Medicine and Health Sciences Commons^™

An Educational Intervention On Provider Knowledge Of Hypertension Guidelines And Home Blood Pressure Monitoring, Alison Claire Oesterritter

DNP Projects

Background: While hypertension is the leading preventable risk factor for cardiovascular disease, disease control remains suboptimal. In the U.S., 47% of adults have hypertension, but only 25% are controlled. Despite having quality evidence-based guidelines, many recommendations are not implemented due to clinical inertia, or the tendency to not change therapy when targets aren’t met. Research has shown that this can be overcome with educational programs. Purpose: To provide training on hypertension guidelines and home blood pressure monitoring (HBPM) to overcome clinical inertia and improve patient outcomes related to hypertension. Methods: The project was a quasi-experimental, pre- and post- …

Strategies To Reduce Chronic Disease: Adding Role To Community Health Workers, Ingrid J. Renwanz Dnp, Pmhfnp-Bc/Aprn, Msn, Rnc

Doctor of Nursing Practice (DNP) Projects

Background: Underserved, rural, immigrant, low-income Latinx communities need to strengthen healthcare access to improve their quality of life (Capitman et al., 2009; McCartney et al., 2019; Save the Children [STC] Organization, 2021). Non-communicable chronic disease of physical and behavioral origin is the leading cause of morbidity for adults and children in Latinx communities (Campbell et al., 2020). Estimates of greater than 30% of the Latinx populations within the United States have these health needs, with projections to reach 28% of the U.S. population by 2060 (Eghaneyan & Murphy, 2019; Ortega et al., 2018).

Local Problem: If poor access to preventive …

Implementation Of A Self-Care Management Program Utilizing Telehealth In Adults With Hypertension, Diann Schmitt

Doctor of Nursing Practice (DNP) Manuscripts

Hypertension (HTN) can lead to heart disease which is the leading cause of death in the United States for men, women, and most racial and ethnic groups. Evidence-based practice supports early recognition of available self-care management (SCM) modalities to impact hypertension improvement and medication adherence. Best practices for heart disease prevention and management include lifestyle modification, reducing out-of-pocket costs, self-management support and education, and self-measured blood pressure monitoring. Successful evidence-based approaches within literature have addressed the modalities and successful outcomes.

The Plan-Do-Study-Act (PDSA) is a quality standard of The Institute of Health Improvement (IHI) was used to conduct this project …

Remote Blood Pressure Monitoring Program: Program Evaluation., Brittany Walker

Doctor of Nursing Practice Papers

The prevalence of hypertension is high at the local, state, and national levels. In 2021, 39% of Kentucky adults were diagnosed with high blood pressure (CDC, 2021). Primary care providers are utilizing remote blood pressure monitoring (RBPM) to assist with the management of hypertension. Literature reveals that remote BP monitoring alone, without the use of other interventions such as counseling and education, may not effectively control blood pressure (Uhlig K, et al, 2013). This project evaluated the RBPM program utilized at a federally qualified health center in Louisville, KY. Patient engagement within the RBPM program includes BP measurement, communication with …

Hypertension: Care Management Program And Medication Adherence, Courtney Montgomery

Student Scholarly Projects

Practice Problem: Medication adherence is a major concern in healthcare as it is a contributing factor to uncontrolled hypertension and resistant hypertension. Uncontrolled hypertension can lead to strokes, heart attacks, kidney failure, and even death.

PICOT: The PICOT question that guided this project was in Medicare Advantage members with hypertension located in Kansas, who were admitted to the hospital or emergency room identified by stratification (P), does care management utilization using hypertension clinical guidelines (I), compared to the stand-alone hypertension clinical practice guideline (C), improve medication adherence (O) over 10 weeks (T)?

Evidence: Hypertension is one of the leading preventable …

Hypertension Education To Enhance Health Literacy, Kylee Westrip

Student Scholarly Projects

Practice Problem: The health of patients suffers greatly when their health literacy is not addressed through evidence-based education material.

