Introduction
High blood pressure, often known as hypertension, is a common condition in which the blood persistently pushes against the artery walls at levels high enough to increase the risk of serious complications. The heart’s ability to pump blood and the resistance of the arteries have a role in determining a person’s blood pressure. Hypertension results from a combination of factors, including narrowing arteries and increased cardiac output. Millimeters of mercury (mm Hg) are the standard unit for measuring blood pressure.
Hypertension condition is a major health issue and concern today. Tens of millions of adults in the United States suffer from it, and many have uncontrolled high blood pressure (Centers for Disease Control and Prevention, 2020). Heart disease, stroke, heart failure, and death are more likely to occur when one has hypertension. Controlling blood pressure and keeping it within normal limits will significantly reduce the chances of acquiring these conditions. According to CDC (2020), only about a quarter of persons with hypertension have it under control. Hypertension results from a complex interplay between lifestyle choices, the surrounding environment, and underlying biological factors.
The decrease in mortality rates from heart disease and stroke in developed countries is largely attributable to the progress made in research into diagnosis and treatment. However, hypertension treatment is still unusual, and presence of low control rates. According to Oparil et al. (2018), pharmacological interventions have significantly reduced cardiovascular morbidity and mortality risk. Their family and friends are greatly affected by the risk and consistency of cardiovascular events of treatment with hypertension. Stroke can occur at any age but is more likely in the elderly population. Unraveling the challenge of hypertension requires contributions from healthcare providers, the healthcare system, and the techniques used to treat hypertensive patients. Unfortunately, the incompetence of the medical staff and patient disobedience with medication may result in a lack of proper control of hypertension.
This problem is particularly interesting to me because, as a registered nurse, it is common to see patients in my unit with hypertension diagnoses. The prevalence in adults over 55 years old is high compared to young generation (Andualem et al., 2020). The subject of this assessment is Mr. Alfonzo, 73 years old African American male diagnosed with hypertension seven years ago. He has a history of alcohol abuse, obesity, stroke, tobacco abuse, and coronary artery disease, significantly affecting his quality of life. Mr. Alfonzo has education on hypertension was given to him during diagnosis; however, he has not been adhering to the recommendations. He admits that sometimes he does not check blood pressure always before taking medication and other times forgets to take medication. This evaluation aims to examine data from peer-reviewed literature, identify nursing practices and government policies that may positively impact the patient’s health, and discuss leadership tactics to improve his health.
Analyzing Evidence Related to the Problem
Changing one’s lifestyle and being compliant with prescribed medications are the most effective evidence-based approaches to treating and maybe curing hypertension. A patient’s adherence to recommended lifestyle changes is influenced by motivation and demographic factors such as education level, patient income, age, self-efficacy, and co-morbidity (Andualem et al., 2020). Other factors include disease awareness, social support, obesity, smoking, alcohol use, and a sedentary lifestyle. Institutional enhancements, like forming multidisciplinary teams with counseling experience, are essential to achieve modification activities. Healthcare organizations should develop programs to improve the ability of hypertension patients to adjust to lifestyle changes, and healthcare workers should be equipped with adequate knowledge of lifestyle changes to help the patients.
For an evidence-based strategy to be effective, it must adhere to certain criteria for selecting data sources. These criteria include using only peer-reviewed, up-to-date, relevant research. Having papers reviewed by other experts in the field is crucial for conducting research with solid evidence. Medical databases such as Cinahl, Medline, and PubMed were used for this analysis to gather data on hypertension. An in-depth search using sources from less than five years was undertaken on hypertension and nursing practice standards to identify relevant results. Unreliable data should be avoided, such as sources that are not peer-reviewed and those that are not up-to-date.
Through policy work, nurses can influence the patient’s state now and in the future. Policy making enables them to influence decision-making and issues related to the problem through political knowledge that helps improve outcomes, prevent illness, and reduce hospital readmissions. Conceptual frameworks and nursing theories provide nurses with perspectives on the patient and professional practice (Ribeiro et al., 2018). In this case, it will assist the practicum in offering better conditions for the hypertension patient and guide the actions taken.
Evidence-based research has shown the impacts of interventions on hypertension. According to Adler (2019), the community-based Hypertension Improvement Project was a large cohort study that assessed a community-based hypertension therapy paradigm. Every day, patients were sent prescription reminders, weekly appointments, and health education messages with short messaging systems (SMS). When the Hypertension Improvement Project was implemented, hypertension was under control in about 72% of patients (Adler, 2019). By offering incentives, the program is more likely to retain the participation of the vast majority of its participants over the long term.
