In 2019, there were about seventy-million Americans with uncontrolled high blood pressure (BP) or hypertension (HTN) (Kitt, Fox, Tucker & McManus, 2019). Hypertension is the leading cause of preventable deaths worldwide (Stephen, Halcomb, McInnes, Batterham & Zwar, 2019). Uncontrolled HTN contributes to stroke, myocardial infarction, and renal failure, and is the most modifiable risk factor for heart disease and death (American Academy of Family Physicians [AAFP], 2019; Oparil & Schmider, 2015). Patients living in rural America have an increased prevalence of HTN and their access to preventative health services is lower (Buford, 2016; Caldwell, Ford, Wallace, Wang & Takahashi, 2016). The increased prevalence of HTN in rural communities does not positively correlate with optimized blood pressure control, which poses a gap in care (Buford, 2016). A multidisciplinary collaboration between registered nurses (RNs) and providers may improve patient outcomes (Ford et al., 2018). The implementation of a collaborative HTN Clinic in a rural setting had the potential to improve BP outcomes by increasing access to services.
The practice improvement project established a HTN Clinic as a collaborative effort between RNs and providers in a rural community. Providers and RNs were educated via modules regarding the protocol and participants took surveys before and after implementation to determine effectiveness and if the HTN Clinic should continue after conclusion of the practice improvement project. The HTN Clinic intervention implemented education for hypertensive patients with an emphasis on medication compliance and lifestyle modifications, as well as medication adjustments through nurse-led protocols.
Despite a short duration of implementation and evaluation, positive results were observed. All HTN Clinic patients had improvement in BP measures and were controlled by the end of the four-week implementation period. Overall, patient access, wait times for appointments, and BP measures for all hypertensive patients improved after implementation. The providers’ and nurses’ knowledge increased through completion of a detailed curriculum. The provider and RN surveys indicated support for continuing the HTN Clinic to improve HTN management and clinic providers felt that the HTN Clinic helped improve their time with patients and quality metrics.
| Identifer | oai:union.ndltd.org:ndsu.edu/oai:library.ndsu.edu:10365/31879 |
| Date | January 2020 |
| Creators | Pink, Nicole Catherine |
| Publisher | North Dakota State University |
| Source Sets | North Dakota State University |
| Detected Language | English |
| Type | text/dissertation |
| Format | application/pdf |
| Rights | NDSU policy 190.6.2, https://www.ndsu.edu/fileadmin/policy/190.pdf |
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