Quality Healthcare: Hypertension

Chamberlain College of Nursing NR 506-NP-Healthcare Policy and Leadership Dr. Thibodeau May 19, 2021

Introduction

As healthcare evolves, so does the need for patients to have access to the care they require and to have confidence in their treatment. Ensuring access to high-quality patient care, accessible treatment, and assisting patients in achieving optimum well-being are among the many expectations that nurse practitioners have for all patients. Quality controls are essential to ensure that healthcare services are delivered appropriately and effectively. These indicators demonstrate that patients are receiving high-quality treatment. The National Committee for Quality Assurance (NCQA) was established to ensure this quality of care by assessing performance and identifying areas that need development (NCQA, 2020). The Healthcare Effectiveness Data and Information Set (HEDIS) is a method for measuring the effectiveness of care across six domains. This paper will examine hypertension, often dubbed the “silent killer” due to its tendency to go unrecognized. Elevated blood pressure can lead to severe complications such as kidney injury, myocardial infarction, congestive heart failure, or cerebrovascular accidents. By analyzing patient interventions for managing high blood pressure and assessing how family nurse practitioners can utilize these interventions, we can better understand how these primary care strategies lead to improved patient outcomes and cost savings for the practice.

Patient Interventions and Measure Outcomes

Patients play a critical role in their wellness and must be aware of behaviors that could impact their long-term health. Interventions are essential to improve physical and mental fitness, particularly in managing hypertension, which affects one billion individuals globally, with 30% of the U.S. population impacted (Liyanage-Don et al., 2019). Patients must take an active role in promoting their well-being, given the prevalence of hypertension. Effective patient interventions are crucial in helping patients manage high blood pressure. Three key interventions include home blood pressure monitoring, adhering to a heart-healthy diet, and increasing physical activity levels.

Home Blood Pressure Monitoring

Home blood pressure monitoring allows patients and clinicians to gain a more comprehensive understanding of blood pressure trends over time. Many individuals are unaware they have high blood pressure, as it often presents without symptoms. Monitoring at home is the only way to detect it early. Regular monitoring can reveal whether blood pressure is consistently high, indicating a need for medical intervention or medication adjustment. Home monitoring is often more accurate than readings taken in a clinical setting due to “white coat hypertension,” where anxiety in a doctor’s office temporarily raises blood pressure (Liyanage-Don, 2019). By keeping a record of home blood pressure readings, patients can provide their healthcare providers with precise information that aids in cardiovascular health management. Monitoring blood pressure at home is a simple yet effective way to participate in healthcare management.

Heart-Healthy Diet

Adopting a heart-healthy diet is crucial for reducing high blood pressure. Proper dietary choices and lifestyle modifications can significantly reduce the prevalence and mortality rate of cardiovascular diseases (Dinu et al., 2017). A heart-healthy diet includes reduced calorie intake, increased consumption of fruits and vegetables, reduced intake of processed meats, minimal sodium and sugar consumption, and increased intake of omega-3 fatty acids (Dinu et al., 2017). This diet not only helps reduce hypertension but also aids in maintaining a healthy weight, lowering the risk of additional health problems. Research shows that nutrients like potassium and magnesium, found in fruits and vegetables, can effectively lower blood pressure (Dinu et al., 2017).

Physical Activity

Increasing physical activity is another essential intervention for lowering blood pressure. Overweight individuals are 1.84 times more likely to develop hypertension than those who are not obese (Kristanti et al., 2019). As obesity increases the risk of hypertension, regular physical activity is vital. Patients should aim for at least 30 minutes of moderate-intensity aerobic exercise five days a week, with their provider’s approval to ensure safety (Deka et al., 2017). Activities such as walking, jogging, cycling, and swimming can be effective forms of exercise (Pescatello et al., 2019). Physical activity also helps with weight management, cardiovascular health, and stress reduction. A healthy weight, strong heart, and good mental well-being all contribute to improved blood pressure levels.

