Evidence-Based Promotion Project: Hypertension
Introduction
Certain populations in the society are said to be more vulnerable than others based on certain conditions or situations in life. The World Health Organization (WHO) defines high risk populations as individuals who cannot anticipate, resist, or cope and recover from the impacts of a disease or disaster. Elderly people, children, malnourished and immunocompromised individuals, and are all classified as high-risk population.
Some of the factors that have been attribute to expose people into vulnerability include poverty, poor housing, homelessness, ethnicity, race, genetic predisposition, as well as poor housing. Current economic indicators in the United States suggest that the most disadvantaged healthcare segments have been lagging behind despite overall increase in economic trends as well as that of racial, ethnic, and socioeconomic disparities.
For instance, the rates of infant mortality which have been falling for a number of years are now increasing among the African Americans; a trend that has been linked highly with poverty (Flynn et al., 2013). This has prompted the government to introduce some important health programs such as the Earned Income Tax Credit and the Social Security fund which have decreased poverty significantly induce major desirable health effects.
Nichols, O’Connor & Dunn, (2014) point out that DNP nurses play a crucial role of addressing and providing solutions in the healthcare field whose complexity keeps increasing. DNPs can impact a healthcare policy by solving disparities that surround the access to quality health care. Mostly, DNPs are the solution to a number of conflicting healthcare issues. One of the major roles that has been adopted by DNPs is identification of high-risk populations.
Predictive analysis has stood out as an important technique for effective identification. This method employs the use of historical and current data as well as modeling so as to predict future events. In predictive analytics, the decision-making process is data driven. Therefore, DNPs use available patient records to identify individuals that need assistance, such as high risk populations.
The African Americans are one of the high risk populations in America. This because of their high likelihood to develop hypertension. Researchers propose that these individuals could be carrying a gene that makes them salt sensitive hence increasing their risk to hypertension. Additionally, African Americans are affected significantly by obesity.
Studies by (Diaz et al., 2014) report that among non-Hispanic Blacks who are 20 years and above 77 percent of women and 63 percent of men are obese. This population also has a high prevalence of diabetes. It is important to note that diabetes and obesity are among the leading risk factors for hypertension and this could therefore be the reason behind the high incidence of hypertension among African Americans.
Evidence-based interventions
Several evidence-based interventions have been put forward to aid in the management of hypertension among the African Americans. One such intervention is the use of advance health care technologies. Technology advances have proven to be an integral part for the management of high-risk populations (James et al., 2014). For instance, technology will be used to support robust communication with high-risk individuals.
Text messaging, emails, social media, and video conferencing will be used by physicians to follow up on hypertensive patients so that they can understand their progress upon medical intervention. The technology will be used to enhance patient accessibility to healthcare. Additionally, health care providers can use remote monitoring or smart phones to optimize the healthcare strategies hence improving patient outcomes.
Another important intervention will be to education the African Americans about the etiology, causes, risk factors, and management of hypertension (Ogedegbe et al., 2014). There is need for patients to be enlightened about the importance of lifestyle changes. For instance, the African Americans will be encouraged to eat healthy foods such as the Dietary Approaches to Stop Hypertension (DASH) diet which stress that patients should take vegetables, fruits, fish, poultry as well as foods that are rich in potassium.
High levels of potassium aid in preventing and controlling high blood pressure. They should also regulate their intake of fats especially the trans-fat which has been proven to be responsible for arteriosclerosis that narrows blood vessels hence worsening hypertension.
Research has proven that one of the reasons behind the high prevalence of hypertension among black Americans is their increased sensitivity to salt (Diaz et al., 2017). Therefore, they should be educated about their need to reduce the intake of salt in their diet. A salt level of about 1500 mgs per day is recommended for a hypertensive patient who is about 50 years and above.
