Holistic Blood Pressure Management Plan in Primary Care

Abstract

Purpose: The purpose of this Doctor of Nursing (DNP) quality improvement (QI) project was to demonstrate the usefulness of implementing a bilingual educational module for patients with hypertension on improving knowledge, self-efficacy, and self-management at Kids Kare Pediatrics and Family Kare Clinic. Background: Uncontrolled hypertension (HTN) is one of the leading causes of death and disability worldwide. Approximately half of individuals diagnosed with HTN achieve adequate blood pressure (BP) control, with a little over a third reporting proper medication adherence. While African Americans are more prone to developing cardiovascular-related complications and premature death, Hispanic Americans, such as Mexican Americans, have higher rates of uncontrolled BP and are disproportionately affected by diabetes mellitus and chronic kidney disease (CKD). Healthcare providers must consider the interconnectedness between mental and social factors, chronic disease, and holistic management. Providing patients with a holistic educational pamphlet in English and Spanish is a quick, inexpensive way of delivering health information on HTN disease management to different populations. Methods: The project design was descriptive quantitative and included the use of a validated tool, the Self-Efficacy for Managing Chronic Disease (SEMCD) 6-item scale to assess pre and posttest self-efficacy. The posttest also inquired about age, enhanced knowledge, perceived usefulness, and if participants would recommend the pamphlet to their friends and family. The Model for Improvement guided the implementation and evaluation of the holistic educational pamphlet. The project director delivered the pretest, the educational intervention, and then the posttest face-to-face in the clinic. Results: Of the nineteen participants, eleven were Spanish-speaking and eight were English-speaking. Individuals who participated in this QI project had a history of HTN, prediabetes or diabetes mellitus, dyslipidemia, anxiety, and/or depression. All of the participants reported increased knowledge and increased self-efficacy in certain domains. All of the participants indicated they found the pamphlet useful and would recommend it. Conclusions: A holistic, evidence-based educational intervention was effective in increasing hypertension knowledge and self-efficacy in self-management at a primary care clinic. Quality improvement projects (QI) such as these can increase the application of evidence-based interventions for different races and ethnicities, chronic diseases, and practice settings.