NURFPX 4900 Assessment 4 : Patient, Family, or Population Health Problem Solution
Summary of the problem
Hypertension, or high blood pressure, affects a large percentage of middle-aged white men. It's the leading cause of mortality and disability from cardiovascular disease, and it's expected to affect about a third of the adult population worldwide. About 45 percent of Caucasian men aged 45 to 64 have hypertension, according to the American Heart Association (ANA, n.d). Hypertension may lead to serious health issues including heart attack, stroke, and renal failure. Hypertension treatment should be approached holistically, taking into account both pharmaceutical and non-pharmaceutical approaches. It has been shown that making positive changes to one's diet, exercise routine, and stress management may have a significant impact on blood pressure and overall cardiovascular health.
Mr. Sam, a 58-year-old Caucasian male, is the subject. He was first diagnosed with hypertension three years ago when he was 55 years old. His high blood pressure runs in the family, and it has been a problem for him for the last year. His current medicine regimen consists of taking Lisinopril and hydrochlorothiazide. Mr. Sam has been a heavy smoker for 30 years, smoking a pack a day. His diet is rich in salt and saturated fats, and he seldom gets any exercise. Since hypertension affects such a large percentage of middle-aged white males, I thought it was worth looking into it. As a nurse, it is my responsibility for offering my patient Mr. Sam the most effective means of hypertension management, among which of these is behavioral change. Addressing this problem may improve my patients' overall health, quality of life, and resilience to hypertension-related disorders and medication dependence. For this reason, it's important to research hypertension treatments that focus on changing patients' behaviors.
Heart disease, stroke, and renal failure are just some of the many health issues linked to hypertension. Everyone is susceptible, although middle-aged white guys are at a higher risk. Among my most important responsibilities as a nurse is advising patients on how to control their hypertension via lifestyle changes including eating less salt, exercising more, and giving up tobacco. Modifying one's way of life is an important part of the long-term therapy of hypertension. As a healthcare provider, it is my duty to counsel patients about hypertension, its treatment options, and the value of adopting healthier habits to lower blood pressure.
Patients' results may be improved and long-term consequences from hypertension can be avoided if we have open, collaborative talks with them about their treatment plans and encourage them to adopt healthier lifestyles. As hypertension affects a sizable population, it is critical to have a deep familiarity with the condition and the methods for treating it. Improving the health of people with hypertension, lowering their risk of problems, and decreasing their reliance on medication are all possible with the implementation of lifestyle adjustments supported by evidence. Since lowering the prevalence of chronic illness may have substantial social and economic advantages, this is of value not just to the patient but also to their loved ones and the larger society.
Intervention
Health outcomes for people facing inequities may be improved by the use of treatments. However, treatments will be more productive and appreciated by patients if they include leadership development, evaluations, family and community engagement, and post-treatment support. The goal of the suggested intervention is to design and execute a system for dealing with hypertension that includes both treatment and prevention measures, such as dietary and behavioural modifications and the proper use of medications. The goal of the Hypertension Management Programme is the treatment and prevention of hypertension in middle-aged white men. Evidence-based recommendations for the diagnosis, treatment, and monitoring of hypertension are implemented by a multidisciplinary team of healthcare experts as part of this programme. The treatment entails a series of steps, including assessment and diagnosis, behavioural change, medication management, and continuous counselling and education. The programme places an emphasis on routine screening and diagnosis of hypertension according to established recommendations so that any problems may be identified and treated as soon as possible. A dietician provides one-on-one guidance and assistance to patients so that they may make positive lifestyle changes, such as decreasing their salt consumption, increasing their physical activity, and reaching and maintaining a healthy weight. When it comes to hypertension management and lowering the risk of problems, the healthcare staff repeatedly stresses the need of making changes to one's way of life.
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To further guarantee that patients are prescribed the most effective drugs for hypertension control, the program also contains medication management recommendations based on evidence-based standards. Their treatment programs are closely reviewed, and if required, adjustments are made to provide the best possible blood pressure management. The program ensures that patients have access to follow-up visits, patient education materials, and support groups to help them better control their hypertension. The medical team works closely with patients to foster self-management and provide the tools necessary for them to actively participate in their treatment. By providing patients with hypertension with all-encompassing care, the Hypertension Management Program improves health outcomes and lessens the likelihood of future complications.
