NURS FPX 6614 Assessment 1 Defining a Gap in Practice Executive Summary
In-depth Analysis or Knowledge Gap
Hypertension symptoms in overweight patients could be managed with the help of medications, but evidence suggests that medications have side effects. These side effects can worsen the situation for an obese hypertensive patient (Gebreyohannes et al., 2019). Additionally, the adverse effects caused by antihypertensive medications make medication adherence difficult for the patient (Gebreyohannes et al., 2019). Cosimo Marcello et al. (2019) reported that only around a third of hypertension patients treated with antihypertensive medication reach the desired number (Cosimo Marcello et al., 2019).
Research by Cosimo Marcello et al. (2019) suggests that low-salt diets and regular exercise may assist obese people in controlling their hypertension symptoms. Patients can safely reduce weight and keep their blood pressure steady with a combination of healthy eating and regular exercise (Cosimo Marcello et al., 2019).
PICOT Question
What is the PICOT question?
For hypertensive obese individuals, a (population, intervention, comparison, outcome, and time) PICOT methodology may be useful for analyzing the relative merits of lifestyle modifications versus medications and filling in the knowledge gap. The PICOT question is: In overweight adults with hypertension do lifestyle modifications as compared to antihypertensive medications result in low blood pressure within 6 month time period?
Population: Overweight adults
Intervention: Lifestyle modifications
Comparison: Lifestyle modifications versus medications
Outcome: Low blood pressure
Time: six months
Explanation of the Selected Gap
According to Alsaigh et al. (2019), proper care planning is necessary to safeguard patients from the potentially lethal implications that hypertension might have. Lifestyle changes have a significant role in lowering blood pressure and postponing the development of hypertension in individuals who are otherwise healthy. Patients with hypertension should consider making lifestyle adjustments first before initiating pharmacologic therapy (Alsaigh et al., 2019). The care coordinator’s responsibility is to educate overweight hypertensive patients. Furthermore, they need to assess their level of knowledge by asking them free-form questions after educating them. This is the last but most important part of the care coordinator’s job. The patient will need to be instructed by the coordinator on how to make the necessary behavioural adjustments so as to achieve the desired outcomes (Karam et al., 2021).
At the regional level, the Joint National Committee (JNC) has recommended that hypertensive patients engage in lifestyle modifications for six months. These modifications, according to the JNC, include increased physical exercise and dietary changes for obese patients, low salt intake, and limited alcohol consumption (de la Sierra, 2019). PREMIER trial was the largest clinical trial performed in the US that evaluated the methods of lowering blood pressure through lifestyle changes. It evaluated the impact on hypertension by making many concomitant adjustments to one’s way of life. This trial showed that weight loss, getting more exercise, and eating well were all great ways to manage hypertension without drugs (Mahmood et al., 2019). Additionally, lifestyle modification and medications can both lower blood pressure within six months, but medications can certainly show their side effects within the six months (Kebede et al., 2022).
Services and Resources for Care Coordination
Resources
Healthcare teams can make use of social media messages, fact sheets, and handouts to educate obese hypertensive patients on lifestyle modifications.
Potential Services
In numerous facilities, care teams consist of nurses, physicians, pharmacists, information technology specialists, and hospital administrators. Nurses, as care coordinators, can play their role in raising awareness among obese hypertensive patients on making healthy lifestyle choices. In addition, the entire team can utilize telehealth to monitor patients’ compliance with their prescribed lifestyle change regimens (Volterrani & Sposato, 2019).
Barriers
The process of care coordination is hindered by several obstacles. These obstacles include insufficient coordination with patients due to a lack of patients’ trust in healthcare professionals or their inability to engage in self-management practices (Heinert et al., 2019). In addition, since health information technology plays a significant part in care coor