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NURSFPX 4090: Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations

Introduction

Mr. Sam, a 58-year-old Caucasian male, is the subject. He was first diagnosed with hypertension three years ago when he was 55 years old. His high blood pressure runs in the family, and it has been a problem for him for the last year. His current medicine regimen consists of taking Lisinopril and hydrochlorothiazide. Mr. Sam has been a heavy smoker for 30 years, smoking a pack a day. His diet is rich in salt and saturated fats, and he seldom gets any exercise.

High blood pressure, or hypertension, is a medical disorder that affects people of all ethnicities and sexes and lasts for an extended period of time. Researchers have shown that middle-aged Caucasian guys are at a higher risk of developing hypertension than those of other racial or ethnic backgrounds. In the United States, hypertension affects about 45 percent of Caucasian males aged 45 to 64 (ANA, n.d.). This proportion is greater than that of any other demographic. Serious health problems, such heart attack, stroke, and renal damage, may develop if hypertension isn't managed. Thus, controlling hypertension is essential for avoiding these side effects. In order to effectively manage hypertension, a combination of behavioral and pharmaceutical strategies is required. This evaluation will look at how care coordination, health IT, and local resources may help with hypertension control for this group.

Analysis of the impact of health care technology on the patient

Technology in medicine has made great strides in the treatment of hypertension. The early identification, diagnosis, and treatment of hypertension, as well as patient education and self-management, have all benefited greatly from technological advancements in the healthcare industry. Several technological options exist to aid with hypertension control. Things like blood pressure monitors, mobile health apps, and telehealth services fall within this category. Monitoring blood pressure at home may be helpful in treating hypertension. With the use of a blood pressure monitor, patients may keep tabs on their BP at home and share that data with their doctor for a more accurate diagnosis and more effective treatment of hypertension. Significant decreases in systolic and diastolic blood pressure were seen with home blood pressure monitoring compared to conventional treatment (Wienert, 2019).

The most popular kind of blood pressure monitor nowadays is digital, however manual monitors are also available. Digital blood pressure monitors are convenient since they are quick to read and accurate. Features like automated memory storing make it possible to monitor changes in blood pressure over time. Because individuals are more likely to feel at ease and provide more accurate readings in their own homes, blood pressure measurements taken at home are more trustworthy than those acquired in clinical settings. Patients with hypertension have a higher chance of recovery if their BP is regularly monitored. Home blood pressure monitoring improves treatment adherence and blood pressure management because it encourages patients to take an active role in their healthcare (Wienert, 2019).

Several factors, such as blood pressure monitor price, technical complexity, and patient acceptance of technology, may work against their widespread adoption. Many people don't use blood pressure monitors because they might be expensive or because their health insurance doesn't cover the expense. There is a wide price range for blood pressure monitors, from far under $20 to well over $100. It might be difficult for some patients to keep tabs on their blood pressure at home because of the high cost of a blood pressure monitor. The intricacy of the technology involved in blood pressure monitors is another possible obstacle to their widespread adoption. Particularly if it has to be synced with a smartphone app or other technology, some patients may find it challenging to utilize the device appropriately. Patients who aren't tech-savvy may be hesitant to utilize a blood pressure monitor. Some patients may be uncomfortable or hesitant to use a blood pressure monitor because of their unfamiliarity with or discomfort with technology. Because of this, some people may be reluctant to use the gadget or disclose their results with their doctor.

By keeping tabs on the user's eating and exercising habits, mobile health apps (apps) may be an efficient aid in the management of high blood pressure. MyFitnessPal and similar apps let users log their diet and exercise, which may help patients keep track of their calorie consumption, prevent weight gain, and improve their cardiovascular health. Boulware et al. (2022) discovered that people with hypertension who used a smartphone app to monitor their food and activity had substantial drops in their blood pressure. The American Heart Association's "Check. Change. Control." programme is one example of a mobile app that aims to help users keep their blood pressure under check. An app is included in this programme so that users may keep tabs on their blood pressure, schedule medication reminders, and get helpful information on hypertension care. A comprehensive analysis published in the Journal of Medical Internet Research indicated that mobile applications for blood pressure management may enhance patient engagement and medication adherence, and can even result in slight improvements in blood pressure control.

There might be obstacles to using mobile applications for blood pressure control, but this is true of any technology. It's possible that some patients won't have smartphones or won't feel comfortable using them. Patient outcomes may be negatively impacted by applications that are difficult to use or that deliver inaccurate information. Medical professionals have a responsibility to advise their patients on the best ways to use mobile applications and to guarantee that their patients can trust and benefit from these tools. In the wake of the 2009 COVID-19 epidemic, telehealth services gained significant traction. These services provide remote doctor-patient communication by means of videoconferencing and encrypted texting. It's especially helpful for hypertensive individuals who either can't go to their checkups or whose condition necessitates constant BP checks (Kes & Polat, 2022). The improved accessibility and convenience provided by telehealth services also contribute to better patient outcomes. Patients may get help from doctors without leaving their homes, which reduces travel time and associated costs. Through its services, patients and doctors are able to keep in touch on a regular basis, which may lead to the early detection and resolution of health problems (Kes & Polat, 2022).

