Prevention of Hypertension at St. Luke's Hospital, Milwaukee, WI: A Comprehensive Approach

Prevention of Hypertension at St. Luke's Hospital, Milwaukee, WI: A Comprehensive Approach

Background information 

Hypertension, commonly known as high blood pressure, is a significant medical condition in which the force of blood pushing against your blood vessel walls is persistently excessive. Over time, this can clog your arteries, resulting in heart disease, strokes, renal failure, and other issues. Hypertension has high financial costs. According to CDC estimates, it costs the country between $131 and $198 billion a year. The expense of treating hypertension is high; in the United States alone, the projected cost of healthcare is more excellent than US$514 232.16, which translates to US$105.55 per person each month (Samanic, 2020). This startling figure includes not just the costs of treating hypertension but also the lost productivity as a result of premature death from linked diseases. The World Health Organization estimates that one in three persons worldwide suffers from hypertension, with rates becoming much higher in wealthy nations (Mills et al., 2020). According to Samanic, over 80 million persons in the United States are estimated to have hypertension by the Centers for Disease Control and Prevention (CDC). However, many are unaware of it because there are not many apparent signs (2020).

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Although the precise causes of primary hypertension are frequently unknown, risk factors for the condition include genetics, age, ethnicity, food, weight, and lifestyle choices, including smoking and binge drinking (Valenzuela et al., 2021). Kidney disease is one of the underlying diseases that can lead to secondary hypertension. Although there is no cure for hypertension, you can effectively control it and lower your risk of problems with medicine and healthy lifestyle choices. The consequences of hypertension are severe in the US. In terms of public health, it has a significant role in the nation's two biggest killers: heart disease and stroke. According to the Centers for Disease Control and Prevention (CDC), hypertension is either the primary cause of or a contributing factor in around 700,000 fatalities annually (Samanic, 2020). This results in a heavy load for physicians, hospitals, and the healthcare system overall.

Input of the problems 

A collaborative effort aimed at avoiding hypertension at St. Luke's Hospital has produced insightful Information from multiple stakeholders. Patients, families, nurses, nurse managers, clinical nurse specialists (CNSs), and doctors have all shared their opinions on the best ways to treat this condition through surveys, focus groups, and open discussions—the significance of a three-pronged approach: staff training, patient education, and regular communication. 

Positive comments about the present hypertension education program have been received from patients and their families. However, there is an apparent demand for more introductory and accessible instructional tools. Reaching a more extensive patient base can entail creating resources such as brochures and videos in multiple languages or formats. However, nursing staff has emphasized the need for more funding and better lines of communication. In order to make sure that nurses, CNSs, and doctors are all on the same page when handling specific situations, this may entail giving nurses access to the most recent recommendations and treatment regimens for hypertension. St. Luke's can enhance patient outcomes and fortify its entire strategy for preventing hypertension by addressing these issues

Process Flowchart 

To streamline the existing processes for hypertension prevention at St. Luke's Hospital, a flow diagram has been developed to visualize the various phases involved. The use of these three themed approaches, staff training, patient education, and regular communication, will be demonstrated, and their involvement in the prevention of hypertension will be discussed. In this process, stakeholders such as physicians, nurse educators, patients, families, and nursing staff are essential. Enhancing staff training, establishing education protocols, employing multimedia resources for patient education, maintaining documentation, and streamlining communication routes are all areas that need to be improved.

St. Luke's Hospital is promoting a team approach to the prevention of hypertension by obtaining feedback from patients, families, and other medical professionals. This criticism emphasizes the necessity for a comprehensive approach. In order to meet these objectives, healthcare professionals should improve each phase of the patient journey. A collection of teaching materials, such as movies, online courses, and translated pamphlets, can enhance patient comprehension and accommodate a variety of learning preferences. Healthcare practitioners will be able to monitor patient progress and adjust treatment programs with the use of standardized management plans that provide clear and uniform documentation. Patients will be empowered to actively participate in treating their hypertension through streamlined communication using secure messaging systems and open communication between staff and patients. This will guarantee that everyone is on the same page. St. Luke's can establish a robust system for controlling and preventing hypertension by putting these recommendations into practice, which will eventually enhance patient outcomes and the standard of care provided

Critique of Current Problem

There are areas for improvement in St. Luke's Hospital's present strategy for preventing hypertension. A significant concern is the need for uniformity in patient education materials and delivery strategies. Patients are given Information that varies in terms of quality, depth, and even language because of this inconsistency. Confusion and knowledge gaps may arise as a result, making it more difficult for them to recognize and control their risk of hypertension.

