs across the lifespan from children to adults. • The National Council for Mental Wellbeing has a toolkit of evidence-based practices for health facilities on this topic and emphasizes specialized training of providers in this complex problem (NC, 2021). • A protocol can be developed with a plan for provider and client psycho-education, to understand its importance, enhance the therapeutic relationship, assessment skills, and learn new tools, and strategies to help clients identify and overcome their individual barriers to medication adherence. Pre & Post intervention questionnaire. * Random chart audits. List of people who were involved in the study TOURO UNIVERSITY NEVADA Sample text. For providers in an outpatient mental health setting providing care for psychiatric patients, will the implementation of evidenced-based medication adherence protocol, as compared to current practice, increase medication compliance, as evidenced by self-reporting, in a 4-week implementation timeline? BACKGROUND PURPOSE AND HYPOTHESIS Problem • About 50% of patients are estimated to be non-adherent with taking their medications as prescribed (Eliasson et al, 2020). • Medication non-adherence in psychiatric mental health patients leads to a lower quality of life, shortened lives and higher health care costs. Background • The project site is a new out-patient psychiatric care group established in January 2022, which offers a parttime or intensive, out-patient hospitalization program, and a variety of outpatient programs for many mental health needs across the lifespan from children to adults. • The National Council for Mental Wellbeing has a toolkit of evidence-based practices for health facilities on this topic and emphasizes specialized training of providers in this complex problem (NC, 2021). • A protocol can be developed with a plan for provider and client psycho-education, to understand its importance, enhance the therapeutic relationship, assessment skills, and learn new tools, and strategies to help clients identify and overcome their individual barriers to medication adherence. METHODS RESULTS Pre and Post Quiz Data • A Paired Samples T-test was performed to test if there was a significant difference in pre and post scores. • . The p-value of .009 being below the commonly used alpha level of .05, indicates that the difference in pre and post quiz scores is statistically significant. • As well, the p-value suggests that there is less than a 1% probability that the observed difference in quiz scores occurred by chance alone. Chi –Square Test • Five random charts per participant was audited weekly for 3 criteria: Medication Adherence Assessment, Barriers and interventions, and patient education on medication adherence or their personal medications. Charting 2/3 was deemed compliant. • The chart data was tabulated, analyzed and interpreted using a crosstabulation table and Chi-square Test to see a detailed view of compliance distribution across staff members and weeks to determine if there was a significant statistical pattern in compliance levels. • The Chi-square test results showed no significant association between the observed data and the expected data. • The lack of significant Chi-square test results suggested that the difference between the observed data and expected data are likely due to random variation rather the meaningful associations or trends, and one cannot draw definitive conclusions. CONCLUSIONS BIBLIOGRAPHY Eliasson L., Clifford S., Mulick A., Jackson C., Vrijens B. (2020). How the EMERGE guideline on medication adherence can improve the quality of clinical trials. Br J Clin Pharmacol. (4): 687-697. doi: 10.1111/bcp.14240. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7098872/ NC. (2021).. Organizational toolkit on medication adherence. National Council for Mental Wellbeing. U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services. Organization on Medication Adherence - National Council.. https://www.thenationalcouncil.org/resources/medication-adherence-toolkit-2/ • A significant finding was an increase in knowledge on the subject including the statistics regarding medication adherence, techniques for improving patient rapport (motivational interviewing), assessment methods (MARS tool), and techniques and for overcoming barriers. • This was seen in the improved post-quiz scores and in the final debriefing survey. School of Nursing 874 American Pacific Drive ∙Henderson, NV∙89014 702.777.1746 Website: http://tun.touro.edu PROJECT AIM/ PURPOSE • To facilitate a quality improvement in medication adherence in a psychiatric out-patient center by introducing an evidence-based protocol and education for the mental health practitioners. . • Staff education. A paired t-test (option A) was utilized. • This will tabulate the pre and post questionnaires’ coded data. • There is an assumption that there will be an improvement in scores Objective 1 Staff Education • Chart documentation. AChi Square test was used to measure compliance/non-compliance (option B). • Gathered from random hart reviews, with two of the three criteria required for compliance. • The three criteria included • 1) Assessment of medication adherence or use of MARS tool, • 2) Assessment of barriers, and • 3) Patient education: on medications or importance of compliance. Objective 2 Chart Documentation • Qualitative analysis. • Focus group survey/ debrief

Woodside, T. L. (2023). Project Repository Details – Doctors of Nursing Practice, Inc. And the DNP Online Community. https://www.doctorsofnursingpractice.org/project-repository-details/
