NURSFPX4900: Assessing the Problem: Leadership, Collaboration, Communication, Change Management, and Policy Considerations

High blood pressure, or hypertension, is a medical condition that affects a sizable percentage of the global population. Hypertension is a huge public health problem since it may cause catastrophic side effects including heart disease, stroke, and renal failure. Over forty percent of persons in their middle years in the United States are affected by hypertension, and according to the Centers for Disease Control and Prevention (CDC), cardiovascular disease is the leading cause of mortality in the nation. According to Campbell et al. (2022), middle-aged Caucasian men are at a greater risk of developing hypertension due to a combination of factors including genetics, lifestyle factors such as diet and exercise, and stress. Public health efforts should prioritize addressing hypertension since it is both preventable and treatable by making positive adjustments to one's way of life.

Part 1

The family I intend to work with the patient’s himself. Mr. Sam, a 58-year-old Caucasian male, was selected as 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 chain smoker for the last 24 years, averaging one pack of cigarettes every day. His diet is rich in salt and saturated fats, and he seldom gets any exercise. Most of Mr. Sam's day is spent behind his firm, where he performs his duties. He blames his job and family obligations for his anxiety. Changing one's way of life is an important part of hypertension treatment since it may aid in maintaining healthy blood pressure levels and warding off consequences. To solve this issue, I will analyze it from many angles, including leadership, teamwork, communication, adaptation, and policy.

Part 2

Analyzing Evidence from Peer-Reviewed Literature

There is a large amount of research that shows how beneficial lifestyle adjustments are for controlling hypertension. Hypertensive people may benefit from lowering their blood pressure by adjusting their lifestyles such losing weight, eating better, exercising regularly, drinking less alcohol, and giving up smoking. Guidelines for the treatment of hypertension have been established by a number of professional organizations. These include the American Heart Association (AHA) and the American College of Cardiology (ACC). According to these recommendations, hypertension should first be treated by focusing on changing one's lifestyle (Sudharsanan et al., 2021).

When hypertension is diagnosed, the patient should begin making lifestyle changes immediately, as advised by the AHA and ACC recommendations. Medication may be required if blood pressure goals are not met by lifestyle changes alone. The recommendations are backed by a substantial amount of information from scholarly journals and other authoritative publications. Lifestyle changes have been shown to be helpful in lowering blood pressure and enhancing cardiovascular outcomes in a number of randomized controlled studies (Sudharsanan et al., 2021).

  Changing one's way of life is stated by vogel et al. (2021) as a primary method of treating prehypertension. In particular, they stress the value of losing weight, increasing physical exercise, and eating a nutritious diet in lowering blood pressure and avoiding the development of hypertension. Relaxation methods like meditation and yoga are also mentioned by the authors as helpful in controlling high blood pressure (Vogel et al., 2021).

Soltani et al. (2019) conducted a clinical investigation to examine the impact of different eating patterns on participants' blood pressure. Blood pressure was significantly reduced in individuals who had a diet rich in fruits and vegetables, moderate in milk fat, and low in both total and saturated fats compared to those who consumed a control diet. This was shown by the fact that those who followed a diet rich in fruits and vegetables also had significantly lower blood pressure. According to the findings provided by Soltani et al. (2019), making modifications to one's lifestyle, such as modifying one's food, has been found to be successful in decreasing blood pressure in those who suffer from hypertension. In order to effectively treat hypertension and encourage positive behavioral changes in patients, evidence-based practice (EBP) must be put into effect.

However, there are a number of obstacles that might prevent the widespread use of EBP from being overcome. One of the most significant obstacles, according to Storey et al. (2019), is healthcare professionals' lack of knowledge, skills, and time. Inadequate treatment of hypertension and lack of understanding of lifestyle adjustments that may be useful in treating the disease are contributed to by insufficient training and a lack of knowledge of EBP recommendations. Inadequate personnel, finance, and access to proper technology and equipment are just a few examples of the limited resources that may be a marriare. It's possible that doctors and nurses just don't have what they need to properly treat hypertension in their patients. Patient education and therapy of hypertension, including lifestyle adjustments, might suffer from a lack of resources (Bell et al., 2021). 

People's resistance to change is another important roadblock in the adoption of evidence-based standards. Healthcare practitioners may be reluctant to adopt new practises or make modifications to their present practises for a variety of reasons, including a lack of organisational support, reluctance to change, and a lack of knowledge about the benefits of evidence-based practise (EBP). An individual's aversion to change may play a role in both ineffective hypertension treatment and poor adherence to lifestyle adjustments. In order to raise the standard of treatment for hypertension patients, medical professionals need to zero in on these issues (Bell et al., 2021). A randomized controlled trial was conducted by Maimaitiaili et al. (2022) to investigate the efficacy of a hypertension treatment plan based on evidence-based guidelines in reducing blood pressure in hypertensive individuals. Following evidence-based hypertension management strategies may significantly lower blood pressure in hypertensive individuals, as shown by the study findings. The findings of this research provide credence to claims that nursing rules and standards might ameliorate hypertension-related patient outcomes. Improving the quality of treatment for hypertension patients and reducing adverse outcomes requires widespread adoption of recommendations supported by scientific evidence. 