This lack of standardization also contributes to varying patient understanding. Patients are less likely to stick to long-term preventive treatments if they do not entirely understand the significance of medicine or lifestyle modifications. Inconsistent Information can also lead to inflated expectations for the management of hypertension and hinder patients' ability to take an active role in their care. 

More training for staff members would solve these problems. Staff members may exacerbate the issue of inconsistent patient understanding with differing degrees of expertise since they may present Information in different ways. St. Luke's can make a number of significant enhancements to solve these problems. First and foremost, it is essential to create a library of standardized teaching resources. To serve a varied patient group, these resources must be dependable, supported by research, and offered in a number of languages. Second, using interactive tools and multimedia materials can boost patient interest and enhance retention of Information. Standardized training programs are also necessary for all staff members who provide patient care. The most recent guidelines for hypertension, patient communication best practices, and cultural competency in health information delivery should all be covered in these seminars.

Literature review

High blood pressure, or hypertension, is a significant risk factor for stroke and heart disease. The good news is that changing one's lifestyle can dramatically lower one's chance of getting hypertension. Several studies have demonstrated that maintaining a healthy diet is essential for preventing hypertension. The DASH (Dietary Approaches to Stop Hypertension) dietary plan, which emphasizes fruits, vegetables, whole grains, and lean protein while reducing red meat, saturated fat, and sodium, has been the subject of research (Zhang et al., 2024). It has been demonstrated that this dietary strategy successfully lowers blood pressure in a number of populations (Mulyati et al., 2021). However, it should be noted that hypertension prevention is a difficult task, as indicated by the extensive study on the subject. 

A study by Gershman reveals a significant theme: patient education is critical in reducing the risk of hypertension (2020). His research demonstrates the efficacy of patient education-focused, evidence-based therapies. These evidence-based interventions prioritize patient education in three key areas: lifestyle modifications, where effective education gives patients the knowledge and skills to adopt healthy habits like a balanced diet, regular exercise, and weight management, all essential for preventing and managing hypertension. The recommended amount of physical activity for adults is at least 150 minutes of moderate-intensity exercise or 75 minutes of vigorous-intensity exercise per week (Palomo-Piñón et al., 2024). Risk assessments, which identify high-risk individuals for early intervention and preventative measures. Early detection of hypertension through education on recognizing risk factors and seeking timely medical attention.

The beneficial effects of standardized education on patient outcomes are further supported by research. According to Goh et al., a multifaceted strategy is necessary for the effective prevention of hypertension, and all patients are guaranteed to receive accurate and thorough Information thanks to standardized education programs and consistent, evidence-based materials (2023). Thorough evaluations enable medical practitioners to customize patient education and treatment regimens according to each patient's unique risk factors and medical background. Continuous staff training provides healthcare personnel with the most recent Information and best practices, while multidisciplinary teamwork promotes a cohesive approach to patient education and care (Teshome et al., 2022). Healthcare facilities can empower individuals to manage their hypertension risks and improve blood pressure control while lowering the risk of consequences by emphasizing patient education and putting these measures into practice.

Keeping a healthy weight is another critical consideration. Obesity and hypertension are strongly correlated, according to research consistently (Zhang et al., 2024). Nutritious food and regular exercise are essential components of weight control techniques that can significantly lower the risk of having high blood pressure.

Learning Objectives 

1. Remembering (knowledge): Explain the definition of hypertension and common risk factors.
2. Understanding (comprehension): Describe the physiological mechanisms underlying hypertension development.
3. Applying (application): Demonstrate techniques for blood pressure monitoring and lifestyle modifications to prevent hypertension.
4. Analyzing (analysis): Identify environmental and personal factors contributing to hypertension and evaluate current prevention strategies.
5. Evaluating (evaluation): Assess the effectiveness of hypertension prevention interventions and identify areas for improvement.

Principles of health literacy

High blood pressure, often known as hypertension, is a silent danger that raises the risk of stroke and heart disease. Fortunately, altering one's lifestyle can significantly lower the chance of getting it. However, for these adjustments to be successful, there needs to be open communication and patient comprehension. Here is when health literacy principles are helpful.

Making Information Accessible: Using language that is easy to grasp is emphasized in health literacy. Patients can feel more empowered by doctors' explanations of blood pressure values (both systolic and diastolic) and how they relate to hypertension. Furthermore, more straightforward explanations of medical concepts should be used in favor of more complicated ones, with the use of charts or diagrams. Additionally, patients ought to be prepared to locate reliable resources for advice on preventing hypertension. Providing resources such as government health websites or pamphlets from reliable health groups can enable people to take control of their health.

