Date Available

5-1-2025

Year of Publication

2025

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

College

Nursing

Department/School/Program

Nursing

Faculty

Dr. Julianne Ossege Ph.D, FNP-BC, FNAP, FAANP

Committee Member

Dr. Lori Fugate, DNP, WHNP-BC, FNP-BC, PMHNP-BC

Faculty

Dr. Elizabeth Tovar Ph.D, APRN, FNP-C, PMHNP0-BCH

Abstract

Abstract

Background: Approximately 1.28 billion adults worldwide have hypertension (HTN), which greatly increases the risk of morbidity and premature death. Home blood pressure monitoring (HBPM) has been shown to increase efficacy of treatment decisions, but is underused in primary care. About 46% of adults are unaware that they have hypertension and only about 21% of those who have been diagnosed have it controlled.

Purpose: The purpose of this project is to evaluate a previous practice improvement project and improve the HBPM process for sustainability.

Methods This HBPM study utilized a retrospective study design combined with a practice improvement project to strengthen the evidence and provide insight for future usage of the two-week HBPM handout. The setting was UK Phyllis D. Corbitt Clinic as this clinic provides primary care for the local Wilmore Community. The PI piloted the HBPM process by identifying adults with a blood pressure >130/80, have a home blood pressure cuff, and provided them with a HBPM handout to be completed and returned in two weeks. The PI utilized UK Center for Clinical and Translational Science (CCTS) to provide the MRNs of 100 patients with a BP >130/80 before and 74 patients after education was completed with the APRNs of Wilmore at a staff meeting to evaluate the usage of smart phrase “.homebpinstructions”, CPT codes, and demographic data.

Results: Education for the APRNs and use of the HBPM smart phrase “.homebpinstructions” resulted in a decrease of 3.63mmHg in the systolic blood pressure after education and a decrease of 2.19mmHg in the diastolic blood pressure. The smart phrase “.homebpinstructions” and CPT codes 99473 and 99474 were underutilized, however the smart phrase usage that included the HBPM handout was increased by 12.2 %. Due to the lack of patients in the HBPM (n=2) quality improvement portion of this project, analysis of this data was not possible.

Conclusion: This DNP project demonstrates the use of provider and patient education for improvement of blood pressure control as well as usage of HBPM. The HBPM handout and smart phrase can be easily disseminated to further clinics and healthcare systems who use EPIC as an EHR. Providers should be aware of the current guidelines from AHA for diagnosis and treatment of hypertension to improve patient outcomes and prevent stroke and heart disease in these patients. Furthermore, future research is needed to focus on eliminating barriers to returning the HBPM handout and improve compliance with HBPM.

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