PICOT: The PICOT question that guided this project was, in adult patients with hypertension (P), how does evidence-based education material (I) compared to the current state of verbal instructions provided (C) affect health literacy rates based on the high blood pressure health literacy scale (O) within 12-weeks (T)?

Evidence: The literature evidence revealed three strong themes, which included information on who is most at risk for low health literacy levels, education delivery methods, and specific education to be used.

Intervention: …

Faith And Information To Treat Hypertension, Tiffany Bell

Student Scholarly Projects

Practice Problem: The prevalence of stroke and hypertension (HTN) in African Americans in the United States is among the highest in the world (American Heart Association, n.d.) with cultural norms as a contributing factor.

PICOT: The PICOT question that guided this project was in African American adults (>18 y/o) (P), how does a faith-based hypertension management program (I), compared to standard hypertension management (C), affect blood pressure measurements (O) within an 8-week timeframe (T)?

Evidence: The integration of motivational interviewing with therapeutic lifestyle changes along with HTN education using a community-based participatory approach delivered in the …

Physical Exercise As A Lifestyle Modification To Lower Blood Pressure In Hypertensive Females With A Body Mass Index Greater Than 25, Kacee Pee

Doctor of Nursing Practice Projects

Background: Hypertension affects many Americans nationwide and, if untreated, can cause heart attack, stroke, and chronic kidney disease. Hypertension (HTN) accounts for about 1 in 5 deaths of U.S. women and is a greater burden for women than men (Wenger et al., 2018). Women who are overweight increase their risk of developing hypertension. Lifestyle modifications, such as diet and exercise, are the first-line treatment for hypertension. Physical exercise is a crucial component of lifestyle therapy for the primary prevention and treatment of hypertension. Several studies consistently demonstrate the beneficial effects of exercise on hypertension, with reductions in both systolic and …

Implementation Of The American Diabetes Association Pharmacological Approach For Adults With Type 2 Diabetes Mellitus With Cardiovascular Disease, Jose Cedillo

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice project is to improve the utilization of the 2022 ADA pharmacological approach for individuals with Type 2 Diabetic Mellitus (T2DM). The project implementation site was an outpatient clinic in Southern California with a large T2DM Hispanic population. The new ADA guidelines recommend selecting a glucagon-like peptide 1(GLP-1RA) and/or sodium-glucose cotransporter two inhibitors (SGLT-2) when clinically appropriate to reduce the risk of major cardiovascular events in T2DM patients.

Background: According to the American Diabetes Association, ASCVD is the leading cause of morbidity and mortality for adult individuals with T2DM. The use of …

Improve Hypertensive Patients’ Compliance Postgraduation From The Virtual Care Team Program, Marcie Santillan

Doctor of Nursing Practice Final Manuscripts

Background: Virtual Care Team (VCT) began their program approximately 15 months ago to assist their most vulnerable patients with chronic and uncontrolled conditions such as hypertension, diabetes mellitus, and nicotine use disorder. The program follows the patients for a year to help them manage their chronic conditions and comply with chronic management. When the Virtual Care Team followed up a few months after the graduation with some recent graduates, it was found that a small number of patients returned to their pre-Virtual Care Team habits.

EBP Purpose: The purpose of the project is to follow up on those …

Hypertension, Bethany Stemen

Masters Theses/Capstone Projects

Hypertension is dangerous and known as the silent killer. It can be managed with proper healthy life choices.

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …

Staff Education: Improving Hypertension Management Among African American Adults, Marie Survie Tunis-Blanc

Walden Dissertations and Doctoral Studies

AbstractHypertension (HTN) is a frequent diagnosis in primary care settings and is disproportionately higher among African Americans. Observed in the clinic were frequent office visits by patients with uncontrolled blood pressure and nonadherence to medication in an outpatient cardiology clinic in Northeast New Jersey. Also, a knowledge gap was noticed among clinical staff on current HTN guidelines. An awareness of evidence-based guidelines was necessary to combat poorly controlled BP in the clinic. The purpose of this Doctor of Nursing Practice project was to create an education program on current HTN guidelines to bridge the knowledge gap among clinic staff. The …

