Date Available

5-3-2024

Year of Publication

2024

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julianne Ossege

Clinical Mentor

Dr. Angela Grubbs

Committee Member

Dr. Julianne Ewen

Abstract

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- survey design combined with a quality improvement process. A chart review was performed to determine hypertension control in 2022. A pre-survey of knowledge of latest guidelines and HBPM was given, followed by education and a post-survey. An HBPM handout was then implemented in practice. Finally, two Plan-Do-Study-Act (PDSA) cycles were conducted to seek provider feedback on the guideline and handout, and tools were provided to help improve utilization. Results: The number of adults with controlled HTN was previously suboptimal at 15.38%. There was an increase in knowledge scores from pre- to post-survey, although not statistically significant. A chart review performed 60 days post intervention showed 21.0% BP control, showing a 73.3% improvement post intervention. Conclusions: While the increase in knowledge scores was not statistically significant, BP control improved post intervention. Implementing the HBPM handout was both simple and cost-effective, highlighting its effectiveness in improving patient outcomes and potential value in sustaining practice change.

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