Action Planning with Self-Monitoring Blood Pressure Improves Blood Pressure Control in Geriatric Patients

Practice Problem: Uncontrolled hypertension is a global healthcare problem. Hypertension is controlled in fewer than 1 in 5 people and has been attributed to premature deaths (WHO, 2021). PICOT: The PICOT question that guided this project was “In patients 65 years of age and older with uncontrolled blood pressure, how does a nurse-led blood pressure control program compared to standard of care improve blood pressure control at an outpatient clinic over 8 weeks?” Evidence: Five studies provided evidence that a nurse-led blood pressure decreased blood pressure results. The evidence supported the practice change of implementing a nurse-led blood pressure control program for patients 65 years and older to improve blood pressure control at an outpatient clinic. Intervention: The registered nurse developed joint goals with the patient based on their individual needs. The action assessed the patient’s treatment such as medication adherence and lifestyle changes (e.g., diet, exercise). The program linked self-monitoring blood pressure with individualized goal planning. Outcome: Due to the COVID-19 pandemic resurgence and an impending strike, timing of the project implementation was impacted. Department staffing and patient census was very low, which resulted in only two participants. Clinical significance was noted with one patient while the second patient did not have a decrease nor increase of their blood pressure at the 2 week follow up visit. Conclusion: Further evaluation of the change in practice over time may provide more evidence of clinical significance. A toolkit was developed and provided to the staff for future implementation and adaptation.