Date of Publication

2022

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

Abstract

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

Dissertation/Thesis

Available for download on Wednesday, May 03, 2023

Included in

Nursing Commons

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