Project Coversheet

Date of Award

4-2021

Degree Type

DNP Project

Degree Name

Doctor of Nursing (ND)

Department

Nursing

Chair

Hector R. Morales, DNP, APRN, PMHCNS-BC

Co-Chair

Laura Rodriguez, DNP, APRN, MCH-CNS

Abstract

Background: Essential hypertension is a chronic disease that can lead to stroke or death if uncontrolled. It is both a global problem in the U.S. and the world.

Problem: A 10-day reflective practice revealed that the current practice of prescribing amlodipine of 2.5mg to 10mg oral tablet daily or Losartan 25mg to 100mg oral tablet daily was ineffective in managing essential hypertension in both newly diagnosed and established patients. The review of the literature guided the selection of an evidence-based practice utilized in implementing this project. The Academic Center for Evidence-Based Practice (ACE) Star Model of Knowledge Transformation (Stevens, 2013) was used to transfer the acquired knowledge into practice.

Design: For this quality improvement project, low doses of thiazides were prescribed as a monotherapy or combination therapy for newly diagnosed or established patients with essential hypertension utilizing the PDSA cycle.

Setting: This quality improvement project was implemented in a small primary care clinic with male and female adult patients aged 44-65 years old.

Intervention: Chlorthalidone 12.5mg tablet to 25mg oral tablet daily or Hydrochlorothiazide 12.5mg to 25mg tablet oral daily was prescribed for newly diagnosed patients or added as an adjunct therapy to established patients with uncontrolled blood pressure. A PDSA cycle guided the implementation of the project for 4 weeks. A blood pressure log was given to the patient with follow-up calls to ensure consistency.

Outcome: The follow-up assessment showed a reduction in the Systolic BP <140 mmHg and Diastolic><90 mmHg. The project concluded that thiazides are effective as a monotherapy o therapy to manage essential hypertension. Significance: The use of a quality improvement intervention has become an integral part of>nursing, especially for doctoral-prepared Advanced Practice Nurses (APRN). It enables the DNP-prepared APRN to identify problems in a clinical practice setting with the knowledge to intervene or solve the problem using quality improvement projects.

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