Date of Award

4-2020

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Marie VanderKooi DNP, RN

Second Advisor

Susan Strouse PhD, RN

Third Advisor

Thomas Hoffman MD

Abstract

Hypertension affects over 38% of adults or approximately 103 million Americans, costing around $131 billion annually in treatment and loss of productivity. It is also an independent risk factor for coronary events, heart failure, stroke, and end-stage renal disease contributing to 410,624 United States (U.S.) deaths in 2014. The American Heart Association (2016) has released the Measure Accurately, Act Rapidly, and Partner with Patient (MAP) protocol in order to address this issue. This project focused on implementing parts of the MAP protocol. The purpose was to improve blood pressure (BP) control of patients diagnosed with hypertension in a primary care setting through the implementation of evidence-based BP gathering techniques and utilization of a home BP measuring (HBPM) log. This quality improvement (QI) project was conducted in a rural primary care setting in West Michigan. Medical assistants were educated on the evidence-based BP gathering techniques while the providers were educated on the importance of patient education on HBPM and handing out the HBPM log. BP readings on a total of 217 patients over the age of 18 seen at the clinic during the implementation period were gathered through chart review. After the implementation of the BP gathering techniques, systolic and diastolic BP were significantly decreased (mean ± standard deviation (SD)/mmHg/from 138.03 ± 18.397 to 134.14 ± 17.865 and from 79.61 ± 10.977 to 77.20 ± 9.937 respectively, both p < 0.05). There was also a significant reduction in SBP following among patients who were given and utilized the HBPM log (mean ± SD/mmHg/from 148.54 ± 20.865 to 136.43 ± 16.461, p < 0.001). There was no significant reduction in diastolic BP among patients who were given the HBPM log (mean ± SD/mmHg/from 80.11 ± 12.080 to 77.59 ± 12.128, p = 0.111). There were no significant changes in systolic and diastolic BP among patients who were not given the HBPM log (mean ± SD/mmHg/from 133.67 ± 18.310 to 126.56 ± 16.295 and from 74.44 ± 7.213 to 72.00 ± 8.456 respectively, p = 0.146 and 0.449 respectively). These results indicate the efficacy of the BP gathering techniques in lowering systolic and diastolic BP and the HBPM log in lowering systolic BP.

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