For other healthy individuals, advised not to increase their intake above 2000 mg as this could result in hypertension development. Obesity, smoking, and diabetes are other major risk factors that all African Americans will be taught about their management. They will be encouraged to present themselves to the healthcare centers for diabetes testing. Similarly, they will be encouraged to watch on their weight and desist from cigarette smoking as well as alcohol intake which can predispose them or increase the severity of hypertension.
The other strategy for managing and reducing hypertension will be by helping patients to design their hypertension treatment plan. Through this plan, patients will be instructed on how to check their blood pressure regularly, follow their treatment plans consistently, and consult their physicians regularly whenever need a clarification about their condition.
Outcome measurements
One of the measurements that will be used to evaluate the outcomes of the hypertension management is the recording of the mean systolic and diastolic pressure of the hypertensive patients who have been taught hypertension management interventions. The recording will be done over a period of one month and plotted on a graph where the shape of the graph will be used to determine whether the patient complied with what he/she learned.
The proportion of patients who will visit to the clinic after the education program will also be determine. A high turnout will be indicate that the patients understood that follow up care is an important pillar in the management of hypertension. Additionally, the physicians will use clinical records to determine how many more individuals have been diagnosed with hypertension since the implementation of the various evidence-based interventions. The number is expected to be lower compared to that of other years.
Epidemiological terminology in the description of interventions and outcomes
A systemic approach is required for effective management of hypertension. The approach entails identification of hypertensive patients, aggressive treatment of hypertension with antihypertensive drugs, proper patient education, and follow-up care. With this approach, modest reduction in the mortality and morbidity of cardiovascular agents will be realized.
However, it is important that note that all this strategies should be combined for clinically significant reductions in hypertension prevalence to be achieved. Supplemental interventions such as self-monitoring of hypertension and adoption of healthy behavior are other important indicators for use in assessing the effectiveness of the implemented strategies.
Lessons learned from developing this interventional program
This project has help me learn that communication is one of the most effective clinical intervention for use during management of a disease. Proper communication helps the public to understand the causes, risk factors, and their role in the prevention and management of a condition. Individuals who are well-informed know what they ought to do and therefore avoid visiting hospitals for treatment or hospitalization which is very expensive.
Secondly, I learned that healthcare providers should accord high-risk population optimum attention and conduct proper research in order to meet their desired goals. This is because interventions used in other parts of the world may not work when dealing with high risk populations hence the need of evidence-based programs. Through this intervention, I believe I can easily take care of an African American patient and also be at the front line in identifying other high risk-populations in the society and the clinical programs that can be used to ensure they live quality lives.
References
Diaz, K. M., Booth, J. N., Seals, S. R., Abdalla, M., Dubbert, P. M., Sims, M., … & Shimbo, D. (2017). Physical Activity and Incident Hypertension in African Americans. Hypertension, HYPERTENSIONAHA-116.
Diaz, K. M., Veerabhadrappa, P., Brown, M. D., Whited, M. C., Dubbert, P. M., & Hickson, D. A. (2014). Prevalence, determinants, and clinical significance of masked hypertension in a population-based sample of African Americans: the Jackson Heart Study. American journal of hypertension, hpu241.
Flynn, S. J., Ameling, J. M., Hill-Briggs, F., Wolff, J. L., Bone, L. R., Levine, D. M., … & Ephraim, P. L. (2013). Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members. Patient Prefer Adherence.
James, P. A., Oparil, S., Carter, B. L., Cushman, W. C., Dennison-Himmelfarb, C., Handler, J., … & Smith, S. C. (2014). 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). Jama, 311(5), 507-520.
Nichols, C., O’Connor, N., & Dunn, D. (2014). Exploring early and future use of DNP prepared nurses within healthcare organizations. Journal of Nursing Administration, 44(2), 74-78.
Ogedegbe, G., Tobin, J. N., Fernandez, S., Cassells, A., Diaz-Gloster, M., Khalida, C., … & Schwartz, J. (2014). Counseling African Americans to Control Hypertension (CAATCH): cluster randomized clinical trial main effects. Circulation, CIRCULATIONAHA-113.
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