Date of Publication


Project Team

Faculty Advisor: Melanie Keiffer, DNP, APRN, ANP-BC, CNE; Site Mentors: Erin Leighton, DNP, APRN, FNP-BC and Deborah Norton, Ed.D, APRN, CDE


Background. The risk for developing uncontrolled hypertension increases with age. Hypertension remains under-controlled and underdiagnosed in rural areas. This trend is exacerbated by the COVID-19 pandemic due to decreases in primary care visits, increases in telehealth visits, and a significant decline in assessment of blood pressure. Evidence reveals that telemedicine in conjunction with self-monitored blood pressure (SMBP) are proven tools to support patients and providers in the remote management of hypertension.

Purpose. This project aimed to improve utilization of self-monitored blood pressure (SMBP) for management of hypertension in older adults (65 years and older) and accuracy of self-reported results at a nurse practitioner-led primary care clinic.

Methods. Standardized protocols for SMBP were developed, deployed, and evaluated at a primary care clinic in a city in Northwestern Vermont. Interventions included the development of protocols for provider initiation of SMBP and a nurse-driven telemedicine follow-up with patients after initiation of SMBP. Patient knowledge of SMBP and patient performance of SMBP technique using an evidence-based competency checklist were evaluated (n=12).

Results. The intervention resulted in an increase in mean patient knowledge assessment score and improved patient SMBP competency post-intervention.

Conclusion. Implementing evidence-based protocols and interventions, and nurse-driven follow-up, enhances the effectiveness of SMBP as a tool to manage hypertension in older adults. Further study to evaluate the accuracy of SMBP to guide diagnosis and treatment in older adults is warranted.

Document Type


Included in

Nursing Commons