NURS FPX 6614 Assessment 1 Defining a Gap in Practice

Assessment 1 Defining a Gap in Practice

Student Name

Capella University

NURS-FPX 6614 Structure and Process in Care Coordination

Prof. Name

Date

Defining a Gap in Practice: Executive Summary

Currently, hypertension affects approximately 116 million individuals in the United States (CDC, 2020). Elevated blood pressure, caused by the forceful circulation of blood throughout the body, results in the thickening of the left ventricular walls of the heart. This thickening is associated with severe cardiac events such as heart attacks, heart failure, and sudden cardiac death (Oparil et al., 2018). Moreover, evidence indicates that individuals who are obese are more susceptible to hypertension symptoms, necessitating healthcare interventions including medications or lifestyle modifications (Semlitsch et al., 2021). The integration of team-based care and the care coordination process holds promise in improving patient health outcomes. This executive summary aims to compare the effectiveness of lifestyle modifications versus medication regimens in managing hypertensive symptoms among overweight patients and assess the influence of care coordination on patient decision-making.

Clinical Priorities for Overweight Hypertensive Patients

The World Health Organization defines obesity as having a weight exceeding 20% of the ideal weight (WHO, 2021). Being overweight or obese is associated with various adverse health consequences, including hypertension, Type II Diabetes mellitus, coronary artery disease, heart failure, kidney disease, and hyperlipidemia (WHO, 2021). Obesity not only predisposes individuals to hypertension but also exacerbates its symptoms. Overweight hypertensive patients exhibit altered hormonal signals, abnormalities in the sympathetic nervous system, and impaired kidney function. Excessive visceral fat, characteristic of obesity, places additional strain on the cardiovascular system (CVS) (Chrysant, 2019). This heightened CVS strain ultimately leads to uncontrolled or persistent hypertension, resulting in symptoms such as dizziness, nosebleeds, headaches, vision changes, chest pain, and muscle tremors (Chrysant, 2019). Thus, it is imperative to develop effective healthcare strategies, encompassing medication regimens or lifestyle modifications, to help overweight patients manage their hypertensive symptoms.

Care Coordination and its Role

Care coordination plays a pivotal role in aiding healthcare providers in assisting overweight hypertensive individuals in managing their hypertension symptoms. Streamlined care coordination processes facilitate improved communication between patients and healthcare professionals, including physicians, nutritionists, pharmacists, and nurses (Karam et al., 2021). Care coordination involves a team-based approach aimed at involving patients in their own care alongside other healthcare team members (Karam et al., 2021).

In-depth Analysis or Knowledge Gap

While hypertension symptoms in overweight patients can be managed through medication, evidence indicates that medications may lead to adverse effects exacerbating the condition in obese hypertensive patients (Gebreyohannes et al., 2019). Furthermore, the side effects associated with antihypertensive medications can impede patient adherence (Gebreyohannes et al., 2019). Research by Cosimo Marcello et al. (2019) suggests that adopting low-salt diets and regular exercise may assist obese individuals in controlling their hypertension symptoms. The evidence demonstrates that patients can safely reduce weight and maintain stable blood pressure through a combination of healthy eating and regular exercise (Cosimo Marcello et al., 2019).

PICOT Question

In overweight adults with hypertension, do lifestyle modifications compared to antihypertensive medications result in lower blood pressure within a six-month period? Population: Overweight adults Intervention: Lifestyle modifications Comparison: Lifestyle modifications versus medications Outcome: Low blood pressure Time: Six months

Explanation of the Selected Gap

Proper care planning is essential to mitigate the potentially fatal consequences of hypertension, as noted by Alsaigh et al. (2019). Lifestyle changes play a significant role in reducing blood pressure and delaying the onset of hypertension in otherwise healthy individuals. Before initiating pharmacologic therapy, hypertensive patients should consider implementing lifestyle modifications (Alsaigh et al., 2019). Care coordinators play a crucial role in educating overweight hypertensive patients and assessing their knowledge level through open-ended questions. This is a pivotal aspect of the care coordinator’s role, as it involves instructing patients on making necessary behavioral changes to achieve desired outcomes (Karam et al., 2021).

