Date of Award

4-2021

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Anne McKay DNP, ANP-BC

Second Advisor

Donna Rinker DNP, FNP-BC

Third Advisor

Thomas Hoffman MD

Abstract

Hypertension is one of the most prevalent conditions in the United States, affecting roughly 45% of adults in the country (Centers for Disease Control and Prevention [CDC], 2020). The CDC (2020) reports that only an estimated 24% of patients have controlled blood pressure, which is defined as blood pressure less than 130/80 mm Hg. In 2017, the American Heart Association (AHA) and American College of Cardiology (ACC) released a comprehensive set of guidelines that aimed to assist providers with hypertension management. The Measure Accurately, Act Rapidly, and Partner with Patients (MAP) protocol was formulated as an evidence-based strategy to improve blood pressure measurement accuracy, minimize time preceding treatment initiation, and involve patients in their blood pressure care (AHA, 2016). Home blood pressure monitoring (HBPM) has been identified as an effective method for assisting both patients and providers in the blood pressure control efforts. This project focused on implementing strategies for increasing the utilization of HBPM in the treatment of adult patients with hypertension at a rural primary care clinic in West Michigan. Within this quality improvement project, medical assistants provided patients with education regarding evidencebased measurement techniques. Providers were responsible for delivering a HBPM log to patients for recording home blood pressures. The DNP student also piloted the use of health coaching visits in patients ³ 60-years-old. Of the 147 eligible patients, 64.62% received the medical assistant-delivered education and 68% received the HBPM log. Patient blood pressure measurement technique had statistically significant improvements following the health coaching visits. Patients also reported increased likelihood of lifestyle modification after the health coaching. These results suggest a similar process for hypertension management may assist with promoting partnerships with patients and providers.

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