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Name
Capella University
NURS-FPX 4900 Capstone project for Nursing
Prof. Name
Date
Hypertension (HTN) is a prevalent health condition in the United States, leading to several complications if left untreated or inadequately managed. The focus of my capstone project was Claudia Lara, who happens to be my daughter. She is a 38-year-old female with long-standing hypertension who recently experienced a hypertensive urgency with a blood pressure spike to 160/90 mmHg, necessitating a hospital visit. Several contributing factors impact her disease management, including poor medication adherence, financial constraints due to recent job loss, poor dietary habits, and a sedentary lifestyle. This project explored the impact of these factors on her health, proposing potential solutions, aiming to improve her overall management and outcomes in dealing with hypertension.
The intervention was a three-pronged approach, integrating medication management (antihypertensives), lifestyle modifications (educational sessions, mindfulness, and cognitive behavioral therapy), and continuous monitoring (home monitoring devices, telehealth, and mobile applications). I utilized the ADKAR model for change to implement these interventions. The ADKAR model is a change management framework that includes Awareness, Desire, Knowledge, Ability, and Reinforcement (Devi & Thekkekara, 2023).
Thus, Clara and her family expressed high satisfaction with the interventions. They appreciated the comprehensive educational sessions that enhanced their understanding of hypertension and its management. The use of telehealth and mobile apps for regular monitoring was particularly valued for its convenience and ease of use. The family felt more confident in supporting Clara’s health journey and found the behavioral counseling and stress management techniques beneficial. Finally, they reported a positive experience, noting the continuous support and follow-ups as critical factors in improving Clara’s health and quality of life.
The interventions designed for Claudia are grounded in evidence-based research, ensuring that I have used peer-reviewed and professional literature to support my plan. The evidence was chosen based on the CRAAP criteria. These criteria assess the currency, relevance, authority, accuracy, and purpose of the articles to check their credibility and trustworthiness. The test ensures information timeliness, relevance to the topic, integrity of authors and journals, truthfulness and accuracy of claims, and the objectives behind the articles (Lowe et al., 2021).
For instance, the article by Strauss et al. (2021) elaborates that antihypertensive medications such as ACE inhibitors or beta-blockers are effective in controlling blood pressure levels. This evidence supported the decision to prescribe specific antihypertensive medications to Claudia, ensuring an evidence-based approach to the pharmacological management of HTN. Similarly, Blumenthal et al. (2024) directed the development of lifestyle modification interventions through patient education to enhance patient understanding of hypertension, its risks, and the importance of medication adherence. This evidence underscored the necessity of conducting educational sessions for Claudia and her family. By improving their knowledge, the sessions aimed to foster better adherence to medication regimens and lifestyle changes.
Furthermore, behavioral counseling, including mindfulness practices and CBT, effectively manages stress and promotes healthier habits (Li, 2021). This evidence validated the inclusion of behavioral counseling services in the intervention. Finally, continuous monitoring was added to the interventions as telehealth technologies are efficient in facilitating regular follow-ups and remote monitoring, improving chronic disease management and patient outcomes (Sadeghi et al., 2020). Based on this evidence, video conferencing and mobile apps for medication reminders and blood pressure tracking were included to ensure ongoing monitoring and adherence, enhancing Claudia’s management of HTN.
In my capstone project for Claudia Lara, I successfully utilized healthcare technologies to improve patient outcomes and ensure consistent communication. The integration of blood pressure monitoring devices enabled precise, real-time tracking of the patient’s blood pressure, empowering both Claudia and her family to self-management practices (Costa & Aguiar, 2021). According to the results, these devices were connected to remote monitoring platforms so that healthcare providers could access blood pressure readings and intervene in a timely manner. Another technology leveraged for Claudia is telehealth, which facilitated regular follow-ups, ensuring continuous medical assistance and timely interventions without the need for frequent in-person visits (Sadeghi et al., 2020). This approach maintained consistent monitoring and reduced the logistical and financial burdens associated with regular hospital visits.
