Management of Hypertensive Patients by a CNS: A Demonstration Project

2.50
Hdl Handle:
http://hdl.handle.net/10755/148525
Type:
Presentation
Title:
Management of Hypertensive Patients by a CNS: A Demonstration Project
Abstract:
Management of Hypertensive Patients by a CNS: A Demonstration Project
Conference Sponsor:Sigma Theta Tau International
Conference Year:2001
Conference Date:November 10 - 14, 2001
Author:Smith, Kandy
P.I. Institution Name:University of Southern Mississippi
Cardiovascular (CV) diseases are the single largest contributing factor to human mortality, and high blood pressure (HBP) is the most prevalent CV risk factor. HBP is the most common chronic disease with as many as 50 million Americans diagnosed. In 1996, the 81st Medical Group, the second largest medical facility in the USAF spent 2.1 million dollars (18% of outpatient drug therapy expenditures) on antihypertensive medication alone. At the national level, lifelong antihypertensive therapy represents a significant component of the nation’s financial commitment to health. Although the monitoring of antihypertensive treatment is usually performed using blood pressure (BP) readings made in the clinic, clinic BPs are often unrepresentative because of the white coat effect. The new JNC VI Guidelines recommend that blood pressure should be measured in such a way that values obtained are representative of patients. In one study, as many as 40% of hypertensive subjects were able to stay off their medications. The goal of treating patients with HBP is to prevent morbidity and mortality associated with HBP and to control BP by the least intrusive means possible. Despite the ready availability of a large number of effective antihypertensive drugs and clear evidence that their use can reduce the morbidity associated with HBP, the proportion of patients with adequately controlled BP is disturbingly small, 24% according the 1995 NHANES III study. Poor adherence to long-term treatment, both lifestyle modifications and pharmacologic therapy has been identified as the major reason for inadequate control of HBP. Lack of traditional HBP control methods including appointment keeping, weight reduction, diet control and medication taking is a major factor among Americans because of discordance between the message and/or the method and the relevant impeding of facilitating factors. Educational interventions are shown to be effective in controlling blood pressure and improving adherence. BP control is multifactorial, but whatever the mechanism, patient behavior is part of the HBP problem and a major part of the solution. The purpose of this demonstration project is to provide a comprehensive educational-behavioral intervention program for hypertensive patients in order to improve patient outcomes associated with HBP. The patients receive special advanced practice, clinical-based nursing intervention in addition to the current usual care available at the 81st Medical Group. The advanced practice nursing/management of high blood pressure implements national consensus guidelines developed by the NIH National High Blood Pressure Education Program Sixth Joint National Committee (known as JNC VI Guidelines). Attention is directed to addressing other cardiovascular risk factors and high blood pressure associated end-organ damage. The nonpharmacologic therapy and lifestyle modification interventions address weight optimization; moderation of sodium and alcohol intake, physical activity, tobacco avoidance, and other approaches. The CNS addresses patient knowledge, patient adherence, barriers to care, and patient communication with other health care providers. The principal goals are reduction in blood pressure and improved satisfaction with available health care. Nursing is ideally prepared to coordinate and maximize the effective use of existing resources within health care facilities, the community, patients and their families. Further understanding of effective CNS interventions may lead to greater use of the CNS as a valuable resource for the provision of community-based nursing services, to enhance the understanding and responsiveness of nurses and other providers regarding issues of barriers to care and treatment.
Repository Posting Date:
26-Oct-2011
Date of Publication:
10-Nov-2001
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleManagement of Hypertensive Patients by a CNS: A Demonstration Projecten_GB
dc.identifier.urihttp://hdl.handle.net/10755/148525-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Management of Hypertensive Patients by a CNS: A Demonstration Project</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">November 10 - 14, 2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Smith, Kandy</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Southern Mississippi</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">kandyks@bellsouth.net</td></tr><tr><td colspan="2" class="item-abstract">Cardiovascular (CV) diseases are the single largest contributing factor to human mortality, and high blood pressure (HBP) is the most prevalent CV risk factor. HBP is the most common chronic disease with as many as 50 million Americans diagnosed. In 1996, the 81st Medical Group, the second largest medical facility in the USAF spent 2.1 million dollars (18% of outpatient drug therapy expenditures) on antihypertensive medication alone. At the national level, lifelong antihypertensive therapy represents a significant component of the nation&rsquo;s financial commitment to health. Although the monitoring of antihypertensive treatment is usually performed using blood pressure (BP) readings made in the clinic, clinic BPs are often unrepresentative because of the white coat effect. The new JNC VI Guidelines recommend that blood pressure should be measured in such a way that values obtained are representative of patients. In one study, as many as 40% of hypertensive subjects were able to stay off their medications. The goal of treating patients with HBP is to prevent morbidity and mortality associated with HBP and to control BP by the least intrusive means possible. Despite the ready availability of a large number of effective antihypertensive drugs and clear evidence that their use can reduce the morbidity associated with HBP, the proportion of patients with adequately controlled BP is disturbingly small, 24% according the 1995 NHANES III study. Poor adherence to long-term treatment, both lifestyle modifications and pharmacologic therapy has been identified as the major reason for inadequate control of HBP. Lack of traditional HBP control methods including appointment keeping, weight reduction, diet control and medication taking is a major factor among Americans because of discordance between the message and/or the method and the relevant impeding of facilitating factors. Educational interventions are shown to be effective in controlling blood pressure and improving adherence. BP control is multifactorial, but whatever the mechanism, patient behavior is part of the HBP problem and a major part of the solution. The purpose of this demonstration project is to provide a comprehensive educational-behavioral intervention program for hypertensive patients in order to improve patient outcomes associated with HBP. The patients receive special advanced practice, clinical-based nursing intervention in addition to the current usual care available at the 81st Medical Group. The advanced practice nursing/management of high blood pressure implements national consensus guidelines developed by the NIH National High Blood Pressure Education Program Sixth Joint National Committee (known as JNC VI Guidelines). Attention is directed to addressing other cardiovascular risk factors and high blood pressure associated end-organ damage. The nonpharmacologic therapy and lifestyle modification interventions address weight optimization; moderation of sodium and alcohol intake, physical activity, tobacco avoidance, and other approaches. The CNS addresses patient knowledge, patient adherence, barriers to care, and patient communication with other health care providers. The principal goals are reduction in blood pressure and improved satisfaction with available health care. Nursing is ideally prepared to coordinate and maximize the effective use of existing resources within health care facilities, the community, patients and their families. Further understanding of effective CNS interventions may lead to greater use of the CNS as a valuable resource for the provision of community-based nursing services, to enhance the understanding and responsiveness of nurses and other providers regarding issues of barriers to care and treatment.</td></tr></table>en_GB
dc.date.available2011-10-26T09:46:28Z-
dc.date.issued2001-11-10en_GB
dc.date.accessioned2011-10-26T09:46:28Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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