Knowledge for Action: Health literacy is more than knowledge comprehension. Using such knowledge to make well-informed judgments is the key. For example, it is insufficient to know that eating a healthy diet is necessary. Patients want helpful advice on eating healthfully, such as controlling portion sizes and identifying low-sodium foods by reading product labels. In a similar vein, elucidating the advantages of physical activity and offering recommendations for integrating it into everyday schedules can close the knowledge gap.

Empowerment Through Self-Management: The ability to control oneself is fostered by health literacy. Physicians can explain how stress management and weight control are healthy practices that help lower blood pressure. This gives people the confidence to alter their lifestyles for the better. Creating individualized strategies with attainable objectives and providing workshops or support groups might help people become even more empowered in their efforts to avoid hypertension. Healthcare professionals may enable people to take charge of their health and lower their risk of hypertension by adhering to these health literacy guidelines.

Measuring learning objectives

1. Remembering (knowledge): Pre- and post-tests assessing knowledge of hypertension and risk factors.
2. Understanding (comprehension): Patient accounts of hypertension-related health effects and self-care strategies.
3. Applying (application): Nurse observations of patient adherence to lifestyle modifications and blood pressure monitoring.
4. Analyzing (analysis): Patient self-assessment tools to identify risk factors and environmental influences on hypertension.
5. Evaluating (evaluation): Patient evaluations of their progress in hypertension prevention and areas for improvement.

To sum up, St. Luke's Hospital can effectively mitigate the risks associated with hypertension and improve patient outcomes by following evidence-based practices and integrating stakeholder input. The prevention of hypertension at the hospital necessitates a comprehensive approach that includes staff training, patient education, and ongoing quality improvement efforts.

References

Gershman, J. (2020). Pharmacists Play a Key Role in Treating Osteoporosis: Patient Education Is a Critical Component of Helping Patients Manage This Common Chronic Condition. Pharmacy Times, 86(11), 64-.  

Goh, P. R. Q., Ng, G. Y. J., Shorey, S., & Lim, S. (2023). Impacts of Standardized Patients as a Teaching Tool to Develop Communication Skills in Nursing Education: A Mixed-Studies Systematic Review. Clinical Simulation in Nursing, 84, 101464-. https://doi.org/10.1016/j.ecns.2023.101464 

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7998524/ 

Mulyati, A. H., Sulaeman, A., Marliyati, S. A., Rafi, M., & Fikri, A. M. (2021). Preclinical Trial of Propolis Extract in Prevention of High Salt Diet- Induced Hypertension. Pharmacognosy Journal, 13(1), 89–96. https://doi.org/10.5530/pj.2021.13.13 

Palomo-Piñón, S., Enciso-Muñoz, J. M., Meaney, E., Díaz-Domínguez, E., Cardona-Muller, D., Pérez, F. P., Cantoral-Farfán, E., Anda-Garay, J. C., Mijangos-Chavez, J., & Antonio- Villa, N. E. (2024). Strategies to prevent, diagnose and treat kidney disease related to systemic arterial hypertension: a narrative review from the Mexican Group of Experts on Arterial Hypertension. BMC Nephrology, 25(1), 24–24. https://doi.org/10.1186/s12882- 023-03450-5 

Samanic, C. M. (2020). Prevalence of self-reported hypertension and antihypertensive medication use by county and rural-urban classification—United States, 2017. MMWR. Morbidity and Mortality Weekly Report, 69. https://www.cdc.gov/mmwr/volumes/69/wr/mm6918a1.htm  

Teshome, D. F., Balcha, S. A., Ayele, T. A., Atnafu, A., Sisay, M., Asfaw, M. G., Mitike, G., & Gelaye, K. A. (2022). High burden of hypertension amongst adult population in rural districts of Northwest Ethiopia: A call for community based intervention. PloS One, 17(10), e0275830–e0275830. https://doi.org/10.1371/journal.pone.0275830 

Valenzuela, P. L., Carrera-Bastos, P., Gálvez, B. G., Ruiz-Hurtado, G., Ordovas, J. M., Ruilope, L. M., & Lucia, A. (2021). Lifestyle interventions for the prevention and treatment of hypertension. Nature Reviews Cardiology, 18(4), 251-275. http://iepres.cl/papers/Lifestyle%20interventions%20for%20the%20%20prevention%20a nd%20treatment%20of%20hypertension.pdf  

Zhang, T., Yang, S., Liu, W., Bai, Q., & Gao, S. (2024). Tai Chi training as a primary care plan for the prevention and management of hypertension: an opinion and positioning article. Annals of Medicine (Helsinki), 56(1), 2320863–2320863. https://doi.org/10.1080/07853890.2024.2320863