Redo- Assessment 1 Class 8

6

ASSESSING THE PROBLEM: LEADERSHIP, COLLABORATION, COMMUNICATION, CHANGE MANAGEMENT, AND POLICY CONSIDERATION.

Assessing the Problem

Hypertension is the clinical term that is used to describe a consistent high level in a patient’s blood pressure. This is a quite common patient concern in the healthcare sector. Uncontrolled hypertension can cause serious health problems. The risk for cardiovascular diseases, stroke, cardiac insufficiency, and death is also increased. To reduce the risk of such conditions, it is important to maintain blood pressure under control. The Centers for Disease Control ( CDC) argues that only one in four adults with hypertension has it under control and almost half of adults with elevated blood pressure are either not prescribed or do not use their medicine (2020). Biological, environmental and lifestyle factors are predisposing factors for hypertension. Study on diagnosis and treatment has made considerable strides, playing an important role in the dramatic decay of heart disease and stroke mortality in developed economies. However, there are relatively low control rates for hypertension. Randomized control studies show a substantial reduction in cardiovascular morbidity and mortality risk in successful medication intervention.

In addition to antihypertensive drugs, the consistency and risk of cardiovascular events for the treatment of hypertension patients, friends and families are also visibly affected. Observation research has showed that a stroke occurrence at any point in life, particularly for elderly adults, is indicative of a lack of adequate blood pressure management. A critical role in helping to demystify this hypertension puzzle is the mechanisms of treatment of hypertensives, healthcare providers and the healthcare system. The failure of the health consultant and the non-observance of prescriptions lead to inadequate regulation of blood pressure.

This subject is of particular interest to me because as a Medical-Surgical RN, it is a common occurrence to see patients in my unit with the diagnosis of hypertension. Of more interest is Mr. Shuabu who is a 76year old African American who is married to a Hispanic-American. He has history of tobacco use, alcohol abuse, diabetes, borderline obesity, coronary artery disease, and stroke which left him with right sided weakness. In addition to pharmacological measures in reducing blood pressure, additional measures include lifestyle improvement and weight loss are target proposed for patients with hypertension. The combination of these has proved that blood pressure is declining. Changes to your lifestyle include loss of weight, exercise, diet, quitting smoking and alcohol and stress reduction.

Analyze evidence from the literature and professional sources to support decisions related to defining and guiding nursing actions related to a health problem.

The integrative therapy for patients has increased the value of improving lifestyles as an effective hypertension control technique. Changing lifestyles means changing traditional behaviors to accomplish those health goals. Common behaviors that lead to the achievement of health goals include eat a balanced diet, increase physical activity, loss of weight, reduction of stress, smoke loss, and reduction of alcohol consumption, etc.

A survey of 1139 people with a hypertension that conformed to lifestyle changes was carried out in an article written by Yang et al. (2017). The lifestyle of patients including smoking, alcohol, salt consumption and physical activity were evaluated. In patients diagnosed with hypertension, the aim of this study was to identify and assess lifestyle changes linked to blood pressure monitoring. Participants explored medication adherence, weight, physical activity, consuming alcohol, salt, and blood pressure readings in weeks 4, 8 and 12. At the end of the study, the performance group comprised 961 participants (84%). It was found that decreased consumption of salt and physical exercise was linked to successful blood pressure control. The study suggested that dietary improvements that help to minimize hypertension include low sodium intakes, minimal or no alcohol, weight loss management, consuming fruits, vegetables, legume, milk products with low fat content, and saturated fat. After 18 months, the researchers also followed participants and there was a further pattern of reduced blood pressure (Yang, et al., 2017).

Research indicates that physical activity is important to decrease blood pressure and enhance quality of life, as these are the effect of lifestyle modifications (Magobe et al . 2017). The study indicates that 10-30 minutes' physical activity can be instrumental in the control of blood pressure at least three days a week. In this study, participants aged from 41 to 80 years diagnosed with hypertension for a period of up to ten years were involved in evaluating the efficacy of lifestyle medication in blood pressure control. The findings of the study enhanced the idea that lifestyle improvements were an successful method for the control of blood pressure, which reduces the risk of progressive cardiovascular problems for patients with healthier lifestyles by 21 percent (Magobe et al. 2017).

Proof from the literature is valid of my own nursing practice.  It is because of uncontrollable hypertension that patients are admitted to the Med-Surgical unit and they may present with hypertensive crisis or stroke. It is discovered that they do not follow this lifestyle behavior as they hear about healthy diet, obesity, smoking or alcohol cessation, and lifestyle modification. Failure of appropriate care, failure to make improvements to lifestyle, and no access to health can present challenges to evidence-based practice (Devkota et al. 2016).

Health professionals should follow a health belief model in efforts to encourage behavioral change. This approach is also used in the provision of treatment to set targets, to make choices and to encourage social inclination to strengthen patient decisions and resolve the perceived obstacles to change (Drevenhom, 2018). This model can properly be incorporated into the treatment of hypertensive patients by allowing them to take decisions and decision-making that impact the health outcomes of patients significantly.

Explain how state board nursing practice standards and/or organizational or governmental policies could affect the patient, family, or population problem you have defined.

The presence of numerous nursing boards in different states strengthens the operation of the American Nursing Association at various levels by implementing and enforcing different policy provisions. For example, the Maryland Board of Nursing (MBON) is intended to protect and improve the safety and conditions of all Maryland residents by ensuring that the health services rendered are securely administered by licensed nursing staff throughout the region. To accomplish this goal, caregivers need to recognize and implement the nursing practice act to promote the provision of treatment in compliance with the practice requirements (MBON, 2020).

Informed healthcare professionals are more skilled in quality care and delivery. Consequently, professional nurses may offer better treatment and defend their patients from any adversity. Knowledgeable nurses abide by a collection of ethical guidelines outlining the actions of nurses. Moreover, the concept of autonomy, based on familiarity with healthcare and the knowledge base, encourages a career to communicate with the patients in a positive way and to provide guidance for a safe life (Fischer, 2016). In addition, ethics forces nurses to ensure that their healthcare management is given to their patients in a constructive manner.

Propose leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient, family, or population problem you have defined.

In maintaining healthy and efficient patient results, nurses play a critical role. Patients with hypertension are educated and treatment coordinated by nurses. Treatment based on patients i.e. a patient-centered care is a good way of treating hypertension. "Tailored to the patient ’s needs, a team-based approach has shown a to be a good form of management to hypertension. Team members include the patient, nurses, doctors, counsellors, pharmacists, and nutritionists. Currently, healthcare professionals are leading teams in hypertension research to explore social, cultural, economic, and behavioral determinants' (Dennison-Himmelfarb et al., 2016). Patient results can be strengthened as a health care leader by keeping abreast of the new evidence-based best practices to increase patient safety. In the provision of high-quality patient care, nursing leaders play an important role (Mansel & Einion, 2019).

Reference

Center for Disease Control and Prevention (2020). Facts about hypertension. https:www.cdc.gov/bloodpressure/facts.html