NURS FPX 6614 Assessment 1 Defining a Gap in Practice

At the regional level, the Joint National Committee (JNC) recommends lifestyle modifications for hypertensive patients over a six-month period. These modifications include increased physical activity, dietary changes for obese patients, reduced salt intake, and limited alcohol consumption (de la Sierra, 2019). The PREMIER trial, the largest clinical trial in the US evaluating blood pressure management through lifestyle changes, demonstrated that weight loss, increased physical activity, and improved dietary choices effectively controlled hypertension without the need for medication (Mahmood et al., 2019). While both lifestyle modifications and medications can lower blood pressure within six months, medications may manifest side effects during this period (Kebede et al., 2022).

Services and Resources for Care Coordination

Resources:

Healthcare teams can utilize social media messages, fact sheets, and handouts to educate obese hypertensive patients about lifestyle modifications.

Potential Services:

Care teams, consisting of nurses, physicians, pharmacists, information technology specialists, and hospital administrators, can collectively raise awareness among obese hypertensive patients about adopting healthy lifestyle choices. Telehealth can be employed to monitor patients’ compliance with prescribed lifestyle changes (Volterrani & Sposato, 2019).

Barriers:

Several obstacles hinder the care coordination process, including patients’ lack of trust in healthcare professionals, inability to engage in self-management practices, challenges related to health information technology, resource constraints, patient beliefs, motivation, and depression (Heinert et al., 2019).

The Type of Care Coordination Intervention

According to the Agency for Healthcare Research and Quality (AHRQ), care coordination is underpinned by five pillars, which include teamwork between staff and patients, effective health information technology utilization, care and medication management, and patient-centered care (Agency for Healthcare Research and Quality, 2018).

Specific and Practical Way

To educate obese hypertensive patients about appropriate lifestyle adjustments, healthcare professionals should utilize the Chronic Care Model. Healthcare organizations need to foster responsibility and accountability, holding regular meetings with key stakeholders such as nurses, physicians, nutritionists, pharmacists, and information technologists. These meetings facilitate communication, knowledge exchange, goal development, and evidence-based care planning (Pilipovic-Broceta et al., 2018). After the planning phase, stakeholders should proceed to implement the plan, assist patients in achieving self-management goals, and conduct follow-up assessments (Agency for Healthcare Research and Quality, 2018).

Support the Strategy for Collaborative Care

A collaborative care strategy should prioritize lifestyle modifications as the primary intervention for healthcare staff and nurses diagnosing hypertension induced by obesity. Overweight hypertensive patients are at greater risk of severe hypertension-related outcomes if they fail to implement lifestyle changes (Csige et al., 2018). Effective collaboration among stakeholders is essential to persuade hypertensive obese individuals to adopt lifestyle changes for optimal health outcomes.

NURS FPX 6614 Assessment 1 Defining a Gap in Practice

Collaboration is facilitated through Team-based Care (TBC), where care coordinators organize regular meetings to set goals and targets for obese hypertensive patients, involving all stakeholders. Nurses, physicians, information technology specialists, nutritionists, physiotherapists, and executives collectively contribute novel ideas (Liu et al., 2019). Nutritionists can devise evidence-based dietary plans, physiotherapists can design suitable exercise regimens, and IT specialists can enhance inter-professional collaboration through technologies such as HIPAA Compliant Text Messaging Platforms and telehealth (Liu et al., 2019).

Example of Strategies

Kreps (2018) recommended a valuable strategy for interdisciplinary teams to work collaboratively for improved health outcomes. This strategy involves the active participation of healthcare providers, administrators, nutritionists, information technology specialists, and consumers in the care process. Team meetings should be held regularly to share relevant patient information, make decisions, establish group interaction norms, introduce new information, distribute responsibilities, encourage diverse perspectives, and discuss pertinent topics (Kreps, 2018).