The Role of Leadership and Change Management Leadership
High-quality patient care and better results can only be achieved with strong leadership in healthcare. A leader establishes a course of action, organizes and motivates their followers to work together to achieve their goals.
A culture of safety, quality, and cooperation among healthcare workers is impossible to achieve without the support of strong leaders in the field. Improved patient outcomes are a direct result of leadership that motivates healthcare providers to collaborate towards that objective (University Research Co., LLC, 2014). Leaders also stress the importance of healthcare workers working together and using established methods that have a track record of success in improving patient outcomes. They provide a setting that promotes lifelong education and the implementation of innovative methods for enhancing patient care. Leadership techniques were essential in the creation of my suggested solution. Working collaboratively with other healthcare experts, I helped pinpoint the issue, examine the available data, and design a solution. I made sure that everyone on the team knew what they were supposed to be doing by using my communication abilities.
Change Management
Interventions designed to boost organizational effectiveness must always include change management. Management of change is the process of conceiving, enacting, and assessing organizational transformation. Any organization will experience change, and successful change management is essential if interventions are to have a lasting impact. Planning, enacting, and assessing are all parts of the change management process. Problem recognition, strategy creation, and resource mapping are all part of the change planning process. The implementation phase is when the plan is put into action, progress is tracked, and problems are solved. Evaluating a change's efficacy and making required revisions is part of the evaluation process. In terms of managing change, I helped the team find and plan ways to get over obstacles to the intervention's rollout. In addition, we devised a strategy for tracking the intervention's success and adjusting it as needed to keep it tailored to the patient's requirements.
Several aspects of my suggested intervention were informed by theories of leadership and change management. First, I worked with several parties involved in the issue (doctors, chemists, and patients) to create a thorough strategy for fixing it. I made sure the intervention is evidence-based, feasible, and in line with the organization's values by getting input from a wide range of people. To get buy-in for my intervention from key players, I used sound communication methods. Throughout the intervention's rollout, I kept everyone in the loop on its progress, updated them often, and dealt with any issues that emerged. To make sure the intervention lasts and has lasting effects, I used change management techniques. I have been doing assessments on a regular basis to gauge the intervention's success, and have been adjusting as needed.
The principles of ethical nursing care guided the creation of the suggested intervention. As a nurse, it is my duty to promote the health, safety, and independence of my patients while respecting their inherent worth and autonomy. The suggested intervention aims to increase patient autonomy and well-being by enhancing the standard of care for middle-aged Caucasian men with hypertension. The intervention is supported by scientific data, and its execution is consistent with the nursing code of ethics, which mandates the use of best practices to ensure patients' health and safety. It promotes healthcare fairness and social justice by taking costs (both systemic and personal) into account. The suggested intervention offers a structure for providing high-quality care that improves patient outcomes and is consistent with nursing principles if its ethicality is guaranteed.
Communication and Collaboration
The hypertension treatment plan should include the patient and their family members. Patients as well as their families may provide valuable perspective to the programme by sharing their own stories on living with and managing hypertension. Patient and family participation improve health outcomes by educating them about the illness process and encouraging them to take an active role in its care. In order to collaborate effectively, it is important to listen attentively, to speak clearly, and to create an atmosphere of mutual respect. Choice supports and motivational interviewing are only two examples of the types of collaborative decision-making tools and methods that healthcare practitioners may use to engage patients and their families in their treatment. Care providers can keep patient and their families involved in their treatment and on track to meet their health objectives through consistent follow-up and open lines of communication (Caracciolo et al., 2022).
The value of hypertension care, including frequent blood pressure monitoring, medication adherence, and lifestyle adjustments including diet and exercise, is better understood when the patient and their family are included in the program. The healthcare team may utilize motivational interviewing to determine whether the patient is ready to make lifestyle changes and to provide encouragement and direction in the face of resistance. Social support from family members, such as being part in the program, may help patients stay motivated and committed to their therapy. In order to foster communication and teamwork, it's crucial for team members to be able to clearly and concisely convey their thoughts and ideas to one another via methods including active listening, speaking up when issues occur, and the use of standardized communication tools (Caracciolo et al., 2022). Building a cooperative atmosphere requires emphasizing the importance of treating one another with dignity and respect, encouraging everyone to take responsibility for their actions, and giving credit where credit is due. Caracciolo (2022) stresses the need of routinely assessing team performance and planning as necessary, as well as the requirement for continual education and training in communication and cooperation skills.