The use of telemedicine has both benefits and risks. Patients may not feel comfortable utilizing videoconferencing or encrypted messaging systems, or they may not have access to the technology. Concerns have been raised concerning the privacy and security of patient data transferred through telehealth programs. Concerns about funding and liability may discourage healthcare professionals from using telehealth services. The usage of technology in nursing is on the rise, according to the available data. According to a national study of registered nurses, more than 90 percent of those polled reported using EHRs in their work (Cambell et al., 2022). Additionally, nurses are increasingly turning to smartphone applications and other forms of mobile health technology to assist with patient education and self-management.

Care Coordination

In order to effectively treat hypertension in middle-aged white males, care coordination and tapping into available community resources are crucial. Care coordination and community resource deployment has been linked to better health outcomes, higher patient satisfaction, and lower healthcare costs (Tan et al., 2020). Care coordination among healthcare professionals and community resources, such as patient education programmes and support groups, has been linked to better blood pressure management in individuals with hypertension, according to the Centres for Disease management and Prevention (CDC). Care coordination involves the active participation of patients and their families in all aspects of health care decision making. By sharing their experiences, opinions, and aspirations towards their health, they provide invaluable insight. Trust can be established, treatment plans can be better adhered to, and patients may be more actively involved in their care when there is good communication with them and their loved ones. All members of the healthcare team should be on the same page with regards to the patient's care plan and treatment objectives, and this is what care coordination tries to achieve. Misunderstandings and uncertainty among healthcare personnel have the potential to adversely affect patient care, thus it's important for them to communicate effectively with one another (Tan et al., 2020).

Hypertension in middle-aged Caucasian guys may be managed with the help of a variety of community services. Community clinics, programs to teach people about healthy eating, and fitness initiatives are all examples. Uninsured and underinsured individuals may get low-cost primary care services at their local community health clinic. Patients may benefit from learning about the effects of their food on their blood pressure via nutrition education programs. Tan et al. (2020) found that patients who participated in exercise programs, such as community fitness classes or gym memberships, had lower resting blood pressure than those who did not. Community health professionals who offered home-based blood pressure monitoring and medication management were shown to enhance blood pressure control in African American and Hispanic patients with hypertension (Lehmann & Simpson, 2022). I have found that care coordination and tapping into local resources are very helpful in controlling hypertension in my patients. Patient outcomes have improved as a result of healthcare practitioners working together, educating patients, and tapping into community resources.

Managing hypertension via care coordination and community services has several advantages, but it also faces certain obstacles. Care coordination and community resources for hypertension control are significantly hampered by a lack of patient education. Many patients don't know what options are available to them or don't realise how crucial it is to control their blood pressure. As a consequence, patients may not follow their prescribed treatments and preventative measures may be neglected (Tan et al., 2020). Care coordination in hypertension treatment has additional challenges due to a lack of available healthcare professionals. Patients have to wait a long time for appointments and have a hard time locating a doctor that focuses on hypertension treatment. Specialist care may be costly for people who lack insurance or cannot afford the associated co-pays or deductibles. Complications become more severe as a consequence of delays in diagnosis and treatment. Managing long-term health issues like hypertension may be difficult in disadvantaged areas due to a lack of access to healthcare professionals, medical facilities, and other resources. As a result, marginalised groups may have worse health outcomes and have less access to necessary medical treatment (Tan et al., 2020).


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By implementing initiatives to expand patients' opportunities to get treatment, educate those patients who do receive care, and reduce resource gaps, healthcare systems may begin to chip away at these obstacles. Access to treatment for people in rural or underserved regions may be improved by healthcare providers using telehealth services to provide remote consultations and monitoring for hypertension patients. Efforts by community health organizations should be directed towards raising public awareness about hypertension and its treatment. Disparities in access to treatment and resources for chronic illnesses like hypertension may be mitigated via the creation of policy initiatives that give funds and resources to underprivileged populations.

Analysis of state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources 

As a nurse, it is important to keep up with the latest developments in healthcare technology, care coordination, and community services, as well as any relevant legislation and regulations. As a result of following these rules and regulations, we are able to provide our patients the best treatment possible while keeping them safe and keeping healthcare expenditures to a minimum for both the government and our clients. The rules and laws at the federal, state, and local levels also have major impacts on how we do business. American Nurses Association (n.d.) recommends that nurses familiarise themselves with these principles and work to implement them in their daily practise to improve patient outcomes.

