Patient, Family, or Population Health Problem Solution

Hypertension is a chronic condition that leads to adverse effects, including a high risk of stroke and heart disease. According to the Centers for Disease Control and Prevention [CDC] (2022), heart disease and stroke are the major causes of premature deaths, increased care costs, disability-adjusted life years (DALYs), lengthy hospitalization, and poor quality of life. The United States incurs approximately $131 billion annually for hypertension prevention, management, and treatment. Since hypertension is primarily a lifestyle condition, it is essential to involve JJ in a collaborative care plan that entails effective communication, incorporating advanced technologies, care coordination, and utilizing community resources.

Strategies for Communicating and Collaborating with the Patient to Improve Outcomes Associated with Hypertension

JJ’s case scenario signifies the need to implement a contingency plan for assisting the patient in addressing the modifiable factors for hypertension. In this sense, involving the patient in regulated physical exercise, educating him on healthy diet plans, smoking, and alcohol cessation programs, and establishing a plan for stress management can improve his health and intercept the disease’s progression, as well as prevent more burdensome conditions, including stroke and heart disease (Verma et al., 2021). While establishing and enacting a contingency care plan for JJ, it is vital to involve him in all care delivery steps by strengthening communication patterns and enhancing interpersonal collaboration.

Communication and collaboration are prerequisites for patient-centered care (PCC). According to Kwame & Petrucka (2021), providing care services consistent with and sensitive to patients’ needs, priorities, and preferences results in positive care outcomes and improved perceptions of quality care. Effective communication is central to patient-centered care because it entails developing a meaningful relationship with the patient and responding to their health concerns, beliefs, and contextual variables (Kwame & Petrucka, 2021). The patient-centered care (PCC) model seeks to debunk and challenge this normalcy by strengthening the patient’s active role in determining care trajectories and influencing decisions.

Healthcare professionals should use communication as an ideal tool for sharing information, coordinating activities, and developing a meaningful relationship with the patient. Kwame & Petrucka (2021) contend that communication should be a two-way dialogue where both parties are open and free to ask questions for clarity, express their opinions, exchange information, and extract meaning from the exchanged information. Also, when communicating with JJ, care providers should incorporate ethical and professional standards by demonstrating emotional intelligence, cultural competence, empathy, and respect. These strategies can enable the patient to effectively share his concern and openly provide information regarding his health needs, preferences, and priorities.

Similarly, healthcare professionals should involve JJ in a team-based, collaborative care plan for treating and managing the condition. According to Santschi et al. (2021), a team-based care model for improving hypertension management entails regular blood pressure monitoring and measurement, motivating the patient to adhere to medications and lifestyle modification programs, such as physical activity and healthy diet plans, and improving patient’s knowledge of self-management approaches. Equally, healthcare professionals should establish clear and convenient schedules for consultation and develop a follow-up plan for assessing the progress.

The Role of Leadership and Change Management in Addressing Hypertension

Healthcare organizations’ leadership should support effective communication and a team-based care model. According to Kwame & Petrucka (2021), communication between healthcare professionals and patients faces various institutional constraints, including shortages in nursing staff, time pressure, burnout, work overload, and the healthcare system’s emphasis on task-centered care. For instance, task-centered care focus on completing care procedures and fulfilling fixed roles instead of valuing and satisfying patients’ and caregivers’ preferences, priorities, and needs (Kwame & Petrucka, 2021). The organization should transition from a task-centered care model to patient-centered care to improve outcomes and safeguard patient safety and well-being.

Effective leadership is necessary for inspiring the incorporation of advanced technologies in all-concerted efforts to prevent, treat, manage, and control hypertension. Kario (2020) contends that wearable devices are among the advanced technologies that enable timely blood pressure monitoring, accurate detection of phenotypes with unfavorable cardiovascular prognosis, and improved monitoring of environmental factors that lead to hypertension. Equally, the organization should support telemedicine and m-Health technologies for preventing, treating, and managing high blood pressure. The widespread adoption of these advanced technologies prompts the organizational leadership to initiate, implement, and sustain policy changes.

