Capella NURS-FPX4900 Assessments Why is the Problem Relevant to My Practice as a Baccalaureate-Prepared Nurse

Nurses are frequently the first point of contact for patients. As a Baccalaureate-prepared nurse, I am trained to provide quality patient care, including initial review at the emergency unit, blood pressure measurements, diagnosis, treatment advice, or referral to a physician or other specialists. The interventions we provide to this group of patients must be aimed at lowering blood pressure and preventing the progression to unfavorable sequelae.

According to Rahimi et al. (2021), every 10 mm Hg reduction in systolic BP significantly reduces the risk of major CVD events by 20% (relative risk 0.80, 95% CI 0.77–0.83), IHD by 17% (relative risk 0.83, 0.78–0.88), stroke by 27% (relative risk 0.73, 0.68–0.77), heart failure by 28% (relative risk 0.72, 0.67–0.78) and all-cause mortality by 13% (0.87, 0.84–0.91). This indicates that even nurses’ efforts to assist hypertensive patients in managing their blood pressure count, and thus, the relevance of my practice to the population group chosen.

Evidence from Peer-Reviewed Literature

Barriers to the Implementation of Evidence-Based Practice in addressing the Problem

As the adult population with hypertension grows, it becomes more difficult for healthcare professionals to assist their patients with blood pressure control. According to the American Medical Association (AMA), there are five barriers to implementing evidence-based practice in hypertensive patients’ care. First, inaccurate and inconsistent blood pressure measurement techniques may impede hypertension diagnosis and management (AMA, 2018).

It is recommended that at least two blood pressure measurements be taken, with the cuff bladder encircling at least 80% of the arm (CDC, 2022), failure of which may result in incorrect readings and the inability to diagnose hypertension. Second, masked hypertension, which causes patients to appear to have normal blood pressures in the office while having elevated blood pressures outside the office, may contribute to hypertension underdiagnosis.

Third, clinical inertia, blamed on the care team, who may be hesitant to initiate and intensify hypertension treatment, may delay treatment and hasten disease progression (AMA, 2018). Fourth, the care team may lack appropriate evidence-based treatment protocols. Finally, poor patient participation in self-management behaviors may jeopardize blood pressure control.