NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

Assessing the Problem; Patient, Family, or Population Health Problem Solution

Hypertension is one of the pandemic disorders that adds to the worldwide morbidity catastrophe. Hypertension, often known as high blood pressure, is a major cause of cardiovascular disorder, particularly ischemic strokes. However, many people with high blood pressure go undiagnosed and live with hypertension for a long period until it is identified. The rising frequency of HTN cannot be dismissed as “one individual’s issue.” Uncontrolled HNT is a leading cause of disability and early mortality worldwide, wreaking havoc on both individuals and health-care systems. This results in a rising economic and societal burden (Huston, 2018).

I am working with a patient John, a 50-year-old man, who suffers from chronic hypertension and is at danger of having a stroke. Face-to-face interviews with personal communication were employed in this practical strategy to examine the entire scenario. He has a history of smoking (present), ETOH (says he no longer consumes), epilepsy episodes (for roughly 4 yrs), and heart failure with maintained ejection fraction. When diagnosed, the ejection fraction (EF) by echocardiography was 50%, owing to hypertension. He states that his breathing and energy levels are identical to his previous visit. He experienced two instances of pillow orthopnea but no instances of paroxysmal nocturnal dyspnea. He denies having any chest pain, palpitations, lightheadedness, vertigo, nausea, edema, or eating problems (he claims his appetite is OK). Despite having a normal EF, he has clinical heart failure based on his echocardiogram history and symptoms of dyspnea and exhaustion. He benefited from medication changes that helped him to better control his blood pressure. While his diastolic blood pressure was normal, his elevated systolic blood pressure exacerbated afterload and backflow pressure, resulting in mild pulmonary hypertension from his heart failure. He doesn’t have any technological knowledge neither he has any transportation help. He has to take bus for every time he comes to the hospital. 

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

Role of Leadership and Change Management Strategies

According to the AHRQ, while leadership has typically been associated with the highest levels of an organisation, frontline staff and their direct manager play critical leadership responsibilities in acting as agents of change and supporting patient-centered care. Population health and longevity enhancement are also driving transformative change, which must count on clinician leadership to achieve its objectives. Today’s nurses are also constantly questioned to illustrate current administration competencies, such as the order to sustain a broad outlook or attitude universal health care and clinical nurse issues; innovative technological abilities that enhance portability and flexibility of associations, relations, and process management; expert judgement skills ingrained in scientific inquiry; and traditions that pervade medical services and improved patient.

The first line of treatment for hypertension is a two-pronged strategy, with an emphasis on lifestyle changes and add-on pharmacological control. Because essential hypertension is thought to be the consequence of interactions between genes and environment, treatment is most effective when several elements in the patient’s life are addressed. The environmental impacts are substantial and explain the majority of the BP variations between people and communities, and their regulation is critical in the treatment of high BP. Dietary excess of salt and fat, dietary deficit of potassium and fibres, alcohol use, physical inactivity, and psychosocial stress are all important lifestyle or environmental variables. Numerous short-term experiments have shown that people can implement these lifestyle modifications to decrease their blood pressure. Dietary changes are the cornerstone of hypertension prevention and therapy.

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

Another strategy is the in cooperation of health record databases in healthcare which provide the clear and consistent preservation of key data such as patient demographics, admission sources and duration of stay, discharge status, diagnoses and treatments, and pertinent costs. Numerous research has been conducted to examine the effects of establishing an electronic medical record on healthcare quality and patient safety, with the majority of studies yielding positive findings. However, other research revealed unfavorable results, which has sparked debate. Campbell et al. (2018) conducted what is likely the broadest and most current metaanalyses on the influence of electronic health records on healthcare quality and patient safety, incorporating 47 research. The study’s findings backed the usage of electronic medical records.

E-health and telehealth may assist in empowering hypertensive patients and promoting self-management, resulting in an improvement in the patient’s medical state. Digital interventions can assist to personalize the physician-patient connection and hence enhance blood pressure and cardiovascular risk management. Remote monitoring and transmission of essential symptoms and indicators should be included in the best recommended healthcare model for telemedicine in hypertension management. Telemedicine has the potential to improve the condition of inadequate hypertension care in many areas. According to current research, telemedicine may be an effective technique for increasing access to therapy and improving results for hypertension patients.

Nursing Ethics and Interventions

Remote monitoring and transmission of essential symptoms and indicators should be included in the best recommended healthcare model for telemedicine in hypertension management. Telemedicine has the potential to improve the condition of inadequate hypertension care in many areas. According to current research, telemedicine may be an effective technique for increasing access to therapy and improving results for hypertension patients. The demand for independence of a patient may clash with standards of care or proposals related to the nursing or other healthcare workers. An individual has the right to decline drugs, therapy, surgeries, or other clinical treatment, irrespectively of the consequence. If a patient refuses to undergo a beneficial therapy, the nurse must respect that decision.