Nurses have been shown to have a significant impact on healthcare outcomes, sickness prevention, and hospital readmission rates. As proponents of evidence-based recommendations and promoters of nursing-led treatments, registered nurses play an essential part in the process of formulating and enacting policy. The American Nurses Association (ANA) has released a set of policy statements on the treatment and prevention of hypertension. Hypertension and behavioral modifications are addressed by nurses in the context of a number of nursing theories and frameworks. Nola Pender's Health Promotion Model (HPM) is a popular theoretical framework that nurses may use to direct their efforts towards promoting healthy lifestyles. The HPM is geared at improving people's well-being and decreasing the prevalence of disease through altering their perceptions, values, and actions in these areas. Another theory that may help nurses with hypertension and lifestyle modifications is Albert Bandura's self-efficacy theory. According to the Self-Efficacy Theory, people are more likely to succeed in changing their behaviors if they have faith in their own abilities to do so (Sudharsanan et al., 2021).

Nursing Practice Standards

Nursing boards at the state level are crucial in setting norms and regulations for the nursing profession. To guarantee that patients get high-quality care and that healthcare is administered safely and effectively, these rules and standards may serve as recommendations for nurses to follow in their practice. Guidelines for nursing practice established by state boards that prioritize patient safety, care quality, and good results.

Regular and precise documentation and monitoring of patients' blood pressure to detect hypertension and any changes in blood pressure is required by state board nursing practice guidelines in the event of hypertension. When measuring a patient's blood pressure, nurses should use the right cuff size, ensure the patient is positioned appropriately, and take repeated readings to ensure accuracy. According to these guidelines, nurses are also expected to provide advice on how to lower blood pressure and take medications as prescribed. Changes in eating habits, physical activity levels, and stress management strategies may be suggested. Nurses are responsible for keeping tabs on their patients' vitals and managing any adverse drug reactions that may occur. The policies of an organization also matter much in terms of hypertension treatment. For instance, healthcare institutions may construct guidelines and recommendations outlining the assessment, therapy, and monitoring of patients with hypertension, all based on evidence-based practice. Guidelines for multidisciplinary teamwork, medication management, and patient education may also be included in such policies.

Compliance with these nurse practice standards and organizational rules has been found to enhance hypertension-related patient outcomes. Oseni et al. (2023) observed that patients' blood pressure was better managed when they followed a hypertension treatment strategy based on national standards. DiPette et al. (2020) observed that primary care clinics' enhanced adherence to evidence-based recommendations and blood pressure control was the result of the introduction of a hypertension treatment strategy. If we want better outcomes and disease prevention from hypertension, nurses must be involved in policy making. Nurses' clinical expertise is crucial in informing national, state, and regional/local guidelines for hypertension care. Policies that address socioeconomic determinants of health that contribute to hypertension, such as availability to nutritious food and safe neighborhoods for physical exercise, are another area where nurses actively lobby for change.

Policy implementation at the municipal, state, and federal levels has an impact on how hypertension is treated. Nursing services relating to hypertension treatment are in more demand as a result of policies that promote access to healthcare for marginalized groups. The need for nurse services such as documentation, monitoring, and education rises in response to policies that mandate the implementation of evidence-based recommendations for hypertension treatment by healthcare professionals. Nurses' capacity to offer high-quality treatment for hypertension patients may be hampered by policies that restrict patients' access to healthcare or the implementation of evidence-based recommendations.

Leadership Strategies to Improve Patient Outcomes

Developing effective leadership techniques is essential to enhancing hypertension-related outcomes, patient-centered treatment, and the patient experience. Patients with hypertension have a lot more to gain from a team approach consisting of specialists from several fields. The nurses, doctors, chemists, and nutritionists at a healthcare facility all work together and coordinate their efforts in this model of care. The expertise of these people allows for the creation of a treatment strategy that considers the whole patient. The multidisciplinary team approach relies heavily on the coordination and leadership of nurses. They play the role of facilitators, making sure everyone in the team is on the same page and doing their part to care for the patient. Patients and their families may benefit from nurses' guidance as they make changes to their lifestyle, take their medications as prescribed, and take charge of their own health care (Kes & Polat, 2022).

ORDER NURSFPX4900 ASSESSMENT 1 HERE

Improvements in patient outcomes may be dramatic when professionals from different fields work together. DesRoches et al. (2012) discovered that patients with hypertension who were treated by a multidisciplinary team had substantial decreases in blood pressure and increased adherence to their medication. Kraus et al. (2021) reported that hypertension patients' blood pressure and medication adherence significantly improved after being treated in a team-based care paradigm. Effective cooperation and communication methods are crucial for implementing a diverse team strategy. This entails holding frequent team meetings, ensuring sure everyone knows their specific tasks, and deciding things collectively. Patients get coordinated and consistent treatment because to the team's ability to effectively communicate with one another. Engaging stakeholders and educating the public are two examples of change management tactics that work well in combating hypertension. This involves including patients and their families in the change process and training healthcare practitioners on evidence-based recommendations and best practices. Organizational structures, procedures, and workflows will need to be revised. Educating and educating employees, including them in decision-making, and giving sufficient resources to back up a team-based approach are all effective change management tactics. 