For better patient care and protection, the American Nurses Association (ANA) has established guidelines for nurses to follow. The American Nurses Association has established guidelines that promote the use of technology by nurses to improve patient care in the areas of communication, clinical decision making, and education. A similar set of rules and procedures is in place at many healthcare facilities to guarantee the appropriate and efficient use of technology to patient care. Electronic health records (EHRs), telehealth services, and mobile health apps may all fall within the purview of such rules (American Nurses Association, n.d.). Team-based care models, such as those used by my company, encourage communication and cooperation between nurses, doctors, and other medical personnel. The models are focused on providing high-quality, person-centered care in a variety of contexts with the goal of enhancing patients' health and well-being.

The Affordable Care Act (ACA) is a piece of legislation from the government that has an effect on how we operate in this field. Provisions are in place to encourage the adoption of EHRs and back up care coordination initiatives. Policies have been established by the Centers for Medicare and Medicaid Services (CMS) to promote the use of telehealth services and to back up community-based treatment for patients with chronic diseases. Ethical considerations play a significant role in nursing practice and shape how nurses go about their jobs. To provide their patients the best treatment possible, nurses need to be well-versed in ethical concepts and use them in their daily work. Consider the ethical concept of autonomy, which states that nurses must respect patients' wishes about their treatment. Nurses are responsible for providing patients with information regarding the potential dangers and advantages of using healthcare technologies so that patients may make educated choices about their health (Yang et al., 2023) while making use of such tools.

Another fundamental concept in nursing ethics is the concept of beneficence. Nurses should speak out for their patients' wellbeing and comfort. In order to enhance patients' health, nurses should prudently refer them to community services that fit their specific needs. Non-maleficence is the ethical principle that nurses should not put their patients in harm's way. When caring for patients, nurses should prioritise their safety and avoid doing anything that might endanger them, such as overusing a technology that isn't appropriate for everyone (Yang et al., 2022). Nurses may find nursing ethics to be an important resource when deciding how to use concepts like care coordination, healthcare technology, and community resources. Nursing practice that is guided by ethical principles ensures that patients always get treatment that considers their values, preferences, and requirements.

Conclusion

Patients with hypertension benefit from better results and higher levels of satisfaction with their care when they have access to better technology, better care coordination, and more community services. It is critical that all patients, regardless of their ability to pay, have access to these technologies, thus all barriers to their widespread use must be eliminated. The nursing community is accountable for upholding standards including healthcare IT, care coordination, and access to community services. Ethical nursing practice requires us to tailor care to each patient based on their values, goals, and current health status. By working together and making use of state-of-the-art healthcare technology and resources, we may be able to help improve patient outcomes and spread better health.

References

American Nurses Association. (n.d.). Care Coordination. Nursingworld.org. Retrieved April 2, 2023, from https://www.nursingworld.org/practice-policy/health-policy/care-

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Campbell, N. R., Whelton, P. K., Orias, M., Wainford, R. D., Cappuccio, F. P., Ide, N., ... & Zhang, X. H. (2022). 2022 World hypertension league, resolve to save lives and international society of hypertension dietary sodium (salt) global call to action. Journal of Human Hypertension, 1-10. https://doi.org/10.1038/s41371-022-00690-0

Boulware, L. E., Ephraim, P. L., Hill-Briggs, F., Roter, D. L., Bone, L. R., Wolff, J. L., ... & Cooper, L. A. (2020). Hypertension self-management in socially disadvantaged African Americans: The Achieving Blood Pressure Control Together (ACT) randomized comparative effectiveness trial. Journal of general internal medicine, 35, 142-152. https://doi.org/10.1007/s11606-019-05396-7

Kes, D., & Polat, U. (2022). The effect of nurse‐led telephone support on adherence to blood pressure control and drug treatment in individuals with primary hypertension: A randomized controlled study. International Journal of Nursing Practice, 28(3), e12995. https://doi.org/10.1111/ijn.12995

Kurniasih, D., Setyoko, P. I., & Saputra, A. S. (2022). Digital Transformation of Health Quality Services in the Healthcare Industry during Disruption and Society 5.0 Era. International Journal of Social and Management Studies, 3(5), 139-143. https://doi.org/10.5555/ijosmas.v3i5.225

Yang, Q., Zheng, Z., Pang, S., Wu, Y., Liu, J., Zhang, J., ... & Xie, L. (2023). Clinical nurse adherence to professional ethics: A grounded theory. Nursing ethics, 30(2), 197-209. https://doi.org/10.1177/09697330221130594

Tan, J., Xu, H., Fan, Q., Neely, O., Doma, R., Gundi, R., Shrestha, B., Shrestha, A., Shrestha, S., Karmacharya, B., Gu, W., Østbye, T., & Yan, L. L. (2020). Hypertension Care

Coordination and Feasibility of Involving Female Community Health Volunteers in Hypertension Management in Kavre District, Nepal: A Qualitative Study. Global heart, 15(1), 73. https://doi.org/10.5334/gh.872

Wienert, J. (2019). Understanding health information technologies as complex interventions with the need for thorough implementation and monitoring to sustain patient safety. Frontiers in ICT, 6, 9. https://doi.org/10.3389/fict.2019.00009




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