Nurses should be aware of and identify their own integrity and moral character, as well as the Code of Ethics for their profession. Nurses must have a fundamental awareness of crucial ethical concepts. The nursing profession must stay committed to patient care while also pushing for patients’ rights to self-identify their needs and cultural norms. Though difficult, ethical issues in nursing constitute a real integration of the art of patient care. Nurses owe it to themselves, their career, and their patients to uphold the highest ethical standards (Huston, 2018). Many organisations have ethics committees in place to address ethical issues. Nurses at all levels of practise should participate in ethics reviews in their chosen specialty area. It is critical to advocate for patient care, patient rights, and ethical treatment. Ethics education should begin in nursing school and continue throughout the nurse’s career.

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

Best Practice Strategies for Communication and Collaboration

Clinical communication and collaboration tools enable the efficient flow of information in a healthcare setting. CC&C systems are IT systems used by practitioners and support workers to communicate and cooperate on patient-related tasks. They are adopted by healthcare providers. They’re utilised to communicate patient data, collect alerts and notifications, and enhance care transitions and patient throughput. Although Health insurance portability and accountability complaint phone and text communication is essential, CC&C solutions have developed to automating additional forms of time-sensitive information sharing, such as nurse call alarms, alerts from remote monitoring equipment, and notifications from electronic health records (Haddad & Geiger, 2021).

Telemedicine improves the accessibility of patients’ electronic data. With the expanding maturity and scale of the telemedicine business, as well as the increased governmental emphasis on deploying HIT, possibilities for leaders in telemedicine and other HIT applications to collaborate are now accessible. Specific areas of collaboration should concentrate on mutually beneficial technological benchmarks and high-quality communication networks that provide interoperability on several levels. Allowing different medical record systems to share patient data, ensuring that multiple distributed medical products can connect with each other or into the very same framework, and providing health professionals providing distant care with immediate access to the patient’s health history are examples of such levels.

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

The considerable distance in between hospital and the HTN patient location might also be a significant impediment to providing effective care. Digital interventions can assist to personalise the physician-patient connection and hence enhance blood pressure and cardiovascular risk reduction. Remote patient monitoring via telemedicine enables physicians and health institutions to reach out to distant patients and expand the number of patients serviced while saving time and maintaining high-quality standards of care delivery. Telemedicine, in particular, increases the tracking and sharing of various biometric data, actively engaging patients in their treatment. In the case of hypertension patients, telemedicine services can be utilised to conveniently and quickly convey the presence of acute symptoms or unexpected BP rises to the referring doctor (Huston, 2018).

State Board Nursing Practice Standards and/or Organizational or Governmental Policies

Despite the obvious benefits of hypertension medication in lowering CVD morbidity and mortality, a considerable number of identified and undiagnosed hypertensive patients are not receiving optimum care. Despite decades of national public and professional education, over 25% of persons with hypertension are ignorant, and almost 30% are not engaged in hypertension care in the United States. 4 Among the 45 percent of people with diagnosed hypertension who are receiving treatment, BP control is achieved in just 64 percent of cases, and rates among American men and women remain as low as 39 percent. For almost 50 years, the role of nurses has been acknowledged in public and professional education to enhance hypertension control, as supported by the US National High Blood Pressure Education Program’s Joint National Committee reports and other publications.

Nurses or nurse practitioners are also in charge of the diagnostic and pharmacological elements of hypertension care. NPs administer and titrate drugs to achieve blood pressure management using well-defined protocols based on national treatment standards. As previously noted, nurse-led hypertension therapy has been shown to result in higher rates of blood pressure control than conventional care. These improved results have occurred from nurses putting more patients on drugs, changing drug regimens more often in response to insufficient blood pressure management, and putting a higher proportion of patients on various drug regimens to achieve better control. Nurses have been found to efficiently treat additional cardiovascular risk factors, such as diabetes and dyslipidaemia, in addition to hypertension. Nurses or nurse practitioners are also in charge of the diagnostic and pharmacological elements of hypertension care. NPs administer and titrate drugs to meet BP goals using well-defined protocols based on national treatment standards (Haddad & Geiger, 2021).

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

The American Nurses Credentialing Centre’s Commission on Accreditation has recognised Lippincott Professional Development as a provider of continuing nursing education. The objective of hypertension therapy is to reduce blood pressure and thereby end-organ damage. This can be done alone via lifestyle modifications or through a mix of lifestyle changes and drugs. For those medications mentioned as having a once or twice day dose schedule, the antihypertensive impact may lessen near the conclusion of the treatment. dosage interval, especially with lower doses an increased dosage may help to lengthen the duration of antihypertensive impact or the requirement to split the dosage Monitoring peak levels should be used to evaluate twice-daily dosage as well as trough reactions (Alotaibi & Federico, 2017). 