A Specific Nursing Diagnosis

The specific nursing diagnosis chosen is hypertension induced by obesity. Overweight individuals are at an elevated risk of developing hypertension, and those already grappling with obesity may experience a worsening of their condition. Obesity is estimated to be responsible for a significant proportion of primary hypertension cases (Shariq & McKenzie, 2020). The accumulation of excess fat triggers physiological changes that can lead to or exacerbate hypertension. Failure to manage weight through lifestyle adjustments in cases of hypertension induced by obesity can result in more severe cardiovascular consequences, including cardiovascular disease, hemorrhage, kidney failure, and vision impairment. Therefore, nurses bear the responsibility of educating their obese hypertensive patients about lifestyle changes to return blood pressure to normal levels (Shariq & McKenzie, 2020).

Planning of the Intervention and Expected Outcomes

Care coordinators must engage in regular meetings to establish goals and targets for the obese hypertensive population, formulate effective care plans, and garner the support of all key stakeholders. Nutritionists can help patients develop efficient diet plans to facilitate weight loss and hypertension control, while physiotherapists can design exercise regimens tailored to obese patients’ needs. IT specialists can assist in deploying health information technologies like HIPAA-compliant text messaging platforms, easing the care coordination process (Liu et al., 2019). Telehealth can be employed to educate patients about lifestyle changes and monitor their adherence to dietary and exercise regimens (Liu et al., 2019). The implementation phase should follow the planning phase, with healthcare providers educating obese hypertensive patients about the benefits of lifestyle modifications over medication use. Telehealth can facilitate patient education and compliance monitoring.

Outcomes

Patients with obesity and hypertension are likely to benefit from this approach by recognizing the superiority of lifestyle changes over medications. Additionally, effective collaboration among healthcare providers is crucial for achieving optimal health outcomes.

Assumptions

This analysis is predicated on the assumption that the care coordination efforts of the healthcare team will enable overweight hypertensive patients to adopt necessary lifestyle changes. These changes are considered more beneficial than medication therapy due to the potential side effects and challenges associated with medication adherence.

Conclusion

In conclusion, healthcare professionals should advise obese patients to implement necessary lifestyle modifications, including dietary changes and physical exercise, to manage their hypertensive symptoms. It is recommended that patients with hypertension explore non-pharmacologic methods first, such as positive changes to their daily routines, before considering pharmacologic therapy. Evidence suggests that antihypertensive medications may lead to side effects, making lifestyle changes a more advantageous approach.
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 CDC. (2020, February 25). Facts About Hypertension. Centers for Disease Control and Prevention. 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 Csige, I., Ujvárosy, D., Szabó, Z., Lőrincz, I., Paragh, G., Harangi, M., & Somodi, S. (2018). The impact of obesity on the cardiovascular system. Journal of Diabetes Research, 2018(3407306), 1–12. https://doi.org/10.1155/2018/3407306

NURS FPX 6614 Assessment 1 Defining a Gap in Practice

de la Sierra, A. (2019). New American and European hypertension guidelines, reconciling the differences. Cardiology and Therapy, 8(2), 157–166. https://doi.org/10.1007/s40119-019-0144-3 Gebreyohannes, E. A., Bhagavathula, A. S., Abebe, T. B., Tefera, Y. G., & Abegaz, T. M. (2019). Adverse effects and non-adherence to antihypertensive medications in University of Gondar Comprehensive Specialized Hospital. Clinical Hypertension, 25(1). https://doi.org/10.1186/s40885-018-0104-6 Heinert, S., Escobar-Schulz, S., Jackson, M., Del Rios, M., Kim, S., Kahkejian, J., & Prendergast, H. (2019). Barriers and facilitators to hypertension control following participation in a church-based hypertension intervention study. American Journal of Health Promotion, 34(1), 52–58. https://doi.org/10.1177/0890117119868384 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 Kebede, T., Taddese, Z., & Girma, A. (2022). Knowledge, attitude and practices of lifestyle modification and associated factors among hypertensive patients on-treatment follow up at Yekatit 12 General Hospital in the largest city of East Africa: A prospective cross-sectional study. PLOS ONE, 17(1), e0262780. https://doi.org/10.1371/journal.pone.0262780
NURS FPX 6614 Assessment 1 Defining a Gap in Practice
Kreps, G. L. (2018). Communication and effective interprofessional health care teams. International Archives of Nursing and Health Care, 2(3). https://doi.org/10.23937/2469-5823/1510051 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 Mahmood, S., Shah, K. U., Khan, T. M., Nawaz, S., Rashid, H., Baqar, S. W. A., & Kamran, S. (2019). Non-pharmacological management of hypertension: in the light of current research. Irish Journal of Medical Science, 188(2), 437–452. https://doi.org/10.1007/s11845-018-1889-8 Oparil, S., Acelajado, M. C., Bakris, G. L., Berlowitz, D. R., Cífková, R., Dominiczak, A. F., Grassi, G., Jordan, J., Poulter, N. R., Rodgers, A., & Whelton, P. K. (2018). Hypertension. Nature Reviews Disease Primers, 4(4), 18014. https://doi.org/10.1038/nrdp.2018.14 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 Shariq, O. A., & McKenzie, T. J. (2020). Obesity-related hypertension: A review of pathophysiology, management, and the role of metabolic surgery. Gland Surgery, 9(1), 80–93. https://doi.org/10.21037/gs.2019.12.03 Volterrani, M., & Sposato, B. (2019). Remote monitoring and telemedicine. European Heart Journal Supplements, 21(Supplement_M), M54–M56. https://doi.org/10.1093/eurheartj/suz266

