Semester

Summer

Date of Graduation

2025

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Committee Chair

Angel Smothers

Committee Member

Charles D. Bess

Committee Member

Martie Helmick

Committee Member

Patricia Barbarito

Committee Member

Kalen Ellifritz

Abstract

Introduction/Background: High blood pressure (HBP) is a significant public health concern. It affects millions of adults in the United States (US) and half of the adult population in the Appalachia regions. High blood pressure is a known risk factor for cardiovascular disease (CVD), which is the leading cause of morbidity and mortality Appalachia. Complications associated with high blood pressure result in substantial economic burdens for patients and their families, healthcare systems, and national economies. High blood pressure is a significant health issue in West Virginia (WV), with an estimated 602,000 people suffering from HBP.

Purpose: The purpose of this project was to improve knowledge, utilization, and self-efficacy of out-of-office blood pressure measurement (OBPM) to improve blood pressure control among adults in primary care.

Intervention: A comprehensive, evidence-based home blood pressure monitoring protocol (HBPM) was developed for the adult primary care population with HBP.

Method: The HBPM protocol's population of interest was the adult primary care population with HBP. Ten participants with HBP were chosen based on blood pressure (BP) readings obtained from the Epic electronic medical records (EMR). The participants were provided a validated electronic BP cuff and educated on proper preparation, optimal measurement conditions, and correct positioning for HBPM performance. Participants documented BP measurements on a paper log or the MyChart BP electronic flowsheet. Weekly touch-base phone calls were conducted to assess the utilization of HBPM.

Results: Six of the ten participants enrolled completed the HBPM protocol. Knowledge and self-efficacy of proper preparation, optimal measurement conditions, and correct positioning for HBPM performance increased significantly. Self-efficacy in completing BP measurements twice daily and recording results decreased. Utilization of HBPM decreased over time.

Conclusion: The project demonstrated the potential to enhance the diagnosis and management of HBP within the primary care setting, decreasing the prevalence of CVD and controlling healthcare costs.

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