Date Approved

4-1-2026

Graduate Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Heather Chappell, DNP, FNP-BC

Second Advisor

Dr. Lisa Zajac, DNP, RN, ANP-BC, OCN, FNAP

Academic Year

2025/2026

Abstract

Background: Home blood pressure monitoring (HBPM) is recommended for hypertension management, yet primary care clinics often lack standardized workflows for distributing, collecting, and using home blood pressure (BP) data. Inconsistent reporting and limited patient understanding of their own BP trends, such as whether readings are stable, elevated, or unchanged, reduce providers ability to make timely clinical decisions.

Problem: Despite evidence supporting HBPM, patients rarely brought usable BP logs to follow‑up visits, limiting providers ability to assess BP control, identify trends, and make timely medication or care plan adjustments.

Approach: This project used a Plan‑Do‑Study‑Act (PDSA) model to implement a standardized 14‑day BP log and brief instruction, including correct technique, twice‑daily readings, and return instructions. When follow‑up appointments were booked 4–6 weeks out, patients were instructed to return logs to the front desk at two weeks for provider review.

Outcomes: Thirty‑four logs were distributed to 38 eligible patients; four were not distributed (one refusal, three lacked BP devices). Ten completed logs were returned (29%). All returned logs demonstrated patient awareness of BP trends. Providers documented care adjustments for 9 of 10 patients.

Conclusions: A standardized HBPM workflow increased patient engagement and generated actionable clinical data. Future implementation should include structured Medical Assistant (MA) training, improved device access, and EMR integration to enhance sustainability.

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