Impact of Health Policy on Quality and Cost of Care
Evidence-based practice, patient-centered care, and interprofessional cooperation are all emphasized throughout the nursing practice standards and organizational policies that inform the formulation of the intervention plan. The American Nurses Association's (ANA) Standards of Practice and Professional Performance for Registered Nurses emphasizes the use of evidence-based practice to guide nursing interventions and the provision of patient-centered care to suit the individual needs and preferences of each patient. The programme is based on the best available evidence since it follows evidence-based recommendations for screening, diagnosis, and therapy of hypertension (ANA, n.d).
The program's interprofessional focus is in line with IPEC's core competencies for interprofessional collaborative practice, which stress the value of open lines of communication, teamwork, and collaboration among healthcare providers to improve patient outcomes. Patients are more likely to get treatment that is holistic in nature and meets their physical, mental, and social needs when a team of healthcare experts is involved (Hannan et al., 2022).
Organizational policies that value teamwork across disciplines served as a foundation for the intervention strategy. The term "interprofessional collaboration" is used to describe the process through which many types of medical experts work together to better serve patients. When it comes to providing high-quality medical treatment to patients, the Institute of Medicine (IOM) stresses the value of interdisciplinary teams. Primary care doctors, nurses, dietitians, and chemists all work together in this programme to control and prevent hypertension in middle-aged Caucasian guys. The World Health Organization (WHO) guideline on pharmacological treatment of hypertension, 2021, emphasizes the importance of accurate diagnosis and appropriate management of hypertension, especially in low- and middle-income countries where hypertension is a significant burden (Ordunez et al., 2023). When a person's blood pressure reaches stage 2 hypertension, which is defined as a systolic reading of 140 mm Hg or higher and a diastolic reading of 90 mm Hg or higher, the guideline suggests beginning pharmaceutical therapy.
The guideline also suggests tailoring care to each patient's unique traits and comorbidities, exploring the possibility of using several therapies at once, and keeping close tabs on patients' responses and levels of adherence. The authors also note that these suggestions are in keeping with preexisting policies and guidelines in the Americas, such as those from the American College of Cardiology/American Heart Association and the Pan American Health Organisation. They stress the need for regional policy and guideline alignment for the uniform and efficient treatment of hypertension (Ordunez et al., 2023) in this context.
Improved Quality of Care
Nursing practice standards and organizational policies that prioritize evidence-based practice and patient-centered care are consistent with the interventions' emphasis on evidence-based recommendations for screening, diagnosis, and treatment of hypertension. The program's goals are to assist patients successfully manage their hypertension via frequent screening and diagnosis, lifestyle adjustments, medication management, and continuing support and education from the healthcare team. Improved quality of care and patient safety may result from the intervention's ability to lessen the likelihood of adverse cardiovascular events and boost patient outcomes. Improvements in general health and savings on healthcare expenses caused by hypertension-related problems are additional benefits of the program's focus on behavioral changes.
An all-encompassing strategy for hypertension treatment in low-income communities, the Hypertension treatment Programme in Argentina was addressed by Campbell et al. (2022). The study's overarching goal was to determine whether or not a comprehensive intervention might effectively help this cohort better manage their hypertension and have fewer cardiovascular events. Community-based interventions to encourage healthy living behaviors were also a part of the intervention, along with the adoption of evidence-based recommendations for hypertension treatment and the training of healthcare professionals in hypertension care. This research has important implications for designing and implementing effective hypertension control programs for underserved communities.
In a community healthcare setting in an urban area, Oseni et al., (2023) studied the efficacy of a nurse-led hypertension treatment paradigm. Patients were randomly assigned to either the nurse-led hypertension treatment intervention or to normal care, and the results of both groups were compared. Systolic and diastolic blood pressure were considerably lower in the intervention group, and medication adherence and self-efficacy for hypertension control were significantly higher.
