NURS FPX 6614 Assessment 1 Defining a Gap in Practice

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Capella University

NURS-FPX 6614 Structure and Process in Care Coordination

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Defining a Gap in Practice: Executive Summary

Present Overview of Hypertension

Hypertension affects approximately 116 million people in the United States (CDC, 2020). The condition forces the heart to pump blood more forcefully, resulting in a thickening of the left ventricular wall, which can lead to heart attack, heart failure, and sudden cardiac death (Oparil et al., 2018). Obese individuals are more susceptible to hypertension, and the management of this condition often requires either medication or lifestyle modifications (Semlitsch et al., 2021). This summary aims to assess the effectiveness of lifestyle changes versus medications in managing hypertension in overweight patients, focusing on how care coordination influences their decision-making.

Clinical Priorities for Overweight Hypertensive Patients

The World Health Organization defines obesity as weighing at least 20% more than the ideal weight (WHO, 2021). Obesity is linked to several health complications, including hypertension, Type II diabetes, coronary artery disease, heart failure, kidney disease, and hyperlipidemia (WHO, 2021). The increased abdominal pressure from visceral fat in obese individuals puts additional strain on the cardiovascular system (Chrysant, 2019). This strain exacerbates hypertension symptoms, making it critical to explore effective healthcare strategies, either through medication or lifestyle modifications, for managing these symptoms in overweight patients.

Care Coordination and Healthcare Outcomes

Care coordination plays a pivotal role in assisting overweight hypertensive individuals in managing their condition. By fostering communication between patients and their healthcare team—including physicians, nutritionists, pharmacists, and nurses—care coordination facilitates better patient outcomes (Karam et al., 2021). The approach focuses on involving patients in their care process, ensuring comprehensive team-based support that helps them manage hypertension symptoms effectively (Karam et al., 2021).

In-depth Analysis of the Knowledge Gap

Medication Side Effects in Hypertension Management

Although medications can manage hypertension, they often come with side effects that make adherence difficult for patients, especially those with obesity (Gebreyohannes et al., 2019). Research indicates that only about one-third of patients receiving antihypertensive treatment achieve target blood pressure levels (Cosimo Marcello et al., 2019). Therefore, lifestyle changes, such as low-salt diets and regular exercise, may offer a safer, more sustainable way for obese patients to manage their blood pressure.

The Role of Lifestyle Modifications

Research supports the efficacy of lifestyle changes, including dietary adjustments and exercise, in reducing hypertension symptoms. These interventions allow patients to maintain a healthy weight and stabilize their blood pressure without relying on medication (Cosimo Marcello et al., 2019). This evidence highlights the importance of evaluating non-pharmacologic approaches as a first-line option for overweight hypertensive patients.

PICOT Question

The PICOT framework provides a structured approach to analyzing the effectiveness of lifestyle modifications versus medications in managing hypertension in overweight individuals. The PICOT question is: In overweight adults with hypertension, do lifestyle modifications, as compared to antihypertensive medications, result in lower blood pressure within six months?

Population: Overweight adults with hypertension
Intervention: Lifestyle modifications
Comparison: Lifestyle modifications versus medications
Outcome: Reduction in blood pressure
Timeframe: Six months

Explanation of the Selected Gap

Care planning and patient education are essential to managing hypertension in overweight patients. Proper lifestyle changes can significantly reduce blood pressure, delaying or preventing the need for medication. Care coordinators are responsible for educating patients and ensuring they understand how lifestyle changes can improve their health outcomes (Alsaigh et al., 2019). Moreover, ongoing evaluation of patients’ knowledge and behavior is a crucial component of effective care coordination.

Services and Resources for Care Coordination

Resources: Social media messages, fact sheets, and handouts are useful tools for educating patients about lifestyle modifications.
Potential Services: Care teams, including nurses, physicians, pharmacists, and IT specialists, can use telehealth to monitor patients’ adherence to prescribed lifestyle changes (Volterrani & Sposato, 2019).

Barriers: Common barriers to care coordination include insufficient patient engagement, lack of trust in healthcare professionals, and technological challenges (Heinert et al., 2019). Addressing these barriers is essential to implementing effective care coordination strategies.

Planning and Expected Outcomes

Effective care coordination requires regular team meetings to discuss goals and develop care plans for hypertensive patients. In collaboration with nutritionists, physiotherapists, and IT specialists, healthcare teams can provide tailored dietary and exercise programs to help patients manage their condition. Telehealth can further enhance patient education and adherence to lifestyle modifications (Liu et al., 2019). The anticipated outcome is improved blood pressure control and reduced reliance on medications.

Conclusion

Healthcare professionals should prioritize lifestyle modifications, such as diet and exercise, for managing hypertension in obese patients. While antihypertensive medications can be effective, they often come with side effects. Lifestyle changes not only reduce blood pressure but also provide long-term health benefits without the complications of medication.

References

Agency for Healthcare Research and Quality. (2018). Care coordination | Agency for Healthcare Research & Quality. Ahrq.gov. https://www.ahrq.gov/ncepcr/care/coordination.html

Alsaigh, S. A. S., Alanazi, M. D., & Alkahtani, M. A. (2019). Lifestyle modifications for hypertension management. The Egyptian Journal of Hospital Medicine, 70(12), 2152–2156. https://doi.org/10.12816/0045044

Centers for Disease Control and Prevention. (2020, February 25). Facts about hypertension. https://www.cdc.gov/bloodpressure/facts.htm#:~:text=Nearly%20half%20of%20adults%20in

Chrysant, S. G. (2019). Pathophysiology and treatment of obesity‐related hypertension. The Journal of Clinical Hypertension, 21(5), 555–559. https://doi.org/10.1111/jch.13518

Cosimo Marcello, B., Maria Domenica, A., Gabriele, P., Elisa, M., & Francesca, B. (2019). Lifestyle and hypertension: An evidence-based review. Journal of Hypertension and Management, 4(1). https://doi.org/10.23937/2474-3690/1510030

Karam, M., Chouinard, M.-C., Poitras, M.-E., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021). Nursing care coordination for patients with complex needs in primary healthcare: A scoping review. International Journal of Integrated Care, 21(1). https://doi.org/10.5334/ijic.5518

NURS FPX 6614 Assessment 1 Defining a Gap in Practice

Liu, X., Sutton, P. R., McKenna, R., Sinanan, M. N., Fellner, B. J., Leu, M. G., & Ewell, C. (2019). Evaluation of secure messaging applications for a health care system: A case study. Applied Clinical Informatics, 10(1), 140–150. https://doi.org/10.1055/s-0039-1678607

Semlitsch, T., Krenn, C., Jeitler, K., Berghold, A., Horvath, K., & Siebenhofer, A. (2021). Long-term effects of weight-reducing diets in people with hypertension. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd008274.pub4

World Health Organization. (2021). Obesity and overweight. WHO. https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight