Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Nora Warshawsky

Clinical Mentor

Dr. Shannon Smith-Stephens

Committee Member

Dr. Peggy El-Mallakh

Abstract

Purpose: To evaluate provider adherence to a clinical guideline for management of hypertension, and to assess improvement in quality of management of student patients with hypertension in a university student clinic.

Methods: A retrospective chart review was conducted to identify student patients with hypertension. Data collected included the demographics of the sample patients, blood pressures, LDL results, weights, and evidence of provider compliance with guidelines.

Results: Of the 13 patient charts audited, providers recommended exercise to 46.15% of patients, weight loss or maintenance to 53.85% of patients, no-added salt diets to 53.85% of patients, low fat to 23.08% of patients, fruits and vegetables to 23.08% of patients, and alcohol moderation to 15.38% of patients. There were no smokers in the sample. Measured outcomes were: LDLs ≤ 130 in 15.38% of patients, achievement of a 5% weight loss if BMI ≥ 25 in 7.69% of patients, weight maintenance if BMI < 25 in 15.38% of patients. A systolic BP of

Conclusion: Outcomes were mixed. Blood pressures improved in more than half of the patients, 7.69% met weight goals. LDLs were recommended for 61.54% of patients but were done in only 23.08% of patients. 61.54% of patients were treated with a preferred ACE1, 7.69% with ACE1/thiazide, 23.08% with a thiazide alone, 7.69% with no antihypertensive. Improvements were made in quality of hypertension management, but further improvement is needed.

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