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Improving Hypertension Using the Million Hearts Initiative at a Nurse Managed Primary Care Center.

Record Type:	Electronic resources : Monograph/item
Title/Author:	Improving Hypertension Using the Million Hearts Initiative at a Nurse Managed Primary Care Center./
Author:	Klym, Kelly Jade.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2021,
Description:	165 p.
Notes:	Source: Dissertations Abstracts International, Volume: 83-06, Section: B.
Contained By:	Dissertations Abstracts International83-06B.
Subject:	Nursing. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28547340
ISBN:	9798496564205

Improving Hypertension Using the Million Hearts Initiative at a Nurse Managed Primary Care Center.
Klym, Kelly Jade.

Improving Hypertension Using the Million Hearts Initiative at a Nurse Managed Primary Care Center. - Ann Arbor : ProQuest Dissertations & Theses, 2021 - 165 p.

Source: Dissertations Abstracts International, Volume: 83-06, Section: B.

Thesis (D.N.P.)--University of Delaware, 2021.

This item must not be sold to any third party vendors.

Background: Hypertension remains an important public health problem because it remains prevalent and increases the risk for cardiovascular disease. The Nurse Managed Primary Care Center (NMPCC) providers utilize The Eighth Joint National Committee (JNC8) guidelines for management of high blood pressure in adults. The goal of this Quality Improvement project was to use the Million Hearts Protocol (MHP) to decrease hypertension and increase patients' self-efficacy at the NMPCC. Local Problem: Within the state of Delaware in 2018, heart disease was the second leading cause of death with 1,990 deaths and was ranked 24th as a cause of death. During this same year, stroke was the fourth leading cause of death in Delaware with 571 deaths. The aim of this project was to determine which protocol, JNC8 or MHI, is best to improve patient self-efficacy and decrease hypertension among patients with persistent hypertension. Methods: The MHP was implemented with one Nurse Practitioner (NP) at a primary care site which provided care of adults including those with hypertension. Patients, aged 18 to 64 years old with essential hypertension treated with the JNC8 protocol but whose BP was not completely controlled, were included in the project. Data collection methods included comparison of participants' baseline blood pressure readings (2 readings), pre/post questionnaires, and review of patients' blood pressure logs. The results of this practice change project were evaluated through percentage changes in blood pressure and through trend analysis using single subject design (SSD). Interventions: Utilize the MHP to improve blood pressure management and increase self-efficacy among patients with hypertension. Patients selected and applied one lifestyle modification (LM) during the duration of the 10- week project. During the project duration patients measured and recorded their blood pressure and other notes in a written diary three times per week. Results: Data trend analyses demonstrated an increase in patients' self-efficacy with a 13% increase in the belief LM can improve their blood pressures with an average 8% decrease in systolic pressure and an average 3.84% decrease in diastolic pressure. Conclusions: The MHP gives detailed insight into the approaches needed to develop a protocol for blood pressure management incorporating patient self-efficacy strategies including one-to-one educational sessions and identification of potential barriers preventing patients from reaching their health goal.

ISBN: 9798496564205Subjects--Topical Terms:

528444
Nursing.
Subjects--Index Terms:

Health belief model

Improving Hypertension Using the Million Hearts Initiative at a Nurse Managed Primary Care Center.
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500 $a Source: Dissertations Abstracts International, Volume: 83-06, Section: B.
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506 $a This item must not be sold to any third party vendors.
520 $a Background: Hypertension remains an important public health problem because it remains prevalent and increases the risk for cardiovascular disease. The Nurse Managed Primary Care Center (NMPCC) providers utilize The Eighth Joint National Committee (JNC8) guidelines for management of high blood pressure in adults. The goal of this Quality Improvement project was to use the Million Hearts Protocol (MHP) to decrease hypertension and increase patients' self-efficacy at the NMPCC. Local Problem: Within the state of Delaware in 2018, heart disease was the second leading cause of death with 1,990 deaths and was ranked 24th as a cause of death. During this same year, stroke was the fourth leading cause of death in Delaware with 571 deaths. The aim of this project was to determine which protocol, JNC8 or MHI, is best to improve patient self-efficacy and decrease hypertension among patients with persistent hypertension. Methods: The MHP was implemented with one Nurse Practitioner (NP) at a primary care site which provided care of adults including those with hypertension. Patients, aged 18 to 64 years old with essential hypertension treated with the JNC8 protocol but whose BP was not completely controlled, were included in the project. Data collection methods included comparison of participants' baseline blood pressure readings (2 readings), pre/post questionnaires, and review of patients' blood pressure logs. The results of this practice change project were evaluated through percentage changes in blood pressure and through trend analysis using single subject design (SSD). Interventions: Utilize the MHP to improve blood pressure management and increase self-efficacy among patients with hypertension. Patients selected and applied one lifestyle modification (LM) during the duration of the 10- week project. During the project duration patients measured and recorded their blood pressure and other notes in a written diary three times per week. Results: Data trend analyses demonstrated an increase in patients' self-efficacy with a 13% increase in the belief LM can improve their blood pressures with an average 8% decrease in systolic pressure and an average 3.84% decrease in diastolic pressure. Conclusions: The MHP gives detailed insight into the approaches needed to develop a protocol for blood pressure management incorporating patient self-efficacy strategies including one-to-one educational sessions and identification of potential barriers preventing patients from reaching their health goal.
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