Nurse Education Regarding Hypertension And Use Of A Follow-Up Call Protocol In Primary Care, Edwin Omar Rivera-Figueroa

Walden Dissertations and Doctoral Studies

AbstractMany patients whose primary or secondary chronic condition is hypertension present to their first follow-up appointment in a primary care facility in the north of Puerto Rico with uncontrolled high blood pressure. Nurses’ knowledge of hypertension is vital to addressing a gap in practice for this patient population and patient quality of life and the prevention of cardiovascular diseases. The practice-focused question guiding this project focused on a nurse educational session for increasing hypertension management knowledge as well as a follow-up phone call protocol that aimed to improve patient care. The theoretical framework guiding this project was Pender’s health promotion …

The Impact Of A Blood Pressure Reduction Program In Optimizing Control Of Hypertension Amongst Adult Females In An Outpatient Ambulatory Clinic, Brooke Englert

DNP Projects

Background: Hypertension (HTN) is a public health problem that, when well-controlled, can significantly reduce the risk of stroke, coronary heart disease, heart failure and death. Effective patient-provider communication strongly incentivizes an improvement in medical outcomes. Communication with patients can often be effectively delegated to other clinical staff, such as registered nurses (RNs) or clinical service technicians (CSTs) (Tavakoly Sany, Behzhad, Ferns & Peyman, 2020).

Purpose: Given the increased risk of all-cause and cardiovascular disease mortality of uncontrolled HTN, the purpose of this study was to implement and evaluate a standardized, evidence-based practice intervention via communication between APRN providers and patients …

A Systematic Review: Relationship Between Medication Adherence And Hypertension, Monica Chan

Master's Projects

Chronic diseases are defined as conditions that are present for over one year and limit activities of daily living or require ongoing medical attention. Heart disease is the number one leading chronic disease in the United States, making up one third of all deaths. In turn it costs the health system $216 billion per year (Center for Disease Control and Prevention, 2023). Uncontrolled blood pressure is a key risk factor for heart disease and stroke. 1 in 2 adults will need to take prescription medication to control blood pressure and lower the risk of having a cardiovascular event. This systematic …

Objective Structured Clinical Examination For Intraoperative Hypotension And Hypertension Management, Andrew Mcginity, James David Ingram

Doctoral Projects

Managing intraoperative hypotension and hypertension is a non-technical skill anesthesia providers need to maintain patient safety. Upon transitioning from didactic training to clinical training, SRNAs may find it difficult to manage a patient’s blood pressure intraoperatively. The ultimate consequence of the delayed or improper treatment of intraoperative blood pressure perturbations is end-organ damage at the patient’s expense. Unintentionally causing a patient harm will lead to an SRNA losing confidence in their abilities. This OSCE is intended to increase SRNA confidence and competence regarding intraoperative hypotension and hypertension management before entering the clinical arena.

The hypotension and hypertension management tools and …

Patient Care Management Of Hypertension Through Improving Follow-Up And Reducing Missed Appointments In A Primary Care Clinic: A Qi Project, Victoria Idubor

Doctor of Nursing Practice

Background. Missed follow-up appointments constitute significant problems clinics and health centers face nationwide. A significant portion of primary care providers’ patients will require follow-up appointments to manage their chronic illnesses. About 20 to 40% of patients seen at this clinic have a history of hypertension. Uncontrolled hypertension has been shown to increase the risk of certain cardiovascular disease events and mortality. Follow-up appointments are crucial for patients with hypertension to monitor for more life-threatening signs and manage their overall care. Purpose. The purpose of this project is to improve the timely management of care for patients with hypertension …

Hypertension-A Global Epidemic, Marie Tanyi

Nursing Student Class Projects (Formerly MSN)

Hypertension is a major cause of premature death and a leading cause of cardiovascular diseases globally. Heart diseases, renal failure, stroke, premature deaths, and disability mostly if not all contribute to the cardiovascular burden and thus pose a public health issue worldwide. The trends in hypertension are similar globally with a high prevalence noted in low and medium-income countries. Studies have identified smoking, unhealthy diet, physical inactivity, alcohol consumption, overweight or obesity, and sedentary lifestyle as modifiable risk factors in these populations. However, hypertension remains a substantial public health concern despite providers’ engagement in multi-component hypertension treatment and patient involvement …

