NURS FPX 6614 Assessment 1 Defining a Gap in Practice Executive Summary
Defining a Gap in Practice: Executive Summary
As of now, hypertension affects an estimated 116 million individuals in the US (CDC, 2020). Due to pumping blood more forcefully to all parts of the body, hypertension thickens the walls of the left chamber of the heart. Heart attack, heart failure, and unexpected cardiac death are all caused by a thick left ventricle (Oparil et al., 2018). Furthermore, proof proposes that corpulent individuals are more inclined to encounter hypertension side effects. They require more health-related adjustments, either medications or way-of-life modifications (Semlitsch et al., 2021). Team-based care combined with the care coordination process has the potential to impact patients’ health. This executive summary aims to compare the efficacy of way-of-life modifications versus medications in managing hypertensive side effects in overweight patients. This executive summary will also analyze the impact of care coordination on patients’ decisions. Get free NURS FPX6614 Assessment 1 Defining a Gap in Practice Executive Summary
Clinical Priorities for Overweight Hypertensive Patients
Stoutness is defined by World Health Organization as 20% more weight than the ideal weight (WHO, 2021). Many adverse health outcomes, including hypertension, Type II Diabetes mellitus, coronary artery disease, heart failure, advancement of kidney disease, and hyperlipidemia, are associated with being overweight or fat (WHO, 2021). Corpulence causes hypertension, however, it also exacerbates the side effects of hypertension in the patient. Overweight hypertensive patients are remembered to have changed hormonal signals, as well as abnormalities in their sympathetic sensory system and kidney capability. The increased abdominal tension caused by visceral fat, as seen in large individuals, places additional strain on the cardiovascular framework (CVS) (Chrysant, 2019). This additional strain on the CVS ultimately brings about uncontrolled or persistent hypertension making the condition worse for them. This persistent hypertension can make overweight patients experience the ill effects of dizziness, nose bleeding, headache, vision changes, chest pain, and muscle tremors (Chrysant, 2019). Subsequently, it is crucial to foster powerful healthcare strategies, either medication regimens or way-of-life modifications that may be useful to overweight patients to manage their hypertensive side effects.
NURS FPX6614 Assessment 1 Defining a Gap in Practice Executive Summary
Care coordination is a critical device for healthcare suppliers to use while assisting overweight hypertensive individuals in managing their hypertension side effects. Patients will find it easier to communicate with their physicians, nutritionists, pharmacists, and medical attendants owing to a streamlined care coordination technique (Karam et al., 2021). Care coordination is a team-based strategy determined to include patients in their own care with other individuals from the healthcare team (Karam et al., 2021).
In-depth Analysis or Knowledge Gap
Hypertension side effects in overweight patients could be managed with the assistance of medications, however proof recommends that medications have aftereffects. These secondary effects can worsen the situation for a large hypertensive patient (Gebreyohannes et al., 2019). Additionally, the adverse impacts caused by antihypertensive medications make medication adherence hard for the patient (Gebreyohannes et al., 2019). Cosimo Marcello et al. (2019) reported that something like 33% of hypertension patients treated with antihypertensive medication reach the ideal number (Cosimo Marcello et al., 2019).
Research by Cosimo Marcello et al. (2019) recommends that low-salt eating regimens and regular exercise may assist hefty individuals in controlling their hypertension side effects. Patients can safely decrease weight and keep their circulatory strain steady with a combination of healthy eating and regular exercise (Cosimo Marcello et al., 2019).
What is the PICOT question?
For hypertensive corpulent individuals, a (population, intervention, comparison, result, and time) PICOT philosophy may be helpful for analyzing the relative benefits of way of life modifications versus medications and filling in the knowledge gap. The PICOT question is: In overweight adults with hypertension do way of life modifications as compared to antihypertensive medications bring about low circulatory strain within half year time span?
Population: Overweight adults
Intervention: Way of life modifications
Comparison: Way of life modifications versus medications
Result: Low circulatory strain
Time: a half year
Explanation of the Selected Gap
According to Alsaigh et al. (2019), appropriate care planning is necessary to safeguard patients from the potentially lethal implications that hypertension could have. Changes in the way of life have a significant job in lowering pulse and postponing the improvement of hypertension in individuals who are otherwise healthy. Patients with hypertension ought to consider making way-of-life adjustments first before initiating pharmacologic therapy (Alsaigh et al., 2019). The care coordinator’s liability is to educate overweight hypertensive patients. Furthermore, they need to assess their degree of knowledge by asking them freestyle questions after educating them. This is the last yet most important part of the care coordinator’s work. The patient should be instructed by the coordinator on the most proficient method to make the necessary behavioral adjustments to achieve the ideal outcomes (Karam et al., 2021).
