Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Hypertension has been a significant health concern among many people globally. The cases of hypertension worldwide have risen, especially in the developed countries, possibly because of the modern lifestyle afforded by these people. Many people with underlying health conditions such as diabetes, renal failure, and stroke are victims of high blood pressure. It is one of the leading causes of death among individuals worldwide. Castro-Porras et al. (2021) showed that in Mexico, 335,863 people died because of high blood pressure between 1998 and 2018. They recorded higher mortality rates in men than women over the period.

These numbers are alarming, and this condition has created a problem among the persons. In assessing the situation, analysis of evidence from peer-reviewed journals, a detailed description of various nursing practice principles that could affect the patient, and leadership strategies to improve the patient’s disease are given.

Hypertension is a prevalent health condition globally, and thus it has been chosen as the clinical problem for assessment. The subject selected for this study is a 71-year-old hypertensive female named Josephine Carly. The BMI calculation of the lady was 33, which showed that she was obese. The lady was a chronic smoker for over thirty years. She was given antihypertensive drugs in the facility to control her condition. The health practitioners provided antihypertensive medication adherence education to her, but they did not instruct her on lifestyle modification. The relevance of the nursing field problem helps provide the most effective treatment method to the patients.

Health care professionals must use credible literature for clinical research entailing diseases. In an evidence-based approach, the author must confirm that the journal used is up to date, relevant to the clinical problem, and is peer-reviewed. In this research paper, the database used was Google Scholar to identify journals having important information on hypertension. All the journals used were published had been published under five years and credible so that reliable and up-to-date information on the topic could be obtained.

In the evidence-based analysis, there was a determination that lifestyle modification was the most effective evidence-based method to control Josephine’s hypertensive condition. Kayame and Mallongi (2018) argued that smoking cigarettes directly correlates to increasing a person’s chance of becoming hypertensive. The study involved 40 participants taken in a multi-random sampling technique. The authors found out that smoking habits increase the likelihood of hypertension. Lifestyle modification by the individual would play a significant role in disease control.

Another helpful peer-reviewed journal used investigated the prevalence and factors linked to hypertension. Otani et al. (2018) data used in the study was from 300,249 participants aged 20 years and above. The study found out that hypertension was linked heavily to age, obesity, and alcoholism. Otani et al. (2018) argued that exercise and being underweight effective ways to control hypertension. The study confirmed that obesity and its risk declined in individuals who had incorporated the exercise program. He et al. (2020) conducted a randomized control trial to establish that reduced salt consumption reduces blood pressure in hypertensive and non-hypertensive patients. He et al. (2020) demonstrated that high salt intake is a health risk in normotensive and hypertensive individuals.

Studies have identified that hypertensive patients face various barriers in managing their condition. Brathwaite et al. (2020) found out that lack of health system resources, knowledge, and beliefs on hypertension, demographics, and social factors like poverty were the fundamental barriers to implementing evidence-based practice into clinical practice. Gebrezgi et al. (2017) proved that stress, non-compliance with medication, failure to exercise, and poor economic status were the most common barriers to hypertension management. Low education levels and stigma from the community members affected the hypertensive patient towards managing their condition.

The nurse’s knowledge of the management significantly improved post-training. Gyamfi et al.’s (2017) study found that training nurses on managing hypertension would substantially improve the patient’s condition. As a nurse, I have experienced many hypertensive patients complain about their medication not affecting their blood pressure. One of the main reasons for non-compliance to the medication is the lower level of education among the patients, and thus it affects their appropriate drug intake. In most instances, after administering the antihypertensives to the patients, the nurses do not advise patients accordingly on lifestyle modification.

Training nurses will help fill this gap in their clinical practice. Drevenhorn (2018) suggested hypertension management should include education and lifestyle management, but a clear protocol for nurses to follow in hypertensive patient management is lacking.

