Learning Session 9

Nurse Engagement in Hypertension Control via Clinical Systems Changes

Speaker: Jennifer Cooper, DNP, RN, APHN-BC, CCP
2014-2016 Fellow
Association of Public Health Nurses

Date: June 10, 2016

Brief Bio: (download)
Jennifer is a Fellow and Project Lead for the Million Hearts Initiative with the Association of Public Health Nurses (APHN) and is working on a project evaluating the effect of a public health nurse and faith community nurse intervention on hypertension prevention.  This work that began in 2013 became the basis for her Doctor of Nursing Practice (DNP) project that was funded by the American Association of Colleges of Nursing’s DNP Evidence-based Practice Award in 2015-2016.  Jennifer has taught public health nursing as adjunct faculty at Georgetown University and Marymount University.   Prior to working in academia, Jennifer was the Project Manager at AARP for the Future of Nursing: Campaign for Action and completed a graduate residency program at the National Council on Aging; both in Washington, D.C.   Jennifer is licensed as a registered nurse in PA, MD and DC and is board-certified as an advanced public health nurse.  She currently practices as a community health nurse in a local health department in Maryland.  Jennifer holds a DNP from The George Washington University, an MSN from Rush University and a BSN from Cedarville University.

Watch the Presentation (25 minutes)

Resources:

  • Transcript

Objectives of the presentation:

  •  Increase the knowledge and ability of state and local health department participants to to promote engagement of nurses as a vital part of the team-based care for control of hypertension

Main points to be covered:

  • Reviewing the impact that can be achieved in hypertension control through nurse engagement with patients
  • Looking at barriers to nurses’ action in achieving hypertension control in patients

Main points presented:

  • There are over 3 million nurses in the U.S., one of the largest segments of the U.S. health care workforce and the largest percentage of the public health workforce.
  • Nurses are in integral part of the Team-based Care model, helping to ensure patients receive follow-up with their prescribed treatment, scheduled appointments and recommended lifestyle changes.
  • Nurses do need refresher in learning proper techniques for blood pressure measurement and motivational interviewing with patients.
  • Nurses go into a community asking “why” the problem exists, before developing the “how” to fix the problem.
  • Nurses are using motivational interviewing to listen and provide support for patients to take an active role in their management of hypertension.
  • Barriers found for persons in managing hypertension include missing appointments, tracking hypertension and not following treatment regimens.
  • Barriers found in the system for managing hypertension include understanding the roles of the public health nurse, primary care nurse and community health nurse in provision of health care; the view that the nurse is limited to a bedside, sick care provider; and limited funding to offer interventions and collect data to show results.
  • Local programs in Maryland, Connecticut, Wisconsin and Oklahoma have shown positive results in hypertension control using community based nurses in local settings. Nurses provide information on hypertension control, visit patients to assess, monitor and provide support of health goals and care recommendations and initiate referrals to other members of the care team, including physicians and pharmacists.

Main take-away points:

  • Community/public health nurses members of the community and provide a critical role in the team-based care model for hypertension control.
  • Patients have a great level of trust in nurses. A relationship is built as the nurse listens to the patient’s health goals, supports the patient’s concerns and barriers, and establishes a connection with the whole family as a coach and cheerleader of the patient.
  • Approaching the patient in a non-judgmental manner, using motivational listening, allows the nurse a better opportunity to work alongside the patient to identify their health goals, and the barriers to achieving those goals, to increase the patient’s confidence in managing their hypertension.
  • State and local public health do, and can, work with nurses as a valued part of the team to affect hypertension through (deleted nurse) assessment, referral and follow-up to patients with hypertension.