Effective leadership and change management can promote patient-centered care and cultivate a culture of excellence by intercepting factors that undermine quality care delivery, including work overload, burnout, and nursing staff shortages. According to Sfantou et al. (2017), organizational leadership determines elements of workplace culture, including activities, shared norms, and practices. In hypertension prevention, treatment, and management, hospital leaders should adopt various elements of transformative leadership to promote creative interventions and support evidence-based practices. These elements include intellectual stimulation, inspirational motivation, individualized consideration, and idealized influence. Finally, the organizational leadership should support patient-centered communication, encourage innovation, and implement quality improvement initiatives to improve care quality.

How the Proposed Intervention will Improve the Quality of Care, Enhance Patient Safety, and Reduce Costs to the Systems and Individual

The proposed intervention encompasses various pharmacological and non-pharmacologic strategies for managing and controlling hypertension, including involving the patient in cigarette and alcohol cessation programs, increasing access to physical exercise opportunities, and educating the patient on regular vital sign monitoring, healthy diets, and self-management. These approaches are consistent with the need to reduce the costs associated with hypertension and related burdensome conditions like heart disease and stroke. Also, the proposed care plan seeks to improve the quality of care and enhance patient safety.

Hypertension and its sequelae, including stroke and heart disease, inflict a massive economic burden on healthcare systems. As a result, implementing non-pharmacologic strategies and encouraging technology-aided interventions can reduce the cost of care by intercepting the disease’s progression and averting complications. Further, utilizing technologies like telemedicine and m-Health applications can reduce the costs associated with in-office visits and in-person consultations (Snoswell et al., 2020). Finally, coordinating care through effective communication can improve adherence to the proposed care interventions and enhance outcomes.

The proposed interventions promote care quality and patient safety by addressing symptoms of hypertension and preventing complications. Verma et al. (2021) contend that lifestyle modification approaches like physical activity, weight loss, mindfulness-based stress management, and limited alcohol consumption effectively lower blood pressure and reduce the likelihood of adverse cardiovascular events, such as stroke, heart failure, and myocardial infarction. Pharmacological methods like administering diuretics and angiotensin-converting enzyme inhibitors should complement these non-pharmacologic strategies to improve hypertension symptoms and prevent complications that can compromise the patient’s quality of life, safety, and well-being.

How State Board of Nursing Practice Standards and Organizational or Governmental Policies Guided the Development of the Proposed Intervention

Various practice standards and policies guided the development of the proposed intervention. For instance, the American Nurses Association (ANA) ethical codes for nurses requires nurse practitioners to; collaborate with other professionals and the public in establishing, maintaining, and improving the ethical environment to provide safe and quality care, participate in interdisciplinary teams to protect human rights, promote health diplomacy, and reduce health disparities and demonstrate compassion and respect for inherent dignity (Haddad & Geiger, 2022). These provisions form the basis of ethical practices in nursing and underpin team-based, collaborative care plans.

Similarly, the Medicaid Incentives for Prevention of Chronic Diseases (MIPCD) influence interventions for preventing, treating, and managing hypertension by supporting smoking cessation programs, weight management interventions, diabetes management, and cholesterol regulation (Witman et al., 2018). The MIPCD program is a provision of the Affordable Care Act (ACA) that supports state and organization-level interventions for preventing chronic conditions, such as cardiovascular diseases and diabetes.

Finally, the Health Insurance Portability and Accountability Act (HIPAA) of 1996 influenced the development of the proposed intervention by regulating the use of telemedicine technology in hypertension management. According to Edemekong et al. (2022), HIPAA requires healthcare organizations to implement physical, administrative, and technical safeguards, such as data protection, employee training, disaster recovery plans, and securing hardware to protect personally identifiable information (PHI). Further, this policy prompts care providers to obtain written consent from patients before sharing information with the covered institutions and healthcare professionals, including billing companies, clearinghouses, and non-patient care employees. This policy is essential in strengthening patients’ autonomy and control over information interoperability and utilization.

