Graduation Semester and Year

Spring 2024

Language

English

Document Type

Dissertation

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Dr. Cathy Brown, DNP, RN, AGPCNP-BC, CNS

Abstract

Abstract

Background: Hypertension (HTN) that is not adequately controlled leads to cardiovascular disease, stroke, and heart disease. It affects 116 million adults (47%) in the United States (U.S.). The HTN compliance rate in a South Texas public health clinic was 64%, below the national benchmark of 76%. Home blood pressure monitoring (HBPM) was recommended in a joint statement by the American Heart Association (AHA) and the American Medical Association (AMA). Literature evidence revealed that the HBPM bundle increased BP control (<140/90 mmHg) compliance.

Methods: A quality improvement (QI) bundle was initiated to address the low HTN compliance rate from a quality management perspective. The bundle consisted of HBPM, an antihypertension medication algorithm, lifestyle education, and a hypertension wallet card for patients to document their home blood pressure readings. Twenty participants, 15 females and 5 males, diagnosed with HTN received the HBPM bundle during the eight-week project. Two BP readings were collected pre-HBPM bundled, after eight weeks of intervention, two BP were taken post-HBPM bundles.

Results: Participants were 18 years and older with an average age of 54.6; the convenience sample comprised 75% females and 25% males, with the majority being African American (AA). The results showed that both pre-HBPM and post-HBPM bundle Systolic BP (SBP) and Diastolic BP (DBP) differences were significant with p values <.001 and <.027., respectively.

Conclusion: HBPM bundled significantly improved HTN adequately controlled <140/90 mm Hg for adult patients diagnosed with HTN in a public health center.

Keywords

adults, hypertension, uncontrolled BP, home HBPM, interventions, HTN wallet cards, vulnerable population, self-monitoring BP, and remote monitoring BP.

Disciplines

Cardiology | Cardiovascular Diseases | Community Health and Preventive Medicine | Family and Consumer Sciences | Family Medicine | Family Practice Nursing | Interprofessional Education | Nursing Administration | Other Pharmacy and Pharmaceutical Sciences | Preventive Medicine | Primary Care | Public Health and Community Nursing | Public Health Education and Promotion | Quality Improvement

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