Conclusion

Nurses have a crucial role in the management of hypertension, a serious health issue that needs immediate care. In order to design complete treatment plans that take into account all elements of hypertension, it is vital to work together with other healthcare experts and use treatments that are supported by evidence. Quality and safety in patient care are ensured through nurse practice standards, organizational policies, and government regulations. Management techniques with the potential to greatly enhance patient outcomes and support patient-centered therapy include the formation of multidisciplinary teams, which are examples of such initiatives. Consistent nursing procedures like monitoring, recording, and patient education may aid in the management of hypertension.

References

Bell, K., Doust, J., McGeechan, K., Horvath, A. R., Barratt, A., Hayen, A., ... & Irwig, L. (2021). The potential for overdiagnosis and underdiagnosis because of blood pressure variability: a comparison of the 2017 ACC/AHA, 2018 ESC/ESH and 2019 NICE hypertension guidelines. Journal of hypertension, 39(2), 236. https://doi.org/10.1097%2FHJH.0000000000002614

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

DesRoches, C., Chang, Y., Kim, J., Mukunda, S., Norman, L., Dittus, R. S., & Donelan, K. (2022). Who wants to work in geriatrics: Findings from a national survey of physicians and nurse practitioners. Nursing Outlook, 70(2), 309-314. https://doi.org/10.1016/j.outlook.2021.10.004 

DiPette, D. J., Goughnour, K., Zuniga, E., Skeete, J., Ridley, E., Angell, S., Brettler, J., Campbell, N. R. C., Coca, A., Connell, K., Doon, R., Jaffe, M., Lopez-Jaramillo, P., Moran, A., Orias, M., Pineiro, D. J., Rosende, A., González, Y. V., & Ordunez, P. (2020). 12 Standardized treatment to improve hypertension control in primary health care: The HEARTS in the Americas Initiative. Journal of clinical hypertension (Greenwich, Conn.), 22(12), 2285–2295. https://doi.org/10.1111/jch.14072

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

Kraus, S., Schiavone, F., Pluzhnikova, A., & Invernizzi, A. C. (2021). Digital transformation in healthcare: Analyzing the current state-of-research. Journal of Business Research, 123, 557-567. https://doi.org/10.1016/j.jbusres.2020.10.030 

Maimaitiaili, R., Li, Y., Zhang, Y., Feng, T., Xu, Y., Yang, H., ... & Zhao, Y. (2022). SIMPLIFIED REGIMEN FOR THE MANAGEMENT OF HYPERTENSION WITH TELEMEDICINE AND BLOOD PRESSURE SELF-MONITORING (SIMPLE): STUDY PROTOCOL FOR A RANDOMIZED CONTROLLED TRIAL. Journal of Hypertension, 40(1), e196-e196. https://doi.org/10.1097/01.hjh.0000837440.66774.08

---

Also Read: Capella University Assignment Writing Services

---

Oseni, T. I. A., Emonriken, A., Ahmed, S. D., & Dic‑Ijiewere, M. (2023). Determinants of Blood Pressure Control among Hypertensive Patients Attending a Rural Teaching Hospital in Southern Nigeria. Nigerian Journal of Clinical Practice, 26(3). https://doi.org/10.1097/NNA.0000000000000739

Soltani, S., Chitsazi, M. J., & Salehi-Abargouei, A. (2018). The effect of dietary approaches to stop hypertension (DASH) on serum inflammatory markers: a systematic review and meta-analysis of randomized trials. Clinical Nutrition, 37(2), 542-550. https://doi.org/10.1016/j.clnu.2017.02.018

Storey, S., Wagner, L., LaMothe, J., Pittman, J., Cohee, A., & Newhouse, R. (2019). Building evidence-based nursing practice capacity in a large statewide health system: a multimodal approach. JONA: The Journal of Nursing Administration, 49(4), 208-214. https://doi.org/10.1097/NNA.0000000000000739 

Sudharsanan, N., Theilmann, M., Kirschbaum, T. K., Manne-Goehler, J., Azadnajafabad, S., Bovet, P., ... & Geldsetzer, P. (2021). Variation in the Proportion of Adults in Need of Blood Pressure–Lowering Medications by Hypertension Care Guideline in Low-and Middle-Income Countries: A Cross-Sectional Study of 1 037 215 Individuals From 50 Nationally Representative Surveys. Circulation, 143(10), 991-1001. https://doi.org/10.1161/CIRCULATIONAHA.120.051620

Vogel, B., Acevedo, M., Appelman, Y., Merz, C. N. B., Chieffo, A., Figtree, G. A., ... & Mehran, R. (2021). The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. The Lancet, 397(10292), 2385-2438. https://doi.org/10.1016/S0140-6736(21)00684-X