Incorporating a multidisciplinary team of healthcare providers, such as nurses, to provide evidence-based treatment and patient education is central to the suggested intervention approach for hypertension control. The results of this research provide credence to the idea that individuals with hypertension might benefit from a nurse-led hypertension care strategy. Interprofessional teamwork and patient-centered care, which are emphasized by nursing practice standards and by the policies of healthcare organizations, justify the presence of nurses on the hypertension treatment team. The National Quality Forum and the Centers for Medicare & Medicaid Services are two organizations that experts cite as providing useful benchmark data. Organizations like this compile information about Indicators of healthcare quality, patient safety, healthcare utilization, and healthcare costs may all be used to assess the viability of the Hypertension Management Program and pinpoint places where it can be improved.
Better patient access to treatment and more options for self-management are both possible because to technological advancements like telemedicine and mobile health (mHealth) apps. The continuity and completeness of a patient's treatment may be ensured by care coordination, which requires cooperation between different medical professionals. It is possible to improve patient participation and care by using community resources like community health workers and patient navigators. The most recent evidence-based recommendations, as well as a patient's unique features and comorbidities, should all be included into the blood pressure thresholds and objectives used, as suggested by Huguet et al. (2021). Patient participation and adherence to treatment regimens are prioritised, and they promote the use of technology like telemedicine and mobile health apps to achieve these goals. In order to provide thorough and efficient hypertension management for diabetic patients, Huguet et al. (2021) stress the significance of care coordination among healthcare providers and the incorporation of community resources like community health workers and health education programmes.
Conclusion
It is our responsibility to provide the highest standard of care to our patients as medical experts. Inadequate treatment or management of hypertension, a common illness with dangerous implications, is common. Hypertension treatment may be more effective, safer, and less expensive with the use of evidence-based strategies including technology, care coordination, and community services. This paper's recommended measures are consistent with current recommendations and research in the area, such as the introduction of a nurse-led hypertension management programme. These measures may help doctors get their patients' blood pressure down as low as possible, which will have positive effects on their patients' health and the healthcare system as a whole.
References
American Nurses Association. (n.d). Nursing: Scope and standards of practice (3rd ed.). Silver Spring, MD: Author. Retrieved from https://www.nursingworld.org/~4af71a/globalassets/catalog/book-toc/nssp3e-sample-
chapter.pdf
Campbell, N. R., Whelton, P. K., Orias, M., Wainford, R. D., Cappuccio, F. P., Ide, N., & Zhang, X. H. (2022). 2022 World hypertension league, resolve to save lives and international society of hypertension dietary sodium (salt) global call to action. Journal of Human Hypertension, 1-10. https://doi.org/10.1038/s41371-022-00690-0
Caracciolo, A. L., Marino, M. M., & Caracciolo, G. (2022). Patient–Physician Relationship in Telemedicine. In Telemedicine: The Computer Transformation of Healthcare (pp. 43-80). Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-99457-0_4
Hannan, J. A., Commodore‐Mensah, Y., Tokieda, N., Smith, A. P., Gawlik, K. S., Murakami, L., ... & Melnyk, B. M. (2022). Improving hypertension control and cardiovascular health: An urgent call to action for nursing. Worldviews on Evidence‐Based Nursing, 19(1), 6-15. https://doi.org/10.1111/wvn.12560
Huguet, N., Larson, A., Angier, H., Marino, M., Green, B. B., Moreno, L., & DeVoe, J. E. (2021). Rates of undiagnosed hypertension and diagnosed hypertension without anti-hypertensive medication following the Affordable Care Act. American Journal of Hypertension, 34(9), 989-998. https://doi.org/10.1093/ajh/hpab069
Ordunez, P., Campbell, N. R., Giraldo Arcila, G. P., Angell, S. Y., Lombardi, C., Brettler, J. W., ... & Sharman, J. E. (2023). HEARTS in the Americas: innovations for improving hypertension and cardiovascular disease risk management in primary care. Revista Panamericana de Salud Pública, 46, e96. https://doi.org/10.26633/RPSP.2022.96
Oseni, T. I. A., Emonriken, A., Ahmed, S. D., & Dic‑Ijiewere, M. (2023). Determinants of Blood Pressure Control among Hypertensive Patients Attending a Rural Teaching Hospital in Southern Nigeria. Nigerian Journal of Clinical Practice, 26(3). https://doi.org/10.1097/NNA.0000000000000739
