NURS-FPX4900 Assessment 3: Assessing the Problem Paper

NURS-FPX4900 Assessment 3: Assessing the Problem Paper

NURS-FPX4900 Assessment 3: Assessing the Problem Paper

How Healthcare Technology, Coordination of Care, and Community Resources can be applied to Address Hypertension

NURS-FPX4900 Assessment 3: Assessing the Problem Paper

Hypertension, also known as blood pressure, is a serious medical that increases the risks of kidney failure, heart diseases, and other equally dangerous diseases. According to World Health Organization (WHO), more than 1.13 billion people globally have hypertension (Bowles, Thosar, Herzig, & Shea, 2018). Of the more than 1.13 billion people, more than 60% live in low- income and middle-income countries.

People with hypertension can have their heart seriously damaged through the hardening of the arteries, reduction in the blood and oxygen flow to the heart. Elevated blood pressure can also cause irregular heartbeat which can lead to sudden death. Among the above complications, hypertension can either block or burst blood vessels supplying blood and oxygen to the brain resulting to stroke (Norlander, Madhur, & Harrison, 2018).

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As much as hypertension is a dangerous condition, deaths from hypertension and the associated complications can be prevented. Management and treatment of hypertension through pharmacological and non-pharmacological methods have shown to be efficient in reducing the risk factors for other complications (Norlander et al., 2018). Management of hypertension is clearly beneficial.

However, a significant percentage of people with hypertension condition are not receiving adequate care mostly because of the healthcare system being inadequate. One of the ways to manage and treat hypertension is to augment traditional health models of managing and treating hypertension with the modern approaches. These modern approaches are based on modern technologies to help the patient manage themselves (Bowles et al., 2018).

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NURS-FPX4900 Assessment 4 Patient Family or Population Health Problem Solution

Analyze the impact of health care technology on hypertension

Self-monitoring of blood pressure can improve control of blood pressure. Additionally, self-monitoring is increasingly becoming part of the treatment and management of hypertension (Rehman, et al., 2017). Self-monitoring compliance can be enhanced through the blood pressure monitoring apps. The apps can communicate between the blood pressure monitor and their smartphones, therefore, allowing the patient to control blood pressure measurement from the app and to do comparisons between the current and previous blood pressure readings.

Some analytics available through this method include tracking blood pressure overtime, alerts on blood pressure trends. Using the app for communication between the patient and clinician makes it tele- monitoring (Rehman, et al., 2017).

Tele-monitoring is closely related to telemedicine. Tele-monitoring is a remote transfer of data where blood pressure readings is transmitted automatically (Parati, Dolan, McManus, & Omboni, 2018). During the transfer, several other important parameters can also be transmitted including oxygen saturations and heart rate data from the patient at home or workplace to a clinician.

Currently, there are several tele-monitoring systems and apps though they differ in how they collect and transmit data and relay the final results. Other differences include the presence or absence of features such as reminders to perform blood pressure measurement or take medicine (Parati et al., 2018).

Recently, studies have been conducted to test how effective home-based tele-monitoring is for treatment and management of hypertension and associated hypertension complications.

Every study included demonstrated a high degree of acceptance of these technologies by both patients and physicians (Lee & Park, 2016). Additionally, the studies demonstrated that physicians are adhering to the tele-monitoring technologies while confirming that the technologies are highly capable of enhancing treatment and management of hypertension, improve hypertensive patient outcomes, and reduce healthcare costs especially because hypertension requires follow-ups (Lee & Park, 2016).

Artificial intelligence (AI) is also a possible application of technology to treat and manage hypertension. AI comprises of interfaces such as Siri and Alexa which can help in updating medication lists and setting medication reminders wirelessly. Although there is scarcity of evidence of how efficient this technology is, there is likelihood that their use will increase as its benefits become clear (Morilla, Sans, Casasa, & Gimenez, 2017).

Incorporating blood pressure data from tele-monitoring into digital healthcare programmes can also make it easy to combine with data from other physiological variables such as heart rate, glucose rate, and exercise. This helps patients to adapt to management recommendations based on pre-determined variables such as demographics, indicated morbidities and comorbidities, barriers to management, and actions during the programme (Morilla et al., 2017).