Finally, I utilized mobile applications for medication reminders and logging blood pressure readings to enhance adherence to the treatment plan and provide a comprehensive view of Claudia’s health trends over time. These devices were also utilized for communication among healthcare providers, the patient, and her family, ensuring seamless information transfer. Yet, prospective improvements in healthcare technology include integrating Artificial Intelligence (AI) for predictive analytics to develop personalized care plans based on real-time data (Visco et al., 2023). Moreover, it is necessary to enhance user interfaces of mobile applications to be more intuitive to increase patient engagement and adherence. By pursuing these opportunities in the future, healthcare systems can optimize patient care to be more effective and personalized.
Healthcare policies and standards set forth by the American Nurses Association (ANA) significantly influenced my capstone project. The ANA standards guided that the interventions should be grounded in evidence-based practice, focusing on patient-centered care, patient education, and advocacy (ANA, 2020). These standards guided the development of my intervention, ensuring they were effective, based on evidence, and grounded in ethical principles.
Similarly, the Affordable Care Act (ACA) played a pivotal role in shaping our approach to care coordination, affordability, and preventive care by leveraging community resources (Isola & Reddivari, 2023). Under these ACA provisions, we facilitated Claudia’s access to necessary healthcare services, including telehealth, which is supported under the ACA to enhance accessibility and reduce costs. This allowed for regular follow-ups and timely interventions, ultimately improving her health outcomes and reducing hospital readmissions. Finally, the regulations set by the Health Insurance Portability and Accountability Act (HIPAA) were crucial in ensuring that all health data collected through telehealth and mobile applications were securely handled (Edemekong et al., 2024). Compliance with HIPAA protected Claudia’s privacy and built trust in using digital health solutions, which is essential for effective patient engagement and adherence.
My project contributed to policy development by highlighting the practical application of the interventions in managing chronic conditions like hypertension. It underscores the importance of integrating health technology with the growing advancement of the healthcare environment, with strict adherence to privacy laws and accessibility standards. As a baccalaureate-prepared nurse, I play a substantial role in policy implementation and development. By understanding and applying existing policies, I and other nurses can ensure that patient care is high-quality and compliant with regulatory standards. Additionally, we can advocate for policy changes based on frontline experiences, contributing to more effective and patient-centered protocols. This project exemplifies the nurse’s role in bridging clinical practice with policy advocating for improved healthcare delivery systems.
The capstone project outcomes largely matched my initial predictions, with Claudia’s blood pressure showing significant improvement due to the integrated approach of medication management, lifestyle modifications, and continuous monitoring. The educational sessions successfully enhanced Claudia and her family’s understanding and adherence, aligning with expectations. The expectations from the use of telehealth and mobile applications exceeded initial plans by providing seamless and effective monitoring, which significantly reduced her need for emergency visits. Nevertheless, there were shortfalls. The behavioral counseling for stress management showed slower progress, indicating the need for a more comprehensive approach by integrating more frequent and diverse therapy options.
These interventions demonstrate potential as best practices for managing hypertension, showcasing their generalizability to similar cases. Moreover, since hypertension is one of the chronic health conditions, these interventions can be generalized for all chronic patients in multiple healthcare settings. However, continuous evaluation and adaptation to interventions are necessary based on individual needs and disease requirements. My intervention has the potential to become an outstanding practice because of its proven efficacy in improving clinical outcomes and patient satisfaction through various evidence-based research.
I have spent a total of nine hours on my practicum project with Claudia and her immediate family. These hours were divided into several sessions focused on understanding her hypertension, exploring her issues, and developing interventions for her. Initially, the focus was on understanding the patient problem and concluding leadership, collaboration, and change management aspects. Then, in the next meeting, my focus was on quality of care, patient safety, and cost management. Finally, before developing the intervention, I explored technological aspects, care coordination, and available community resources for her use. Finally, a multifaceted intervention was developed, and the project was evaluated for patient outcomes. This practicum time provided valuable insights into the multidimensional challenges of hypertension management and highlighted the importance of personalized care, family involvement, and technological innovations in improving patient outcomes. All experiences are documented in the Capella Academic Portal, fulfilling practicum requirements.
Throughout the capstone project and the RN-to-BSN program, I have experienced significant personal and professional growth. Initially, my approach to patient care was primarily task-oriented, focusing on immediate needs. However, through this program, I have developed a deeper understanding of the importance of holistic, patient-centered care, integrating evidence-based practices to address complex health issues comprehensively. I learned to assess patient needs more thoroughly, consider psychosocial factors, and implement interventions that encompass a holistic approach.
