Hypertensive Patients’ Education and Evidence-Based Care

PICOT Question

Will hypertensive patients who fail to follow treatment rules (noncompliance) (P) benefit from an educational protocol and counselling sessions (I) compared to noncompliant patients who do not receive these interventions (C) by increasing the adequate treatment rules (compliance) and improving blood pressure (O) within a documented one year of trending results with three-month follow-up intervals (T)?

Search Strategy Conducted

The study’s search strategy included several steps. First, the keywords were chosen; they included words and phrases like “hypertension,” “treatment rules,” “noncompliance,” “educational protocol,” “counseling” and their various combinations. Similarly, the exclusion and inclusion criteria were determined: it was established that only recent (no older than five years) and high-quality sources in English would be employed. Then, the keywords were used to complete the search for works in electronic databases. The largest and most reputable databases were chosen, including MEDLINE and CINAHL (Gerrish & Lathlean, 2015). Upon finding a source with an appropriate title, its abstract was considered to determine its potential usefulness. If the previous step suggested that the source could be viewed as useful, it was obtained and quickly reviewed to prove or disprove the assumption.

Critical Appraisal of the Evidence Performed

The critical appraisal of the evidence was performed with the help of the suggestions included in the AORN’s Model for Evidence Rating (Spruce, Wicklin, Hicks, Conner, & Dunn, 2014). The process involved determining the type of the study and proceeding to assess its quality. In the Model, the specific features that need to be reviewed differ for various types of research; for example, the quality of control needs to be considered for randomized controlled trials. Apart from that, certain quality features are the same for different types of studies, including, for example, reliability and validity of instruments used, sample sizes, and so on. The Model views randomized controlled trials and systematic literature reviews as the highest levels in the hierarchy of evidence, which is why the focus of the literature research was on the two types of research, but other sources were also accepted if they proved to be sufficiently high-quality. Low-quality evidence was excluded from the study.


Gerrish, K., & Lathlean, J. (2015). The research process in nursing (7th ed.). Chichester, West Sussex, UK: Wiley Blackwell.

Spruce, L., Wicklin, S. A., Hicks, R. W., Conner, R., & Dunn, D. (2014). Introducing AORN’s new model for evidence rating. AORN Journal, 99(2), 243-255. Web.