The adoption of technologies in the management and treatment of hypertension is beneficial to all the parties involved. Note that, these technologies parties build and maintain relations (Lee & Park, 2016). Besides the clear evidence associated with the application of technologies in the management of blood pressure, they are also important in that, they help in growing and maintaining relationship between the patient and physicians which consequently influences management of blood pressure and other associated complications.

However, there are barriers to the implementation and use of such technologies which include inadequate infrastructure. Additionally, there are costs implications associated with the technologies in terms of installation and maintenance. Other barriers include privacy and legal issues and lack of reimbursements (Rehman, et al., 2017).

How Care Coordination and the Utilization of Community Resources can be used to Address Hypertension

If every hypertensive patient was treated adequately to reach the recommendations of the clinical guidelines, it would be possible to avert more than 45,000 deaths as a result of hypertension in the United States. Note that, treating and managing hypertension and associated complications costs about $155 billion. This money comprises of direct medical costs and lost productivity. Recommendations from the Community Preventive Services Task Force (Task Force) can be of great help to healthcare and public health organizations in delivering patient care whose efficacy for blood pressure management has been proven (Dye, Williams, & Evatt, 2015).

The Task Force recommends the use of team-based care to make improvements in blood pressure control. These recommendations from the Task Force are on the basis of evidence of its effectiveness to increasing the number of people with controlled blood pressure along with the reduction of systolic and diastolic blood pressure. The strength of this evidence was considered because more than 75 studies were involved. Also note that, the studies involved team-based care organized mainly with professional nurses and pharmacists collaborating with care providers and patients (Niiranen, et al., 2017).

A team-based approach to blood pressure control refers to an organizational approach comprising of a multi-disciplinary team to improve quality of care among the patients and the achievement of organizational goals (Kravetz & Walsh, 2016). The main parties in a team-based approach is the patient.

Other participants are primary care givers attending the patient, and other healthcare professionals among them nurses, community health workers, pharmacists, and dieticians. Additionally, every responsibility – drug administration, follow-up activities, self-management, and adherence – is shared among the participants each according to the capabilities (Kravetz & Walsh, 2016).

Team-based approach to treatment and management of hypertension has been proved to be efficient. This efficacy was confirmed following the findings of randomized control trials (RCTs) and meta-analysis of the RCTs involving nurses and pharmacists interventions. In the interventions, the nurses achieved lower blood pressure scores and higher blood pressure goals as compared to normal approach to blood pressure control. The outcomes achieve in this study are consistent with another set of outcomes achieved at the same facility. In the second outcomes, there was lower readmission rates, higher patient satisfaction, and improved quality of care (Dye et al., 2015).

It is important that hypertensive patients are made to use community resources such as National Heart, Lung, and Blood Institute to improve their health and cope with hypertension. From this resource, patients will be regularly updated on hypertension management, therefore, improving patients’ knowledge about the condition. There is also the American Heart Association which educates people on healthy living. Additionally, American Heart Association, encourages appropriate cardiac care in an attempt to reduce deaths and disabilities as a result of stroke and other cardiovascular diseases (Kravetz & Walsh, 2016).

There exists some barriers to full utilization of community resources. These barriers include inconsistent patient follow-up and inadequate economic resources for access other community resources. In the studies, participants report that they are financially constrained and cannot, therefore, seek medical attention. However, state and federal governments are collaborating to ensure patients have access to healthcare services and resources they need to improve their health outcomes and disease management practices (Dye et al., 2015).

State Board Nursing Practice Standards and Organizational or Governmental Policies Associated with Health Care Technology, Care Coordination, and Community Resources

A good national health system is the one that contributes in quality health coverage for everyone by targeting the health needs of the people and delivering universal healthcare. Health systems are, however, complex and intricate. According to WHO, governments should build an effective health system by developing national health policies that, when implemented, will significantly reduce morbidity and mortality and reduce risks and threats to health. Policies are a set of protocols that are based on the health needs, environment, and conditions. The application of policies serve as the guidelines and directives of the health system (National Association of School Nurses, 2016).