Furthermore, my hands-on experience with telehealth and mobile health applications has expanded my competencies in utilizing digital tools to enhance patient outcomes. I learned to analyze and apply healthcare policies critically, strengthening my nursing practice with current standards to promote patient safety and quality of care. The program has also bolstered my confidence in advocating for patients, engaging with families, and collaborating with multidisciplinary teams. Reflecting on my journey, I recognize the growth in my clinical judgment, communication skills, and leadership abilities. This comprehensive experience has prepared me to contribute effectively to the evolving landscape of healthcare, fostering a commitment to lifelong learning and professional excellence.
In conclusion, working on the capstone project that focused on managing Claudia’s hypertension has been a crucial part of my nursing education experience. Through comprehensive assessment, strategic interventions, and the application of evidence-based practices, I made significant progress in improving Claudia’s health outcomes and quality of life. The project highlighted the importance of leadership, change management, and ethical nursing practices in delivering patient-centered care. Moving forward, the lessons learned from this project will continue to guide my practice, emphasizing continuous improvement, patient advocacy, and the integration of technological advancements to optimize patient care.
ANA. (2020). Nursing scope of practice. American Nurses Association; nursingworld.org. https://www.nursingworld.org/practice-policy/scope-of-practice/
Blumenthal, J. A., Smith, P. J., Mabe, S., Hinderliter, A. L., Craighead, L. W., Watkins, L. L., Ingle, K., Tyson, C. C., Lin, P., Kraus, W. E., Liao, L., & Sherwood, A. (2023). Effects of lifestyle modification on psychosocial function in patients with resistant hypertension. Journal of Cardiopulmonary Rehabilitation and Prevention, 44(1). https://doi.org/10.1097/hcr.0000000000000801
Costa, D., & Aguiar, F. (2021). Self-Management of blood pressure control at home in chronic kidney disease: Nursing interventions and health gains. In www.intechopen.com. IntechOpen. https://www.intechopen.com/chapters/75662
Devi V, R., & Thekkekara, J. V. (2023). Change management: A survey of literature in view of analysing the advantages of ADKAR model. RGUHS Journal of Allied Health Sciences, 3(2). https://doi.org/10.26463/rjahs.3_2_2
Edemekong, P. F., Haydel, M. J., & Annamaraju, P. (2024). Health Insurance Portability and Accountability Act (HIPAA). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK500019/
Isola, S., & Reddivari, A. K. R. (2023). Affordable Care Act (ACA). Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK549767/
Li, Y. (2021). The efficacy of cognitive behavioral therapy-based interventions on patients with hypertension: A systematic review and meta-analysis. Preventive Medicine Reports, 23, 101477. https://doi.org/10.1016/j.pmedr.2021.101477
Lowe, M. S., Macy, K. V., Murphy, E., & Kani, J. (2021). Questioning CRAAP. Journal of the Scholarship of Teaching and Learning, 21(3). https://doi.org/10.14434/josotl.v21i3.30744
Sadeghi, C., Khan, H. A., Gudleski, G., Reynolds, J. L., & Bakhai, S. Y. (2020). Multifaceted strategies to improve blood pressure control in a primary care clinic: A quality improvement project. International Journal of Cardiology Hypertension, 7, 100060. https://doi.org/10.1016/j.ijchy.2020.100060
Strauss, M. H., Hall, A. S., & Narkiewicz, K. (2021). The combination of beta-blockers and ACE inhibitors across the spectrum of cardiovascular diseases. Cardiovascular Drugs and Therapy, 37(4). https://doi.org/10.1007/s10557-021-07248-1
Visco, V., Izzo, C., Mancusi, C., Rispoli, A., Tedeschi, M., Virtuoso, N., Giano, A., Gioia, R., Melfi, A., Serio, B., Rusciano, M. R., Di Pietro, P., Bramanti, A., Galasso, G., D’Angelo, G., Carrizzo, A., Vecchione, C., & Ciccarelli, M. (2023). Artificial intelligence in hypertension management: An ace up your sleeve. Journal of Cardiovascular Development and Disease, 10(2), 74. https://doi.org/10.3390/jcdd10020074
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