This assessment builds on what I previously discussed in the other three evaluations concerning Mrs. Josephine’s hypertensive case. The 71-year-old patient was diagnosed with hypertension when she was 65 years. She has been trying to manage the condition through a home-based approach. She retired four years ago, and her husband died when she was 69 years old. Josephine lives with her two daughters, who work in a small cafeteria to support the family financially. The focus on hypertension in these papers was because of the recent rise in hypertension cases globally, especially in developed countries.
Mills et al. (2020) showed that hypertension is the leading cause of mortality among cardiovascular diseases. The study estimated that in 2010, approximately 1.4 billion adults had hypertension. The paper aims to find the solutions to Josephines’s hypertensive case. The problem applies to my clinical practice because it stresses using evidence-based approaches to help in the effective management of hypertension.
Leadership is a crucial intervention in managing hypertension, especially the one that Mrs. Josephine has. It facilitates the adherence of the standard health management plans to improve the patient’s condition. Leaders should demonstrate their leadership skills in handling diseases, especially hypertension and other chronic illnesses, which require a follow-up. The senior nurses and practitioners should ensure that the nurses assigned to handle Josephine’s case adhere to the standard health care plan and maintain the patient follow-up. These senior health practitioners act as the leaders to direct the younger nurses to manage diseases effectively.
Mansaray (2019) demonstrated that change leadership requires leaders who will help the people develop standards that can support them in adapting to the change. In such a case, the leaders carefully designate duties to the clinicians based on their ability and even offer support where there is need.
The leader should also help the clinicians ensure that the patient adheres to the set medication and lifestyle change standards. Patients should willingly listen to the proposed recommendations from the nurses and leaders to improve the condition’s management. According to Tuohy (2019), intellectual communication practice in nursing is essential to ensure optimal patient care delivery. The leader has the mandate to ensure a proper flow of communication between the stakeholders involved in the patient’s condition control. Leadership and change management had a significant effect on the development of the suggested medical interventions on Josephine.
These features defined my communication with Josephine and thus facilitating consultative meetings with her family and other stakeholders who intended to provide patient-centered care. I required the old lady to quit smoking, exercise regularly, reduce salt intake and adhere to antihypertensive medication. My leadership strategy enabled Josephine to adopt the set standard medical interventions I had proposed to her.
In finding the right intervention plans, consideration of nursing ethics is essential. In nursing ethics, Greaney and O’Mathúna (2017) emphasized that respecting patients’ autonomy is critical in delivering quality health care. In autonomy, the nurse should respect the patient’s perspectives, opinions, and values. In this health care plan, I strived to respect Josephine’s views, especially by encouraging her to make informed personal choices on hypertension management. The autonomy principle was vital in determining how I effectively engaged with the patient.
The second principle I strived for was to build trust and confidentiality between Josephine and me. West (2020) showed that establishing a solid trust relationship between the practitioner and the patient improves outcomes. It facilitates better communication between the patient and the medical personnel. Patients disclose confidential information to nurses so that they can be treated and advised accordingly. With the trust I had established with Josephine, she could quickly adopt the proposed intervention plans. I practiced the veracity principle and ensured I was honest with the patient and her family members.
The combined effect of communication between the client and practitioner is essential in meeting the patient’s needs. Abdolrahimi et al. (2018) suggested that the nurses emulating their leader can help improve nurses’ communication. Holding meeting with the patient and family members aims towards improving communication between the parties. During these sessions, the nurse needs to consider the feedback from the patient concerning the intervention plan. The family members offer suggestions on things that can improve the intervention plan.
The second way to improve collaboration between the patient and the practitioner is to ensure that each stakeholder is accountable for the role they have to play in the intervention plan. According to Collette et al. (2017), there was the suggestion that this collaborative nurse-patient or nurse-physician provide holistic and safe patient care. In the intervention plan, Josephine was to play her role in the intervention by quitting smoking, reducing salt intake, regular exercise, and adhering to the hypertensive medication. As a physician, I provided the right advice to her and ensured that she stuck to the intervention standards. I required the family to provide the right environment to facilitate the intervention plan events.
Government policies and the State Board of Nursing establishes guidelines that define the proper conduct of the nursing practice. The Nursing Standard emphasizes the adherence of ethical principles by nurses to improve the health care services delivered to clients. According to Cashin et al. (2017), nursing standards aim to safeguard the patient against nurse’s maleficence. The government initiates medical policies such as the Affordable Care Act, Medicaid, and Medicare to ensure the clinician meets the patient’s needs (Carey et al., 2020). One concept I integrated into ensuring efficient health delivery to Josephine was HIPAA.
I explained to Mrs. Josephine about the Affordable Care Act significance. McKenna et al. (2017) stated that the Affordable Care Act increased hypertensive patients’ health care access. Even lower-income earners like Josephine can have equal access to hypertensive health care under this policy. Individuals living in the most marginalized areas have had the most significant benefit from the program. The policy bridges the inequality gap that people with low social and economic standards experience in developed countries. The insurance is affordable to nearly everyone; thus, it helped Josephine acquire antihypertensive medications to help control her condition.
Proposed interventions are essential in determining the quality of health care offered to Josephine. Educating Josephine on hypertension control strategies like quitting smoking, exercising, reducing salt intake, and frequently checking her blood sugar would significantly help her manage the condition. The proposed intervention also aims towards the patient is having access to resources like health. Incorporating Affordable Care Act would dramatically help the patient address the inaccessibility of the health centers. Ree (2020) established that combining patient-centered care in clinical practice improves patients’ outcomes through the effectiveness of the therapy.
Since Josephine experiences low economic standards of living, advocation of home-best remedy in hypertension management would help reduce the costs she would incur because of transport. This home-based remedy intervention would improve access to health care and reduce her medical expenditures. The home-based remedy would also be important in preventing nosocomial infections. Immunocompromised individuals with underlying health conditions are more susceptible to these infections. It would help reduce the number of hospital readmission that she would encounter. Incorporating an evidence-based strategy in managing Josephine’s hypertension ensures that only reliable and proven information is used to control the disease.
Community resources, coordinated care, and technology can apply to solve the patient’s condition efficiently. Integrating telehealthcare and M-health into the case can efficiently improve the communication between the nurse and Josephine, which leads to Josephine’s improved outcome. The regular contact through telehealthcare with Josephine effectively improved her adherence to medication and lifestyle modification (Lin et al., 2020). Blood pressure sensors can improve the personal management of the condition of the patient.
Care coordination entails a collaborative effect between all the concerned stakeholders in ensuring the safety of the patient. They include the health care gives and the family members to provide the essential care for the patient’s recovery process. The relevant stakeholders incorporate the evidence-based approach to ensure the management of the patient’s condition. Dzau and Balatbat (2019) suggested an improved patient outcome if stakeholders integrate care coordination into practice. Community resources such as CDC (2021) educate hypertensives and normotensives individuals on preventing and controlling hypertension. Health education plays a significant role in determining the quality of health care services the hypertensives receive. These resources enable the participants to find the best way they can effectively solve the clinical problems.
The solutions to Josephine’s hypertensive clinical problem were developed through an evidence-based approach. Strategies need to be sought to ensure effective and collaborative communication between the stakeholders. The government and Nursing Board have a role to play in shaping the conduct of nursing practice. The interventions developed through evidence-based practice would significantly help to manage Josephine’s condition. Lifestyle modification and medication adherence were the main proposed strategies to control the disease. The proposed interventions will positively affect the quality of health care. Application of technology, care coordination, and community resources improve the patient’s outcome.
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