Bridging The Gap: Improving Hypertension In African American Women And Preventing Cardiovascular Disease, Latoshia Danielle Williams

Doctor of Nursing Practice Scholarly Projects

Problem Statement: There is a disproportionate number of African American women (AAW) diagnosed with hypertension (HTN) with modifiable health and behavior risk factors that contribute to cardiovascular disease (CVD). Purpose: The purpose of this DNP project was aimed at evaluating if a 12-week educational program using Life Simple 7 guidelines from the American Heart Association (AHA) within a primary care facility for adults diagnosed with hypertension and who are overweight would reduce blood pressure, body mass index, and increase knowledge regarding hypertension. Methods: A pretest and posttest intervention design was utilized to determine the outcomes of this study. The setting …

Hypertension Management In Primary Care Using Target:Bp; Meeting Patient Goals And Quality Measures, Hollie Yoder

Doctor of Nursing Practice Projects

Hypertensive disease is a global problem impacting millions of individuals aged 18 years and above. Uncontrolled hypertension management can lead to significant complications and death . Primary care providers are challenged to improve patient outcomes in patients with hypertensive disease while complying with clinical quality measures for high blood pressure as outlined by the Center for Medicare and Medicaid Services Merit-based Incentive Payment System (MIP) performance measures. The purpose of this project was to improve high blood pressure in patients diagnosed with primary hypertension utilizing the American Heart Association (AHA) and the American Medical Association (AMA) Target: Blood Pressure (BP) …

Walking Is Worthy: Walking For Hypertension, Ashleigh Y. Peterson

Evidence-Based Practice Project Reports

Elevated blood pressure (BP), or hypertension (HTN), can cause a cascade of detrimental effects to the body. It is associated with increased risk of stroke, angina, myocardial infarction, heart failure, peripheral artery disease, end-stage renal disease, and abdominal aortic aneurysms (Whelton et al., 2018). HTN is also a major risk factor for the development of cardiovascular disease (CVD), which is the United States’ (U.S.) leading cause of death in men and women (U.S. Preventive Services Task Force [USPSTF], 2020). The PICOT question for this project was: does an eight-week (T) structured walking program utilizing a smartwatch for step counts and …

Thiazide-Like Diuretics As First-Line Treatment To Improve Blood Pressure Management, Raquel Okubo

Cohort X

Background: Thiazide diuretics are currently the first-line treatment for hypertension (HTN). This class of drugs includes hydrochlorothiazide (HCTZ) and the thiazide-like diuretic, chlorthalidone (CTDN). The quality improvement project began in the fall semester with a 10- day reflective practice log to assess my current practice. A review of the clinical practice log allowed me to evaluate my current practice and identify three opportunities to improve my practice. I developed three potential PICOT questions and selected one for the QI project with the guidance of my Doctor of Nursing Practice (DNP) chairperson. I performed a literature review to gather the best …

Benefits Of Fasting In Adults Long Term, Talea Jones

Nursing | Senior Theses

In nursing education, we are often taught that through diet, exercise and medications one is able to live a healthy life. Fasting is not a subject that readily comes to mind as a way to prevent chronic illnesses from occurring. However, for years, cultures have used fasting as a way to replenish themselves and to clean themselves as if they were new beings. Nursing education does not highlight the process of fasting in any way close to the extent that medications are prescribed to control illnesses.