NURS FPX6614 Assessment 1 Defining a Gap in Practice Executive Summary
At the regional level, the Joint National Board (JNC) has suggested that hypertensive patients engage in way-of-life modifications for a half year. These modifications, according to the JNC, include increased physical exercise and dietary changes for corpulent patients, low salt intake, and restricted alcohol utilization (de la Sierra, 2019). The head trial was the largest clinical trial performed in the US that evaluated the techniques for lowering pulse through changes in way of life. It evaluated the impact on hypertension by making many concomitant adjustments to one’s way of life. This trial showed that weight reduction, getting more exercise, and eating very much were all great ways to manage hypertension without drugs (Mahmood et al., 2019). Additionally, way-of-life modification and medications can both lower pulse within a half year, yet medications can certainly show their incidental effects within the half-year time frame (Kebede et al., 2022).
Services and Resources for Care Coordination
Healthcare teams can make utilization of social media messages, fact sheets, and handouts to educate large hypertensive patients on way-of-life modifications.
In various facilities, care teams consist of attendants, physicians, pharmacists, information innovation specialists, and hospital administrators. Attendants, as care coordinators, can play their part in raising awareness among large hypertensive patients on making healthy way-of-life decisions. In addition, the whole team can use telehealth to monitor patients’ compliance with their recommended way of life change regimens (Volterrani and Sposato, 2019).
The course of care coordination is hindered by various obstacles. These obstacles include insufficient coordination with patients because of a lack of patients’ confidence in healthcare professionals or their inability to engage in self-management practices (Heinert et al., 2019). In addition, since health information innovation plays a significant part in care coordination, medical attendants and other individuals from the healthcare team may experience obstacles to its effective use. Also, a lack of resources can also be an issue in the care coordination process. Convictions of stout hypertensive patients, patient motivation, and melancholy could also be a barrier to the care coordination process (Heinert et al., 2019).
The Type of Care Coordination Intervention
Care coordination, according to the Agency for Healthcare Research and Quality (AHRQ), is supported by five pillars. These five pillars include teamwork between the staff and patients, powerful utilization of health information innovation, care, and medication management, and patient-focused care (Agency for Healthcare Research and Quality, 2018).
Specific and Practical Way
According to Pilipovic-Broceta et al. (2018), to teach large hypertensive patients about the appropriate way-of-life adjustments, healthcare professionals should use the Persistent Care Model. It is essential for the organization to foster liability and accountability. Executives in the healthcare industry should hold regular meetings with all important stakeholders, including medical attendants, physicians, nutritionists, pharmacists, and information technologists. These team meetings will aid in communication and the exchange of knowledge. It will assist with discussing patient necessities and goals and foster a proof-based care plan (Pilipovic-Broceta et al., 2018).
NURS FPX6614 Assessment 1 Defining a Gap in Practice Executive Summary
According to the Agency for Healthcare Research and Quality, (2018) after the planning phase, stakeholders should execute the plan, assist and mentor patients in achieving self-management targets, and then do a development (Agency for Healthcare Research and Quality, 2018).
Support the Strategy for Collaborative Care
The main diagnosis by health care staff and attendants to support collaborative care strategy is to favor way-of-life modifications. Large hypertensive patients are more vulnerable to the fatal impacts of hypertension in the event that they don’t make the appropriate way of life changes (Csige et al., 2018). To attain optimal health and avoid incidental effects, it is more important to adhere to an exercise program and a nutritious eating regimen than to take medication. These goals are attainable on the off chance that all stakeholders collaborate as a team.
