Developing systems to improve hypertension monitoring at a primary care clinic
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Theresa Marie Holsan, DNP, RN, FNP-C
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- Alpha Kappa at-Large
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Session presented on: Tuesday, July 23, 2013:
Scope and Significance: Primary care clinics are responsible for evaluation of patients with hypertension (HTN) and reporting care to effectively treat this disease. Despite recommended guidelines about 59% of the adult patients in the United States with HTN are being treated and only 34% of those treated have well-controlled blood pressure (BP). Specific objectives of the project were to: 1. Increase the percentage of adult hypertensive patients with adequately controlled BP(<140/90 mm Hg); 2. Standardize BP techniques by ancillary staff and providers and to improve BP documentation; and 3. Evaluate and accurately use the patient reminder system for follow-up care.
Review of the Literature: A comprehensive review of original studies published in English from all countries beginning 2000 to January 2012 was performed. Relevant literature was identified through CINAHL, PubMed, and OVID using the search terms hypertension, quality improvement, follow-up, BP methods, and BP control.
Methods: A pre-post design was used over a 15 month project period. Multiple plan-do-study-act (PDSA) cycles were initiated and three practice outcomes evaluated. Descriptive statistics and Pearson Chi-square were used to evaluate the effectiveness of the interventions.
Findings: BP was entered in the vital sign section of the chart 100% and variation in BP measurement was reduced. Changes to patient follow up resulted in 93% of patients with HTN having a follow-up visit entered into the electronic medical record (EMR). Adult hypertensive patients with adequately controlled BP improved from 56.8% to 75.3%. ?2 (1, N=958) =36.36, p<.0001, v=.195.
Implications for Nursing: A combination of chart review and quality improvement methodology offered a powerful way to improve practice. The interventions provided measurable and sustainable improvements through collective efforts. Communication was strengthened and use of the EMR was augmented. Hypertension is a global health issue, without accurate BP data clinicians cannot make decisions to improve patient outcomes.
24th International Nursing Research Congress Theme: Bridge the Gap Between Research and Practice Through Collaboration. Held at the Hilton Prague Hotel.
Items submitted to a conference/event were evaluated/peer-reviewed at the time of abstract submission to the event. No other peer-review was provided prior to submission to the Henderson Repository.
Type | Presentation |
Acquisition | Proxy-submission |
Review Type | Abstract Review Only: Reviewed by Event Host |
Format | Text-based Document |
Evidence Level | N/A |
Research Approach | N/A |
Keywords | Hypertension; Quality Improvement; Follow-Up |
Name | 24th International Nursing Research Congress |
Host | Sigma Theta Tau International |
Location | Prague, Czech Republic |
Date | 2013 |
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