Quality of Care and Patient Safety

Higher QC is connected with improved blood pressure management in hypertensive individuals. Younger individuals with no cardiac risk factors are more likely to get subpar treatment. Quality measurement methods, such as the one provided in this paper, can help guide future attempts to enhance quality. According to the data, the quality of care for hypertension patients falls short of the ideal. Over the course of two years, patients got around 72 percent of the indicated essential care routines, and 77 percent of patients with persistently raised blood pressure had some change in therapy documented in the medical record. Though still troubling, these rates are greater than in earlier studies of smaller groups. Some of the disparities might be attributed to variations in the research population, while others could be attributed to more permissive definitions of what constitutes a shift in therapy. We gave the modification more time to take effect and counted moving to different regimes (Khalil et al., 2019). 

Costs to System and Individual

Even in populations with relatively high average health expenses, health spending is concentrated. The top 10% of those with the greatest health spending accounted for 50% of total health spending among those reporting fair or poor health. Health-care expenditures rise as people become older, and this pattern holds true regardless of insurance status or gender. Persons who do not have insurance for the full year have considerably lower overall health expenditures on average in all age groups than people who have insurance for part of the year or the entire year. The usage of resources as a direct outcome of the treatment and health care process is referred to as direct expenses. Indirect costs are any ‘losses’ borne by society as a result of sickness, illness, and treatment.

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

The real expenses of providing health-care services, including the price of surgeries, treatments, and drugs. When hospital executives and clinicians discuss health care expenses, they are often referring to their production costs, or the money spent on the resources required to care for patients. In 2020, the average monthly cost of health insurance in the United States will be $456 for an individual and $1,152 for a family. However, charges vary across a wide range of health insurance. A study discovered five factors that influence healthcare costs: an ageing population, illness prevalence or incidence, medical service consumption, and service pricing and intensity (Asch et al., 2005).

Care Coordination and Community Resources

Community-based care coordination is a collaborative effort of health care professionals, clinics and hospitals, specialists, pharmacists, mental health experts, community agencies, and others to deliver patient-cantered, coordinated care. Care coordination has been highlighted as a key means of improving how the healthcare system works for patients, particularly in terms of efficiency and safety. Most significantly, focused care coordination has the potential to enhance outcomes for patients, providers, and payers. Treatment coordination ensures that a patient’s requirements and choices for care are recognised and shared across physicians, patients, and families when the patient goes from one healthcare environment to another (Khalil et al., 2019).

Collaborative practice fosters higher levels of quality, safety, and effectiveness in care, leading to improved patient outcomes, and is in line with nursing’s holistically, patient-cantered paradigm of care. Coordination is required when participants rely on one another to carry out diverse tasks in a patient’s care. To carry out these actions in a coordinated manner, each participant must be aware of their own and others’ duties, as well as the available resources. Clinical care coordination is critical to providing timely and effective patient care. Evaluation, resource use, time management, and organisational skills are all aspects of clinical care coordination. Setting priorities and making clinical decisions are also part of it.

NURS FPX 4900 Assessment 4 Patient Family or Population Health Problem Solution JJ

The following websites provide patient-friendly hypertension materials and links as community resources for HTN:

  • American Heart Association: High Blood Pressure 
  • National Heart, Lung, and Blood Institute: High Blood Pressure 
  • National Institute of Neurological Disorders and Stroke: Mind Your Risks

References 

Asch, S. M., McGlynn, E. A., Hiatt, L., Adams, J., Hicks, J., DeCristofaro, A., Chen, R., LaPuerta, P., & Kerr, E. A. (2005). Quality of care for hypertension in the United States. BMC Cardiovascular Disorders5(1). https://doi.org/10.1186/1471-2261-5-1

Alotaibi, Y. K., & Federico, F. (2017). The impact of health information technology on patient safety. Saudi Medical Journal38(12), 1173–1180. https://doi.org/10.15537/smj.2017.12.20631

Ferdinand, K. C., Balavoine, F., Besse, B., Black, H. R., Desbrandes, S., Dittrich, H. C., … & NEW HOPE Investigators. (2019). Efficacy and safety of Firibastat, a first-in-class brain aminopeptidase A inhibitor, in hypertensive overweight patients of multiple ethnic origins: A Phase 2, open-label, multicenter, dose-titrating study. Circulation140(2), 138-146.

How do health expenditures vary across the population? – Peterson-KFF Health System Tracker. (2021, December 2). Peterson-KFF Health System Tracker. https://www.healthsystemtracker.org/chart-collection/health-expenditures-vary-across-population/

Haddad, L. M., & Geiger, R. A. (2021, August 30). Nursing Ethical Considerations. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK526054/

Huston, C. J. (2018). What Defines A True Leader in Healthcare? HMP Global Learning Network; Today’s Wound Clinic. https://www.hmpgloballearningnetwork.com/site/twc/articles/what-defines-true-leader-healthcare

Kaplan, B. (2020). Revisting health information technology ethical, legal, and social issues and evaluation: telehealth/telemedicine and COVID-19. International journal of medical informatics, 104239.

Khalil, A., Perry, H., Lanssens, D., & Gyselaers, W. (2019). Telemonitoring for hypertensive disease in pregnancy. Expert review of medical devices16(8), 653-661.

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