Measuring Outcomes

Family nurse practitioners can assess the effectiveness of these interventions through self-reporting outcome measures and performance-based outcome assessments. Self-reported outcomes provide subjective data based on the patient’s perception of success, such as their adherence to a heart-healthy diet. The nurse practitioner can use this information to determine the effectiveness of dietary interventions. In contrast, regular blood pressure readings and physical activity levels offer objective data that can be measured and evaluated. By examining the patient’s blood pressure records and observing their ability to engage in physical activity, the nurse practitioner can assess the success of these interventions. Monitoring changes in exercise stamina and vital signs over time also provides valuable insights into the patient’s progress.

Patient Outcomes and Cost Savings

Patient interventions encourage active participation in treatment, promote compliance, and ensure that patients are well-informed about their conditions and treatment options. Educating patients on improving their interventions can help them enhance their current health and promote long-term wellness. Many healthcare providers, particularly nurse practitioners, utilize the “Institute for Healthcare Improvement Triple Aim Framework” to promote population health, improve patient safety, and reduce costs (Verma et al., 2016). By effectively managing hypertension through patient interventions, unnecessary and unscheduled doctor visits can be avoided, allowing healthcare providers to focus on other patients. Although more office visits may generate additional revenue, long wait times can drive patients to seek care elsewhere, which negatively impacts the clinic’s revenue and the patient’s well-being. Properly managed hypertension can also reduce insurance reimbursement issues and decrease the need for follow-up visits, ultimately saving costs for both patients and the practice.

Improved Patient Ratings

Effective patient interventions can lead to enhanced patient well-being, which in turn can attract more patients and generate additional revenue. Medicare and other insurance providers often link reimbursement rates to patient satisfaction and ratings (Lindsay, 2017). While healthcare providers strive to deliver the best care possible, patient satisfaction is crucial to maintaining high ratings. Patient interventions, such as home blood pressure monitoring, dietary changes, and increased physical activity, empower patients to take control of their health. When patients see improvements in their well-being, they are more likely to be satisfied with their care and provide positive feedback, leading to higher patient ratings.

Conclusion

Hypertension is a widespread condition that poses significant health risks, including kidney failure, myocardial infarction, cerebrovascular injury, and congestive heart failure. To achieve the best patient outcomes, it is essential to integrate interventions into daily life. By analyzing three patient interventions for hypertension management, discussing how nurse practitioners can measure the effectiveness of these interventions, and exploring the impact on cost savings and patient satisfaction, it is clear that patient interventions are both effective and necessary. With the support of nurse practitioners and other healthcare providers, patients can positively impact their health and prevent hypertension from becoming a silent killer.

References

• Deka, P., Pozehl, B., Williams, M. A., & Yates, B. (2017). Adherence to recommended exercise guidelines in patients with heart failure. Heart Failure Reviews, 22(1), 41–53.
• Dinu, M., Pagliai, G., & Sofi, F. (2017). A heart-healthy diet: Recent insights and practical recommendations. Current Cardiology Reports, 19(10), 95.
• Kristanti, D., & Prihartono, N. (2019). Obesity as a predictor of hypertension in adult population: A 14-years retrospective cohort study. Indian Journal of Public Health Research & Development, 10(6), 491–497.
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• Liyanage-Don, N., Fung, D., Phillips, E., & Kronish, I. M. (2019). Implementing home blood pressure monitoring into clinical practice. Current Hypertension Reports, 21(2), 14.
• National Committee for Quality Assurance. (2020). HEDIS measures. Retrieved from http://www.ncqa.org/hedis/measures/
• Pescatello, L., Buchner, D., Jakicic, J., Powell, K., Kraus, W., & Bloodgood, B. (2019). Physical activity to prevent and treat hypertension: A systematic review. Medicine & Science in Sports & Exercise, 51, 1314-1323.
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