Year of Publication

2014

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Lynne A Jensen

Clinical Mentor

Dr. Martha Biddle

Committee Member

Dr. Nancy R Kloha

Abstract

Purpose: To evaluate provider adherence to JNC 7 by assessing documentation of blood pressure control and interventions in the absence of control in order to assist providers in reaching Healthy People 2020 goal of blood pressure control.

Methods: A retrospective chart review was conducted for patients with essential hypertension. Data collected included blood pressure, use of a home blood pressure log, documentation of blood pressure medication compliance, and provider interventions in the absence of blood pressure control across three visits. A provider survey regarding provider barriers to blood pressure control was also completed.

Results: All surveyed providers were aware and in agreement with JNC 7 blood pressure goals and hypertension management plans. Providers also felt greater than 50% of their patients were considered to have blood pressure control. The medical record review demonstrated blood pressure control in 24% of patients across all three visits, with greater control in patients older than 65 years as compared to 18-65 year olds. Providers failed to document interventions in 18.2% to 20% of patients in the absence of blood pressure control.

Conclusion: Providers overestimate the presence of blood pressure control in their patients, as well as fail to make management changes in the absence of blood pressure control, indicating clinical inertia. Creating awareness of performance in blood pressure control and educating providers on the importance of documenting interventions is essential in working towards meeting blood pressure control goals.

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