The Florida Board of Nursing also plays a significant role in licensing, monitoring, disciplining, educating, and rehabilitating its licenses to assure that nurses are fit and competent when providing healthcare services for the people of Florida. The Florida Board of Nursing also specifies the rules and regulations guiding the education process of the nurses (Robertson & Schmid, n.d.).

Recently, healthcare organizations have been adopting different technologies to promote the health statuses of people with hypertension. Additionally, the rapid development and increase in the use of technology in the domains of healthcare has caused nurses to respond proactively to different experiences in the process of caring for people with hypertension.

Advanced standards of care should be certified and licensed by a national association through the board of nursing. The Florida Board of Nursing is responsible for specifying the requirements for nursing categories. The Affordable Care Act (ACA) of 2010 provides opportunities that enable nurses create a patient-centered approach. The policy has shifted the nursing focus towards a preventive approach.

The shift of the focus has been necessitated by the need to manage chronic conditions including hypertensions. The Health Insurance Portability and Accountability Act (HIPAA) also significantly impacts role of nursing. With this policy, nurses are contributing to the privacy of patients’ health information (National Association of School Nurses, 2016).

NURS-FPX4900 Assessment 3: Assessing the Problem Paper References

Bowles, N. P., Thosar, S. S., Herzig, M. X., & Shea, S. A. (2018). Chronotherapy for hypertension. Current Hypertension Report, 20(11), 1-24.

Dye, C. J., Williams, J. E., & Evatt, J. H. (2015). Improving hypertension self-management with community health coaches. Health Promotion Practice, 16(2), 271-281.

Kravetz, J. D., & Walsh, R. F. (2016). Team-based hypertension management to improve blood pressure control. Journal of Primary Care & Community Health, 7(4), 272-275.

Lee, C. J., & Park, S. (2016). The role of home blood pressure tele-monitoring for blood pressure control. Pulse, 4(2-3), 78-84.

Morilla, M. D., Sans, M., Casasa, A., & Gimenez, N. (2017). Implementing technology in healthcare: Insights from physicians. BMC Medical Informatics and Decision Making, 17(1), 1-9.

Niiranen, T. J., McCabe, E. L., Larson, M. G., Henglin, M., Lakdawala, N. K., Vasan, R. S., & Cheng, S. (2017). Risk for hypertension crosses generations in the community: A multi- generational cohort study. European Heart Journal, 38(29), 2300-2308.

Norlander, A. E., Madhur, M. S., & Harrison, D. G. (2018). The immunology of hypertension. Journal of Experimental Medicine, 215(1), 21-33.

Nurses, N. A. (2016). Framework for 21st century school nursing practice: National Association of School Nurses. NASN School Nurse, 31(1), 45-53.

Parati, G., Dolan, E., McManus, R. J., & Omboni, S. (2018). Home blood pressure telemonitoring in the 21st century. The Journal of Clinical Hypertension, 20(7), 1128- 1132. https://pubmed.ncbi.nlm.nih.gov/30003701/

Rehman, H., Kamal, A. K., Morris, P. B., Sayani, S., Merchant, A. T., & Virani, S. S. (2017). Mobile health (mHealth) technology for the management of hypertension and hyperlipidermia: Slow start loads of potential. Current Atheroscerosis Reports, 19(3), 12.

Robertson, L., & Schmid, S. W. (No date). Florida: Laws and rules of nursing.

Instructions For the Assignment – NURS-FPX4900 Assessment 3: Assessing the Problem Paper

Complete this assessment in two parts.

Part 1

Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2

Report on your experiences during the second 2 hours of your practicum.

Whom did you meet with?

What did you learn from them?

Comment on the evidence-based practice (EBP) documents or websites you reviewed.

  • What did you learn from that review?
  • Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.
  • Did your plan to address the problem change, based upon your experiences?

What surprised you, or was of particular interest to you, and why?

CORE ELMS

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in CORE ELMS.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

  • Analyze the impact of health care technology on the patient, family, or population problem.

Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.

Determine whether the evidence is consistent with technology use you see in your nursing practice.

Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.

Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.

Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.

Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.

Identify barriers to the use of care coordination and community resources in the context of this problem.

Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form.

Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.

  • Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources.

Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.