Name
Chamberlain University
NR-702: DNP Project & Practicum I
Prof. Name
Date
The developed PICOT question is: In patients diagnosed with high blood pressure (BP) and receiving antihypertensive therapy, how does the adoption of a Dietary Approaches to Stop Hypertension (DASH) program, compared to standard care, affect the incidence of uncontrolled hypertension in a primary care setting over 12 weeks?
Uncontrolled hypertension is a critical health challenge at the practicum site, with nearly 59% of patients continuing to present elevated BP despite pharmacological treatment. Such persistent hypertension significantly elevates the risk of severe complications, including myocardial infarction, stroke, and chronic kidney disease. These outcomes not only affect patient quality of life but also place a heavy burden on healthcare systems through increased hospitalizations, long-term treatments, and associated costs.
Traditional antihypertensive therapy alone often fails to address modifiable lifestyle factors, such as poor diet, sedentary behavior, and dyslipidemia, which further exacerbate uncontrolled hypertension. Recent evidence highlights the importance of combining pharmacological management with lifestyle-based interventions to achieve better health outcomes (Alnooh et al., 2022; Guo et al., 2021). By focusing on dietary and behavioral changes, primary care providers can play a crucial role in preventing complications and promoting cardiovascular health.
The overarching aim of this quality improvement project is to assess the effectiveness of the DASH program in lowering the prevalence of uncontrolled hypertension at the practicum site.
Specific objectives include:
To implement the DASH program among patients with uncontrolled hypertension.
To evaluate changes in cardiovascular risk markers such as total cholesterol, LDL, HDL, and systolic/diastolic BP.
To determine whether adherence to the program results in a measurable decline in uncontrolled hypertension rates over a 12-week period.
To identify barriers and facilitators to implementing a structured diet program in primary care practice.
The DASH diet has been recognized globally as a gold-standard nutritional approach for managing hypertension. It emphasizes the consumption of nutrient-rich foods such as fruits, vegetables, whole grains, nuts, lean proteins, and low-fat dairy while minimizing sodium, saturated fats, and added sugars. Unlike medication-only interventions, the DASH program focuses on sustainable lifestyle change, which promotes long-term cardiovascular health.
Research demonstrates that the DASH diet not only lowers blood pressure but also improves lipid profiles, reduces systemic inflammation, and decreases the risk of metabolic syndrome (Guo et al., 2021). Importantly, patient adherence to the DASH plan has been shown to improve when paired with educational support and continuous monitoring, making it a viable strategy in real-world clinical practice.
| PICOT Element | Description |
|---|---|
| Population (P) | Adults diagnosed with hypertension currently on antihypertensive therapy |
| Intervention (I) | Implementation of the DASH diet program |
| Comparison (C) | Usual care or standard clinical practice without structured dietary modification |
| Outcome (O) | Reduction in the rate of uncontrolled hypertension; improvements in cholesterol and BP levels |
| Time (T) | 12 weeks |
It is anticipated that the introduction of the DASH diet will:
Improve patients’ adherence to healthier dietary practices, leading to sustainable behavior change.
Lower systolic and diastolic BP values within 12 weeks.
Enhance lipid control by reducing LDL cholesterol while improving HDL cholesterol levels.
Significantly decrease the proportion of patients experiencing uncontrolled hypertension at the practicum site.
By fostering self-management and dietary awareness, the intervention is expected to enhance both short-term clinical outcomes and long-term cardiovascular health.
If proven effective, the incorporation of the DASH program into routine primary care protocols could provide a scalable model for chronic disease management. Such an approach has the potential to:
Reduce hospital admissions linked to hypertensive emergencies.
Lower healthcare costs associated with stroke, heart failure, and renal disease.
Empower patients through self-directed lifestyle management, improving satisfaction and overall quality of life.
Moreover, integrating diet-based interventions into primary care aligns with preventive health goals and population health strategies, contributing to healthier communities.
Alnooh, G., Alessa, T., Hawley, M., & de Witte, L. (2022). The use of dietary approaches to stop hypertension (DASH) mobile apps for supporting a healthy diet and controlling hypertension in adults: Systematic review. Journal of Medical Internet Research Cardio, 6(2), e35876. https://doi.org/10.2196/35876
Guo, R., Li, N., Yang, R., Liao, X. Y., Zhang, Y., Zhu, B. F., & Lei, Y. (2021). Effects of the modified DASH diet on adults with elevated blood pressure or hypertension: A systematic review and meta-analysis. Frontiers in Nutrition, 8, 725020. https://doi.org/10.3389/fnut.2021.72502