It is critical for all vital stakeholders to collaborate in order to persuade hypertensive corpulent individuals to undertake way-of-life adjustments to achieve optimal health outcomes. With the assistance of Team-based Care (TBC), the care coordinator should organize month-to-month meetings to foster goals and targets for large hypertensive patients and to include all stakeholders. At the point when medical caretakers, physicians, information
Agency for Healthcare Research and Quality. (2018). Care Coordination | Agency for Healthcare Research & Quality. Ahrq.gov. https://www.ahrq.gov/ncepcr/care/coordination.html
Alsaigh, S. A. S., Alanazi, M. D., & Alkahtani, M. A. (2019). Lifestyle modifications for hypertension management. The Egyptian Journal of Hospital Medicine, 70(12), 2152–2156. https://doi.org/10.12816/0045044
CDC. (2020, February 25). Facts About Hypertension. Centers for Disease Control and Prevention. https://www.cdc.gov/bloodpressure/facts.htm#:~:text=Nearly%20half%20of%20adults%20in
Chrysant, S. G. (2019). Pathophysiology and treatment of obesity‐related hypertension. The Journal of Clinical Hypertension, 21(5), 555–559. https://doi.org/10.1111/jch.13518
Cosimo Marcello, B., Maria Domenica, A., Gabriele, P., Elisa, M., & Francesca, B. (2019). Lifestyle and hypertension: An evidence-based review. Journal of Hypertension and Management, 4(1). https://doi.org/10.23937/2474-3690/1510030
Csige, I., Ujvárosy, D., Szabó, Z., Lőrincz, I., Paragh, G., Harangi, M., & Somodi, S. (2018). The impact of obesity on the cardiovascular system. Journal of Diabetes Research, 2018(3407306), 1–12. https://doi.org/10.1155/2018/3407306
de la Sierra, A. (2019). New American and European hypertension guidelines, reconciling the differences. Cardiology and Therapy, 8(2), 157–166. https://doi.org/10.1007/s40119-019-0144-3
Gebreyohannes, E. A., Bhagavathula, A. S., Abebe, T. B., Tefera, Y. G., & Abegaz, T. M. (2019). Adverse effects and non-adherence to antihypertensive medications in University of Gondar Comprehensive Specialized Hospital. Clinical Hypertension, 25(1). https://doi.org/10.1186/s40885-018-0104-6
Heinert, S., Escobar-Schulz, S., Jackson, M., Del Rios, M., Kim, S., Kahkejian, J., & Prendergast, H. (2019). Barriers and facilitators to hypertension control following participation in a church-based hypertension intervention study. American Journal of Health Promotion, 34(1), 52–58. https://doi.org/10.1177/0890117119868384
Karam, M., Chouinard, M.-C., Poitras, M.-E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021). Nursing care coordination for patients with complex needs in primary healthcare: A scoping review. International Journal of Integrated Care, 21(1). https://doi.org/10.5334/ijic.5518
Kebede, T., Taddese, Z., & Girma, A. (2022). Knowledge, attitude, and practices of lifestyle modification and associated factors among hypertensive patients on-treatment follow up at Yekatit 12 General Hospital in the largest city of East Africa: A prospective cross-sectional study. PLOS ONE, 17(1), e0262780. https://doi.org/10.1371/journal.pone.0262780
Kreps, G. L. (2018). Communication and effective interprofessional health care teams. International Archives of Nursing and Health Care, 2(3). https://doi.org/10.23937/2469-5823/1510051
Liu, X., Sutton, P. R., McKenna, R., Sinanan, M. N., Fellner, B. J., Leu, M. G., & Ewell, C. (2019). Evaluation of secure messaging applications for a health care system: A case study. Applied Clinical Informatics, 10(1), 140–150. https://doi.org/10.1055/s-0039-1678607
Mahmood, S., Shah, K. U., Khan, T. M., Nawaz, S., Rashid, H., Baqar, S. W. A., & Kamran, S. (2019). Non-pharmacological management of hypertension: in the light of current research. Irish Journal of Medical Science, 188(2), 437–452. https://doi.org/10.1007/s11845-018-1889-8
Oparil, S., Acelajado, M. C., Bakris, G. L., Berlowitz, D. R., Cífková, R., Dominiczak, A. F., Grassi, G., Jordan, J., Poulter, N. R., Rodgers, A., & Whelton, P. K. (2018). Hypertension. Nature Reviews Disease Primers, 4(4), 18014. https://doi.org/10.1038/nrdp.2018.14
Semlitsch, T., Krenn, C., Jeitler, K., Berghold, A., Horvath, K., & Siebenhofer, A. (2021). Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd008274.pub4
Shariq, O. A., & McKenzie, T. J. (2020). Obesity-related hypertension: A review of pathophysiology, management, and the role of metabolic surgery. Gland Surgery, 9(1), 80–93. https://doi.org/10.21037/gs.2019.12.03
Volterrani, M., & Sposato, B. (2019). Remote monitoring and telemedicine. European Heart Journal Supplements, 21(Supplement_M), M54–M56. https://doi.org/10.1093/eurheartj/suz266
WHO. (2021). Obesity and Overweight. World Health Organisation; WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight