Management of hypertension and its complications requires health care providers to understand the reason for developing the disease. Complications of hypertension (HTN) are more prevalent when patient interventions are not consistently performed by staff. A gap in staff knowledge regarding the management of patients with HTN was noted at an outpatient clinic in the southwestern United States. A staff education project based on the Eighth Joint National Committee (JNC-8) guidelines for HTN management was developed to address the gap in knowledge. This DNP project sought to understand the impact of an evidence-based staff education program in improving the knowledge of nursing staff on HTN management. The health belief model and social cognitive theory guided the project. Three expert panelists evaluated the education program content and agreed that the content was relevant to clinical practice and would improve staff knowledge regarding management of HTN. Eight nurses participated in the education program, first completing a pretest questionnaire followed by educational program content in digital format. Participants reviewed the program for 1 week followed by a PowerPoint presentation at a staff meeting. Posttest questionnaires were completed by 7 participants using a 5-point Likert scale ranging from completely unaware to completely aware. Posttest results indicated that nursing staff knowledge increased to completely aware (100%) of the JNC-8 guidelines for HTN management compared with completely unaware before the program. The project emphasizes the potential for positive social change when translating evidence to practice through staff education to improve patient management and outcomes for the treatment of HTN.

Racial disparities in cardiovascular disease (CVD) have become a matter of national concern. We investigated racial disparities and trends in glycosylated hemoglobin, high-density lipoprotein (HDL), C-reactive protein, plasma homocysteine, albuminuria, and other risk factors among 4758 diagnosed hypertensive subjects age 18 years or older from the National Health and Nutrition Examination Survey, 1999-2006. Compared with non-Hispanic whites, Hispanics, and non-Hispanic blacks were more likely to have uncontrolled blood pressure (BP) (Hispanics odds ratio [OR]: 1.58, 95% confidence interval [CI]: 1.21-2.07; blacks OR: 1.42, 95% CI: 0.21-1.67), elevated glycosylated hemoglobin (Hispanics OR: 2.70, 95% CI: 1.89-3.87; blacks OR: 2.17, 95% CI: 1.70-2.77), albuminuria (Hispanics OR: 2.36, 95% CI: 1.71-3.27; blacks OR: 1.80, 95% CI: 1.47-2.20), and less likely to have central obesity (Hispanics OR: 0.68, 95% CI: 0.51-0.91; blacks OR: 0.70, 95% CI: 0.58-0.84). Blacks had lower risks of elevated serum cholesterol (OR: 0.81, 95% CI: 0.67-0.98) and low HDL (OR: 0.76, 95% CI: 0.61-0.94) than whites. The risk of high serum homocysteine was lower in Hispanics and higher in blacks compared with whites (Hispanics OR: 0.64, 95% CI: 0.46-0.90; blacks OR: 1.36, 95% CI: 1.14-1.63). These results highlight the need for targeted interventions to aggressively treat uncontrolled BP, elevated glycosylated hemoglobin in Hispanic and black hypertensive subjects, and high serum homocysteine in blacks, to reduce disparities in CVD risk factors and CVD-associated morbidity and mortality.