State Board of Nursing Practice and Governmental Policies
Nurses must have ample knowledge of the Nurse Practice Act, which sets forth and governs the parameters registered nurses may use in their professional activities. Every state has a nursing board that oversees applying laws and standards for nurses in the workplace. The Nurse Practice Act, which varies from state to state, is in place to guarantee that nurses in every jurisdiction are qualified and capable of performing their duties to the best of their abilities. Research carried out by Ferdinand et al. (2018) shows that nursing practice standards and government policies have guidelines for nurses managing hypertension. The guidelines have greatly enhanced patient outcomes and well-being.
States and the local government have implemented policies and interventions that are sustainable, affordable, and cost-effective to address the challenge of hypertension in society. A nurse’s care for a patient must always be done following the rules and regulations (Spector et al., 2018). Regulation of the nursing profession relies heavily on the Board of Nursing and its Nurse Practice Standards. Registered nurses can provide their patients and themselves with safe and effective care due to the oversight of the Nursing and Midwifery Board. Nurses must be aware that they need to deliver care that is legal, ethical, and free from harm to their patients. Adherence to the state’s nursing practice standards will ensure that Mr. Alfonzo will receive high-quality nursing care, which has consequences for the incorporation of non-maleficence and autonomy during the development of his treatment plan.
Leadership Methods that Boost Outcomes
Nurses are essential to patient health, quality promotion, and healthcare satisfaction. Research carried out by Carthon (2020) shows that hypertension patients benefit from leadership strategies, coordinated treatment, and the educational efforts of nurses. One of the most effective approaches for managing hypertension is patient-centered therapy tailored to each individual’s requirements (Carthon et al., 2020). A more comprehensive strategy is required for Mr. Alfonzo to receive the best possible care and improve his outcomes. A multidisciplinary approach can effectively address a team effort involving the patient, their primary care physician, cardiologist, and other specialists. A multidisciplinary approach to patient care allows for improved coordination and communication among the various medical professionals involved in this case (Carthon et al., 2020). Care coordination within the team reduces the likelihood that the patient will receive disjointed care, reducing hospitalizations and unnecessary medical treatment, improving adherence to medical treatment, and ultimately raising the quality of care.
For the change management strategy for the patient, I will implement a multidisciplinary strategy to maintain normal blood pressure. Diagnosing the root of treatment resistance is best accomplished with hypertension experts. If no causative treatments are available, multidisciplinary therapies comprising nurses, pharmacists, dietitians, physiotherapists, social workers, psychologists, and community health professionals should be considered. They should also be considered if pharmaceutical and non-pharmacological blood pressure tests are insufficient. I will ensure medication management, patient follow-up, adherence, and self-management.
Conclusion
Hypertension has been a problem of concern and greatly affects older adults. The assessment entails a male patient Mr. Alfonzo who was diagnosed with hypertension but had not followed medical recommendations effectively. To achieve the best health results, Mr. Alfonzo’s hypertension treatment plan should be established using the most precise and evidence-based data possible. Hypertension patients treated by interdisciplinary groups have better outcomes and experience less medical turmoil. It is the responsibility of each nurse to follow the regulations for nursing practice in effect in their state at the time of practice. Working together, these factors can help those with hypertension enhance their health and well-being and lessen the severity of hypertension’s negative impacts on their health on the path to recovery.
References
Adler, A., Laar, A., Prieto-Merino, D., Der, R., Mangortey, D., Dirks, R., & Perel, P. (2019). Can a nurse-led community-based model of hypertension care improve hypertension control in Ghana? BMJ, 9(4). Web.
Andualem, A., Gelaye, H., & Damtie, Y. (2020). Adherence to lifestyle modifications and associated factors among adult hypertensive patients attending chronic follow-up units of Dessie referral hospital, North East Ethiopia, 2020. Integrated Blood Pressure Control, 13, 145.
Carthon, J. M. B., Brom, H., Poghosyan, L., Daus, M., Todd, B., & Aiken, L. (2020). Supportive clinical practice environments associated with patient-centered care. The Journal for Nurse Practitioners, 16(4), 294-298. Web.
Center for Disease Control and Prevention. (2020). High blood pressure. Web.
Oparil, S., Acelajado, M. C., Bakris, G. L., Berlowitz, D. R., CĂfková, R., Dominiczak, A. F., & Whelton, P. K. (2018). Hypertension. Nature reviews. Disease Primers, 4, 18014. Web.
Spector, N., Hooper, J. I., Silvestre, J., & Qian, H. (2018). Board of nursing approval of registered nurse education programs. Journal of Nursing Regulation, 8(4), 22-31. Web.