ADDITIONAL INSTRUCTIONS FOR THE CLASS – NURS FPX 6614 Assessment 1 Defining a Gap in Practice

Who we are

We are a professional custom writing website. If you have searched for a question and bumped into our website just know you are in the right place to get help with your coursework.

Do you handle any type of coursework?

Yes. We have posted our previous orders to display our experience. Since we have done this question before, we can also do it for you. To make sure we do it perfectly, please fill out our Order Form. Filling the order form correctly will assist our team in referencing, specifications, and future communication.

Is it hard to Place an Order?

  • 1. Click on “Order Now” on the main Menu and a new page will appear with an order form to be filled.
  • 2. Fill in your paper’s requirements in the “PAPER INFORMATION” section and the system will calculate your order price/cost.
  • 3. Fill in your paper’s academic level, deadline, and the required number of pages from the drop-down menus.
  • 4. Click “FINAL STEP” to enter your registration details and get an account with us for record-keeping and then, click on “PROCEED TO CHECKOUT” at the bottom of the page.
  • 5. From there, the payment sections will show, follow the guided payment process and your order will be available for our writing team to work on it.

SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS – NURS FPX 6614 Assessment 1 Defining a Gap in Practice

We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium.
  • Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, including a minimum of one scholarly source, and be at least 250 words. Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source. One or two-sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words. I encourage you to incorporate the readings from the week (as applicable) into your responses.
  • Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately. In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies. Participation posts do not require a scholarly source/citation (unless you cite someone else’s work). Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
  • APA Format and Writing Quality
Familiarize yourself with the APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required). Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation. I highly recommend using the APA Publication Manual, 6th edition.
  • Use of Direct Quotes
I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.
  • LopesWrite Policy
For assignments that need to be submitted to Lopes Write, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me. Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes. Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own? Visit the Writing Center in the Student Success Center, under the Resources tab in Loud-cloud for tips on improving your paper and SI score.
  • Late Policy
The university’s policy on late assignments is a 10% penalty PER DAY LATE. This also applies to late DQ replies. Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances. If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect. I do not accept assignments that are two or more weeks late unless we have worked out an extension. As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading. NURS FPX 6614 Assessment 1 Defining a Gap in Practice
  • Communication
Communication is so very important. There are multiple ways to communicate with me: Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class. Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours. NURS FPX 6614 Assessment 1 Defining a Gap in Practice

    SCORE A+ WITH HELP FROM OUR PROFESSIONAL WRITERS

    We will process your orders through multiple stages and checks to ensure that what we are delivering to you, in the end, is something that is precise as you envisioned it. All of our essay writing service products are 100% original, ensuring that there is no plagiarism in them. The sources are well-researched and cited so it is interesting. Our goal is to help as many students as possible with their assignments, i.e. our prices are affordable and services premium. Looking for a Similar Assignment? Order a custom-written, plagiarism-free paper