Increasing Patient Understanding and Self-Management of Hypertension During Nurse-Led Visits

Abstract

Purpose. This quality improvement (QI) project aims to effectively increase medical assistants (MAs), registered nurses (RNs), and patients’ confidence in managing hypertension by implementing nurse-led visits for hypertension management. Background. Hypertension is one of the leading causes of morbidity and mortality in the United States (US). Over 116 million Americans have been diagnosed with hypertension and since hypertension usually presents with no symptoms, many go undiagnosed. Hypertension can be successfully managed with lifestyle modifications and pharmacotherapy. Implementing nurse-led visits to assist in the management of hypertension is an effective way to ensure follow-up and provide education for patients with high blood pressure. Methods. A quality improvement project utilizing rapid Plan-Do-Study-Act cycles. Tests of change in the areas of team engagement, patient confidence, and systems change were analyzed through bi-weekly chart audits and run charts over four PDSA cycles. Results. 100% of MAs and RNs participated in the pre-survey, education, and post-survey. The post-survey revealed a 100% increase in confidence in blood pressure measurement and management. 11 patients participated in the pre-survey, nurse-led visit, and post-survey. The surveys conveyed that patients face multiple barriers to their hypertension management and that 100% of patients reported that nurse-led visits improved their confidence in managing their blood pressure. A 2,000% increase in nurse-led visits was achieved since there was no standardized nurse-led hypertension visit prior to this quality improvement project. Conclusions. Incorporating nurse-led visits for hypertension at the primary care level may increase patient confidence in managing blood pressure and improve understanding through education. Medical assistant (MA) and registered nurse (RN) base knowledge of blood pressure measurement and management should be the core education aspect prior to implementing a nurse-led visit. Maintaining a patient-centered approach and tailoring nurse-led visits to each patient’s individualized needs allows patients to be active participants in their healthcare. Further investigation is needed to see if improved patient confidence correlates with improved patient outcomes.