No Show Appointments: Challenge throughout healthcare system (Briatore et al., 2019) Results in deteriorated health outcomes (Wolff et al., 2019) Impacts patients, providers, & practices (Lance et al., 2021) No Show = No advance notice of intention not to attend appointment Cancellation = advance notice given of intention not to attend appointment (Marbouh et al., 2020) National no show rates are highly variable: 5% - 55% (Penzias et al., 2019). InProblem Description In a primary care practice, how do live telephone appointment reminders compared to current practice affect no show rates over a six-week time period? Population: Primary care practice Intervention: Live telephone appointment reminders Comparison: Current practice Outcomes: No show rates Time: a six-week time period PICOT Question • Patients who answered the live telephone appointment reminder and confirmed their appointment were more likely to attend their appointment • No show rate for the overall practice and nurse practitioner decreased during the one full month of the intervention Interpretation Dissemination Plan • Begin at practice level • Define workflow • Develop training module • Provide script • Expand calling responsibility beyond nurse • Clinical and operational leadership meet monthly Implications for Nursing Practice • Potential to create and increase patient access to appointments • Preventative protocols cannot be initiated in patients who do not attend appointments (Lance et al., 2021) • Partnerships and therapeutic relationships are formed between patient and provider with appointment attendance (AACN, 2006) References/Contacts No Show Appointment Impact on Patients: • Deteriorated Health Outcomes (Wolff et al., 2019) • Increased likelihood of hospitalization • Patients seeking acute care for non-acute needs • Limits patient access to care (Lagman et al., 2021) • Extends appointment unavailability (Shahab & Meili, 2019) • Limits preventative protocols, resulting in uncontrolled chronic diseases (Lance et al., 2021) • Higher Mortality (Brown et al., 2020) • Low-income patients are at higher risk for: • No health insurance • No access to healthcare • Increased worse health outcomes (Boshers et al., 2021) No Show Appointment Impact on Staff: • Decreased quality of care provided (Marbouh et al., 2020) • Decreased productivity, efficiency & lost time (Fiori et al., 2020; Kumthekar & Johnson, 2018) • Squandering of physical and human resources (Lance et al., 2021) • Impact on cost & revenue (Dantas et al., 2018) • Est. financial loss per primary care consultation in U.S. = $274 (Lagman et al., 2021) • Live telephone appointment reminder shave lower no show rate than text messages or no reminders (Lance et al., 2021) • Timing of appointment reminder is important (Adams et al., 2019) • Calling 24 hours in advance is associated with lower no show rate (Lagman et al., 2021) • Forgetfullness = most common reason for no shows (Penzias et al., 2019) • Estimated annual gross revenue loss in U.S. = $84,000 - $380,000 (Lagman et al., 2021) • Estimated annual gross revenue loss in U.S. $84,000 - $380,000 (Lagman et al., 2021) • Gender not a strong predictor of patient no show behavior (Dantas et al., 2018) • Racial minorities at higher risk for no show behavior (Penzias et al., 2019) • 259 pts. called, 10 pts. excluded, total pts. = 249 • 58.8% (n = 134) answered phone when called • 60.8% (n = 115) who answered phone also attended appointment • Statistical significant correlation (p = .000) between pts. who answered the phone and attended appointment • Of pts. who answered phone: 49.9% confirmed, 3.2% rescheduled, 1.6% cancelled their appointment • 72.7% = female gender; 34.5% = age 59+ yrs.; 70.1% = Black/AA • No relationship between appointment attendance and age/gender • Higher show rates among White pts. than Black or African American Patient Telephone Answer & Appointment Attendance There is a strong correlation between patients who answer the live telephone appointment reminder calls and patients who attend their appointments. The practice and nurse practitioner experienced an overall decrease in no show attendance during the one full month of the intervention. Tara L. Woodside: <PRESIDIO_ANONYMIZED_EMAIL_ADDRESS> • Small sample size • Limited demographic details • Staffing • Budget constraints Location: urban primary care practice in a tertiary healthcare system in the Northeast Inclusion Criteria were patients who: 1. Were at least 18 years old 2. Had a 10-digit telephone number listed in chart Exclusion Criteria included patients who: 1. Under the age of 18 years 2. Were adults under guardianship 3. Were incarcerated 4. Had a preferred language other than English 5. Were unwilling to speak with the caller Process: 1. Access chosen nurse practitioner’s schedule daily 2. Call patients scheduled for any appointment type 24 hours in advance of scheduled appointment 3. Phone calls were made between the hours of 3pm-7pm 4. Caller used the secured phone application, Avaya One-X Communicator 5. Caller read from a pre-written script, approximately 10 seconds in length 6. Enter information into data log: 1. If patient confirmed, canceled, or rescheduled appointment 2. Demographic information: age, race, gender • 7/10/2022: Collaborative Institutional Training Initiative (CITI) in Human Subjects Research completed • 10/14/2022: Primary Care Practice leadership permission received • 11/4/2022: Organization’s Institutional Review Board (IRB) permission received • 11/21/2022: Human Subjects Review Committee approval from Wilmington University received Pender’s Health Promotion Model (HPM) 1. Personal Characteristics & Behaviors • Patients are unique and shaped by their individual environment (Aqtam & Darawwad, 2018) • The practice must know how to effectively reach their patients. 2. Assessment of Health Promoting Behavior • Interdisciplinary collaboration and communication should exist between nursing and operations 3. Behavioral Outcome: • Did patients attend their scheduled appointments? • Is there a correlation between no show rate and intervention? Evaluate no show rates at primary care practice Perform an evidence-based intervention Evaluate impac/ t of intervention on the no show rate Theoretical Framework Process Specific Aims Available Knowledg