Author Biographical Info

Narayani Koirala is a dedicated post-master DNP student with over 20 years of nursing experience, including home health, med-surge, and ICU roles. She is currently practicing as a Family Nurse Practitioner (FNP) and serving a low socioeconomic population. She is passionate about transforming healthcare and driving quality improvement initiatives.

Date of Doctor of Nursing Practice Project Completion

Spring 2024

Faculty Advisor

Dr. Jessica S. Coviello

Abstract

Background: Hypertension is a major risk factor for cardiovascular disease morbidity and mortality with over half of all cardiovascular deaths attributed to it (CDC, 2022). “It is estimated that one-third of adults are hypertensive worldwide. Predictions indicate that one billion individuals will be hypertensive by 2025” (Eghbali et al., 2022). Non-adherence to prescription medication and lifestyle changes is a significant problem and prevalent in the Hispanic population due to various factors related to social determinants of health.

Aim: This project aimed to increase patient adherence to hypertension treatment therapy in Hispanic adults with hypertension for improved blood pressure control and ultimately help to lower healthcare costs.

Method: Patient teaching by a health care provider utilizing a patient-centered shared decision-making education approach was the focus of the intervention. The Plan/Do/Study/Act (PDSA) cycles were utilized to improve project outcomes. Questionaries for pre-educational and post-educational sessions measured patients’ increased understanding of the management of hypertension. The measurement of adherence to treatment therapy was the blood pressure comparison from baseline and at the end of three months.

Results: The participating patients had increased adherence to treatment therapy reflected in blood pressure readings. 19 patients out of 30 had at least a ten mmHg decrease in systolic blood pressure and a minimum of a five mmHg drop in diastolic blood pressure compared to the initial blood pressure recorded at the start of the project.

Conclusion: Improving blood pressure treatment adherence leads to greater blood pressure control. Strategies to improve patient/ provider decision-making affected BP control over a 3 months period.

Keywords

blood pressure, hypertension, shared decision making, hispanic population, adherence

Included in

Nursing Commons

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