QI - Hypertension Management by zach crady

Kronebusch, B. J., Rismeyer, D. L., Enos, M. M., Swenson, L. L., Witwer, S. G., & Hunt, V. L. (2020). Registered Nurse Visits to Improve Hypertension Management: A Quality Improvement Project. Nursing Economic$, 38(3), 121–132.

firedoven — 2023-04-22 15:23:24 UTC

Problem

firedoven — 2023-04-28 13:36:33 UTC

What is the effectiveness of enhanced RN visits as compared to usual care for improving outcomes in patients with hypertension

Supporting Data

firedoven — 2023-04-28 13:38:52 UTC

Intervention took place in two primary care clinics serving both primary care internal medicine and family medicine patients
Conducted from February to December 2016
Sample group of 15 males and 15 females and a control group of 15 males and 15 females
Average age of 55 for the sample group and 56 for the control group

Problem

firedoven — 2023-04-28 13:49:15 UTC

Patients with uncontrolled hypertension will continue to increase, particularly as the diagnosis and management of high blood pressure align with guidelines endorsed by the 2017 American College of Cardiology/American Heart Association

Current Practice

firedoven — 2023-04-28 14:01:10 UTC

In 2015, the Center for Disease Control and Prevention reported only 48% of adults with hypertension were well controlled

firedoven — 2023-04-28 14:31:16 UTC

Adults 18 to 60 year old patients with hypertension and uncontrolled hypertension
BP goal of <140/90 mm Hg and >90/50 mm Hg

firedoven — 2023-04-28 14:33:17 UTC

RN visits every 2 weeks for 12 weeks

firedoven — 2023-04-28 15:16:27 UTC

The QI Project quantitative
Study involved 60 in two groups
30 were women and 30 men
Vital signs were checked consistently

firedoven — 2023-04-28 15:17:25 UTC

The results showed an improvement to patients with uncontrolled hypertension

firedoven — 2023-04-28 15:18:39 UTC

By implementing the use of RNs to visit patients at home gave the results a promising outcome.

firedoven — 2023-04-28 15:40:31 UTC

RN visits for medication management and lifestyle modifications resulted in patient reaching BP goal, while improving access to care for other acute and complex conditions.

firedoven — 2023-04-28 15:45:07 UTC

RN performing these visits and telephone calls experienced enhanced satisfaction with their roles

firedoven — 2023-04-28 15:47:31 UTC

Collaborative, evidence-based, and innovative care strategies using inter professional team members have the potential to continue to improve hypertension control patients.

firedoven — 2023-04-28 15:48:47 UTC

The benefits of this model of care are far reaching as an approach to chronic disease and optimal outcomes

firedoven — 2023-04-28 15:51:03 UTC

RN visits were effective in helping patients achieve BP control at a higher rate and shorter time than usual care without negatively impacting provider satisfaction or patient safety

firedoven — 2023-04-28 15:52:56 UTC

93% of patients reached their BP goal in a median 2 weeks compared to 86% in a median 8 weeks in usual care group

Plan

firedoven — 2023-04-28 17:57:48 UTC

To reach health goals through managing uncontrolled hypertension by assigning RNs to manage patient care proactively.

Do:

firedoven — 2023-04-28 18:08:27 UTC

Groups were set-up to record BP on a schedule and how these results were compared to control group at the end of the trial

Study:

firedoven — 2023-04-28 18:10:05 UTC

The uncontrolled hypertension patients that were assigned RN visits had a higher success rate in reaching their BP goals in a faster time frame than the control group.

Act:

firedoven — 2023-04-28 18:11:07 UTC

The data shows that the benefit of this practice can lead to better outcomes for the patient and RNs that take part

firedoven — 2023-04-28 18:15:53 UTC

A limitation that was found during this project was that physicians were slow to enroll patients into the group.
Another limitation was group size. This was a small group and implementation would need to be carried out on a larger scale to get more accurate results