How Technology, Care Coordination, and the Utilization of Community Resources Apply in Addressing Hypertension

Telemedicine technology and its components, such as wearable devices and m-Health applications, can improve hypertension management interventions by improving communication and supporting interactive care plans. Omboni et al. (2021) state that telemedicine facilitates e-learning, medical imaging and diagnostic, remote consultation, progress tracking, and drug management. Further, the technology provides opportunities for accurate and timely vital signs monitoring and communication (Omboni et al., 2021). The entry of telemedicine technology in hypertension management can lower the costs associated with in-office visits, strengthen patients’ participation in care plans, and improve care coordination and collaboration between healthcare professionals and patients.

Similarly, care coordination and utilization of community resources are fundamental in promoting hypertension prevention, treatment, and management approaches. Care coordination entails teamwork, the creation of proactive care plans, approaches for supporting the patient’s self-management goals, and aligning community resources with patients’ health needs and goals (Agency for Healthcare Research and Quality, 2018). On the other hand, community resources are physical and virtual assets that can improve patient health and wellness. They include expert offices, gymnasia, community-based organizations, health education centers, and online websites like the American Heart Association (AHA) and the National Institute of Neurological Disorders. These resources provide timely information, recommendations for lowering blood pressure, and suggestions for lifestyle modification and hypertension management.

Conclusion

Hypertension is a primary cause of burdensome conditions, including stroke and heart disease. Patients grappling with high blood pressure require individualized care plans emphasizing pharmacologic and non-pharmacologic approaches, such as weight management, healthy diet education, physical activity, smoking and alcoholism cessation, and medication adherence. Care coordination and the subsequent incorporation of advanced technologies like telemedicine can facilitate the implementation of interactive, team-based care plans. It is essential for healthcare professionals to comply with ethical standards of nursing practice and align their activities with the provisions of landmark governmental policies, including the Affordable Care Act (ACA) and the Health Insurance Portability and Accountability Act (HIPAA), when caring for hypertensive patients.

References

Agency for Healthcare Research and Quality. (2018). Care coordination. https://www.ahrq.gov/ncepcr/care/coordination.html

Centers for Disease Control and Prevention. (2022). High blood pressure facts. https://www.cdc.gov/bloodpressure/facts.htm

Edemekong, P. F., Haydel, M. J., & Annamaraju, P. (2022). Health insurance portability and accountability act (HIPAA). StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500019/

Haddad, L. M., & Geiger, R. A. (2022, August 22). Nursing ethical considerations. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Kario, K. (2020). Management of hypertension in the digital era. Hypertension, 76(3), 640–650. https://doi.org/10.1161/hypertensionaha.120.14742

Kwame, A., & Petrucka, P. M. (2021). A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nursing20(1). https://doi.org/10.1186/s12912-021-00684-2

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Santschi, V., Wuerzner, G., Pais, B., Chiolero, A., Schaller, P., Cloutier, L., Paradis, G., & Burnier, M. (2021). Team-based care for improving hypertension management: A pragmatic randomized controlled trial. Frontiers in Cardiovascular Medicine8. https://doi.org/10.3389/fcvm.2021.760662

Sfantou, D., Laliotis, A., Patelarou, A., Sifaki- Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of leadership style towards the quality-of-care measures in healthcare settings: A systematic review. Healthcare, 5(4), 73. NCBI. https://doi.org/10.3390/healthcare5040073

Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J. (2020). Determining if telehealth can reduce health system costs: Scoping review. Journal of Medical Internet Research22(10), e17298. https://doi.org/10.2196/17298

Verma, N., Rastogi, S., Chia, Y., Siddique, S., Turana, Y., Cheng, H., Sogunuru, G. P., Tay, J. C., Teo, B. W., Wang, T., TSOI, K. K. F., & Kario, K. (2021). Non‐pharmacological management of hypertension. The Journal of Clinical Hypertension23(7). https://doi.org/10.1111/jch.14236

Witman, A., Acquah, J., Alva, M., Hoerger, T., & Romaire, M. (2018). Medicaid incentives for preventing chronic disease: Effects of financial incentives for smoking cessation. Health Services Research, 53(6), 5016–5034. https://doi.org/10.1111/1475-6773.12994

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