In many countries, a nursing board that regulates that provides the guidelines and standards of clinical nursing practice has been established. According to Cashin (2018), these boards license and control the nursing clinical behavior pattern among the practitioners. The nursing practice standard comprises three core components: professional care values, evaluation competencies, and interventions (Whittaker et al., 2019). Nurses should know the standards of nursing practices applicable to their professional geographic area.

Nurses have a huge role in ensuring patient outcomes, preventing illness, and reducing hospital readmissions. McHugh et al. (2017) argued that, in case of a complicated condition, referral of the patient by nurses to a higher level hospital could help reduce hospital readmissions. Implementing patient-centered care improves hypertension management. Asmirajanti et al. (2019) showed that nursing documentation in hospitals improves treatment effectiveness and patient outcomes. Lau et al. (2020) showed that the conceptual framework in nursing helps nurses be creative and carefully structure essential clinical practices, thus improving patient outcomes. The theory can aid in the more straightforward incorporation of community health nursing practice into education and research. It improves client-centered care, nursing education, and service improvements towards the sick.

Nursing board practice standards and governmental policies affect hypertensive patients management. Government has a role in formulating support programs for hypertensive individuals, according to Annadurai (2018). It has a role in sensitizing the public on facts regarding high blood pressure and the significance of lifestyle modifications. Nurses have a function to ensure that they actively engage in leading the transformational changes in the health care meant to improve the patient’s outcome. The nursing board ensures nurse personnel training in clinical practices, entailing management of hypertensive patients (Blackstone et al., 2017).

They must provide patient-centered care and quality improvement within the clinical practice (Salmond & Echevarria, 2017). Haye and Tolera Agama (2020) showed that the federal, local, and national governments should finance hypertensive treatment and screening programs. It will help in the early diagnosis and offer the right advice on lifestyle modification to hypertension patients.

Effective leadership strategies entail a leader ensuring proper communication in the organization, encouraging his followers, delegate powers and activities without bias, and listen to his people. An effective leader puts the team first, creates development opportunities for his followers, and has honesty in their communication (Zbierowski, 2019). Incorporating patient centered-care in clinical practice is one of the most effective methods of managing hypertensive patients.

Good leadership in nursing is a crucial intervention that can help address the hypertension condition in the population. As a practical nurse leader, delegate duties to the members of the support groups and help in facilitating educational techniques based on lifestyle change among hypertensive patients. Embree et al. (2018) showed that collaborative practice in nursing helps improve patient care and delivery of services. A practitioner collaborating with her colleague in solving the clinical hypertension problem improves the help offered to the patients.

In team-based nursing practice, the free flow of communication among the practitioners effectively helps the patient manage the disease condition. The team effectively encourages the patient towards adopting the lifestyle change practices and thus working towards managing hypertension. The collaborative team method stresses the importance of patient-centered care while maintaining patients’ autonomy (King-Jensen et al., 2017). The teamwork among nurses promotes a better patient outcome, thus reducing the number of hospital readmission cases.

In a practical assessment of the problem, I spent six months with Mrs. Josephine Carly, a 71-year-old hypertensive patient. Her blood pressure had been elevated, and she was gaining weight. She informed me that the healthcare provider had only given her antihypertensive drugs without advice on her lifestyle practices. On accessing her based on knowledge of hypertension, I realized she was poorly informed about the condition. For the practicum’s purpose, I stressed to Mrs. Josephine that nurses aim to educate their patients to help them manage the disease. “When a patient is diagnosed with a new condition, they become stunned and stressed. Proper education can help solve this gap,” I said to her.

I incorporated influential nurse theories to show effective communication while educating the patient. Every nurse should assess the client’s readiness to implement lifestyle practices. I identified barriers like lack of insurance, old age, and insufficient funds that made the client unable to change her lifestyle practices. A collaborative team-based approach can help in the elimination of these barriers. The patient-centered approach makes the patient decide on the interventions she wants to undertake.

The part nurses play in disease management cannot be underestimated. Nurses should focus on a patient-centered approach as it allows autonomy and improves the patient’s outcome. Education promotion serves to enhance awareness of condition management. Hypertensive patients should be accorded the essential resources to help manage the condition.


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