Year of Publication

2015

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sharon Lock

Clinical Mentor

Dr. Kevin T. Scully

Committee Member

Dr. Nancy Kloha

Abstract

Approximately 1 in 3 adults In the United States (U. S.) with approximately half being women have hypertension, a significant risk factor for cardiovascular disease (CVD) and stroke (Nwankwo, Yoon, Burt, & Gu, 2013). Nearly 70% of people who had a first heart attack, 80% of those who had a first stroke, and 75% of those who had congestive heart failure (CHF) have hypertension (Mozaffarian et al., 2013). Hypertension was the underlying or contributing cause of more than 375,000 deaths in 2011. Despite multiple publications of national hypertension guidelines, only 50% of adults with hypertension have their blood pressure under control (Nwankwo et al., 2013). One possible explanation for such a high rate of uncontrolled blood pressure is providers may not be adhering to hypertension guidelines.

This capstone report is comprised of three manuscripts that focus on providers and their adherence to hypertension guidelines for women. The first manuscript presents a literature review pertaining to providers and their adherence to hypertension guidelines while discussing factors that affect their adherence such as patient age, gender, and comorbidities. The second manuscript presents an analysis of the 2014 Evidence-Based Practice Guideline for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee (JNC 8), using an adapted version of the Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument (2001). The content used to compile the first two manuscripts led to a descriptive study, which examined providers and their adherence to the 2014 JNC 8 evidence-based practice guideline primarily in women at a primary care university clinic. The third and final manuscript consists of the details of this study, and presents some practical implications for improving provider adherence to these evidence-based guidelines.

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