There are many types of fasting that are used in the United States. Fasting …

Healthcare Screenings In The Occupational And Workplace Setting: Taking Control Over Blood Pressure, Darryl W. Horton

UNLV Theses, Dissertations, Professional Papers, and Capstones

Undiagnosed hypertension continues to be a growing concern worldwide leading to cardiovascular disease and other chronic illnesses and can contribute to death. The prevalence of hypertension continues to increase even with guidelines on screening, hypertension education, disease prevention, disease maintenance, and management. The purpose of this project was to determine if the implementation of a workplace blood pressure screening program would improve hypertension knowledge and reduce the burden of hypertension within workplace. A descriptive, cross-sectional design using convenience sampling was conducted. Participants were screened by measuring blood pressures, and the Hypertension Evaluation of Lifestyle Management scale (HELM) was utilized to …

Action Planning With Self-Monitoring Blood Pressure Improves Blood Pressure Control In Geriatric Patients, Thuy Ai Oh

Student Scholarly Projects

Practice Problem: Uncontrolled hypertension is a global healthcare problem. Hypertension is controlled in fewer than 1 in 5 people and has been attributed to premature deaths (WHO, 2021).

PICOT: The PICOT question that guided this project was “In patients 65 years of age and older with uncontrolled blood pressure, how does a nurse-led blood pressure control program compared to standard of care improve blood pressure control at an outpatient clinic over 8 weeks?”

Evidence: Five studies provided evidence that a nurse-led blood pressure decreased blood pressure results. The evidence supported the practice change of implementing a nurse-led …

Utilizing Motivational Interviewing Intervention To Improve Compliance With Self-Care Among Hispanic Adults With Obesity, Type 2 Diabetes Mellitus, And Hypertension, Mariagorety O. Nwiloh

Cohort X

Obesity, hypertension, and type 2 diabetes mellitus (type 2 DM) have continued to plague the healthcare system and the economy of the United States of America. They are most common among African Americans and Hispanic Americans. The objective of this quality improvement project was to improve compliance to self-care regarding self-monitoring of blood glucose, blood pressure, and exercise to achieve target fasting blood glucose (FBG) ≤ 120 mg/dL, blood pressure (BP) ≤ 130/80mm Hg and a weight loss of ≥5 pounds among adult Hispanics aged 18- 65 years old. A weekly motivational interviewing (MI) session was conducted for 6 weeks …

Improving Knowledge And Competency Of Self-Monitored Blood Pressure In Older Adults, Edna Koh Hwa Tang, Melanie Keiffer Dnp, Aprn, Anp-Bc, Cne

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background. The risk for developing uncontrolled hypertension increases with age. Hypertension remains under-controlled and underdiagnosed in rural areas. This trend is exacerbated by the COVID-19 pandemic due to decreases in primary care visits, increases in telehealth visits, and a significant decline in assessment of blood pressure. Evidence reveals that telemedicine in conjunction with self-monitored blood pressure (SMBP) are proven tools to support patients and providers in the remote management of hypertension.

Purpose. This project aimed to improve utilization of self-monitored blood pressure (SMBP) for management of hypertension in older adults (65 years and older) and accuracy of self-reported …

Improving Medication Adherence For African American Patients With Hypertension, Kimberly Fitzgerald

Walden Dissertations and Doctoral Studies

Adherence to antihypertensive medications is essential for positive outcomes in treating hypertension (HTN). But the rate of nonadherence to antihypertensive medications among African Americans (AA) is low. The purpose of this DNP project was to develop a clinical practice guideline (CPG) that would assist in improving hypertensive medication adherence in the AA patient population as well as assess whether the CPG would be recommended by a team of content experts for use in their practice. The Hypertension Medication Adherence CPG incorporated the medication adherence model and the transtheoretical model to generate evidence-based interventions. Grading of Recommendations Assessment, Development, and Evaluation …

Thinking Inside The Food Pantry Box, Elizabeth Shoaf

Doctor of Nursing Practice Projects

Background: Prior research has indicated a varying relationship between food security and obesity risk. Food insecurity is a known complication of men and women’s underlying health issues, such as hypertension and diabetes, because of altered food choices.

Objective: Provide healthier food options to the food insecure within the facility’s food distribution boxes, as available, for the two most common health issues (diabetes and high blood pressure).

Methods: Clients at a local food pantry were interviewed individually to learn more about food insecurity and complicating health issues, such as obesity, diabetes, and high blood pressure (hypertension) while simultaneously offering alternative food …