Connecting Nursing Theory and Evidence-Based Change Model for DPI Project Essay

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Introduction

In America, in a group of every 10 individuals, 6 of them have a chronic disease such as kidney failure, cancer, gall bladder blockage, and so forth. There are also other deadly chronic diseases that are the major causes of deaths and disability in America (Schiffrin et al., 2020). They have increased the costs of healthcare, and an example of such a disease is hypertension. Modern health care promotes change by collecting data and using the data in problem solutions. This paper uses the Direct Practice Improvement (DPI) approach to provide a solution to increase hypertension awareness and control in a period of four weeks. The following paper outlines the interaction between religious beliefs, Christian faith being the selected example, and medical practice in both nursing theory and evidence-based models.

Purpose of the Project

‘’In adult patients, 18 to 85 years old with hypertension treated in an out-patient setting (P), how does the Newest Vital Sign (NVS), Hypertension Knowledge level scale (HK-LS) questionnaire, and healthcare effectiveness Data and Information Set (HEDIS) guidelines (health literacy tools) applied in teach-back method (1) compare to traditional teaching (without teach-back) (C) improve hypertension awareness and management (O) within a four-week period (T)?’’

Hypertension has been a common problem affecting adults in the USA, which has been a common risk factor. Hypertension is a severe chronic disease that also poses a great risk of evolving other chronic conditions such as heart failure, problems of the brain, and kidney-related problems. According to data from the National Health and Nutrition Examination Survey, which was conducted between 2017 to 2018, the commonness of hypertension in adults was 45.4%, with a higher percentage affecting men at the rate of 51.0% and women at 39.0% (Wang et al., 2018). It was reported that hypertension was increasing with age as a higher percentage was reported among the aged. At the age of 18 to 39, it was at a percentage of 22.4, a percentage of 54 for the age of 40 to 59, and a percentage of 74.5 for those of 60 and above years of age (Taylor et al., 2018). The comprehensive report indicated that approximately 1.3 billion people worldwide have hypertension. The report further suggested that the majority of those with hypertension are low and middle-income earners.

Christian Worldviews

The nine beliefs are outlined within the doctrinal statements of the Grand Canyon University and reflect a number of major Christian convictions. These include the use of the old and new testament, the union of the father, son, and the holy spirit, man created in the likeness of God, the regeneration of the holy spirit, and salvation as defined by Christ’s Church. Another three beliefs are focused on Jesus, stating that salvation can only be attained through Jesus, the story of his resurrection, and the recollection of his life. These specific beliefs relate to Christian worldviews and health through the beliefs that give credence to the existence of God and that God takes a hand in the process of healing. Other aspects of the doctrinals claim that man was created in the image of God and was like God. However, having broken the moral nature that was initially given to him, all people are inheriting the sinful nature from generation to generation, and therefore, we are all condemned.

Christians, therefore, say that as a result, God takes moral actions against humans as they are sinners, and an example is the evolution of chronic diseases such as hypertension. In summary, Christians believe that there is a punishment in the form of detachment; an example is a chronic disease that may require isolation, such as the prevailing COVID-19 epidemic.

Organization’s Mission and Vision to Theory and Model

The prevalence of a chronic illness in society calls for an immediate change in the ways in which healthcare is provided in society. The current healthcare system is complicated and lacks special access to technology. Healthcare providers lack enough information on the special care required by patients with hypertension, and instead of offering the needed complex healthcare by the said patients, they emphasize advanced home-based care. This results in poor communication between the patients and the nurses, which poses the risks of the occurrence of medical severe results. According to recent revelation, most patients with chronic diseases have little or rather no knowledge at all of their condition (Mills & He 2020). In that case, most of them do not comply with the medical prescription since they do not know what they are getting treated for and how beneficial it is to them.

Connection of Mission and Vision Statement to Nursing Theory

The mission of this organization is, therefore, to do proper research on how to deliver quality healthcare, especially on hypertension, as well as find out how hypertension can be prevented and controlled. The organization begins creating awareness of the hypertension epidemic since most people lack knowledge about the disease. This will help reduce the mortality rates associated with the disease since the earlier report indicates that 59% of patients of the age of 65 and above lack adequate information on health, and overall of 80% of the patients as well (Umemura et al., 2019). Dorethea Orem’s self-care nursing theory relates to the mission of the company on the basis of individuals having the resources to improve their own wellbeing. Orem’s theory focuses on self-care as a function of people having the knowledge and ability to maintain their health, similarly, the mission of the organization aims to improve the quality of care, and by extension, the ways in which health information is provided. That will be achieved through the inclusion of improved technology and by performing quality assessments.

Connection of Mission and Vision Statement to Evidence-Based Model

The organization will as well advocate for the simplifying of medical procedures in a way that patients can understand. This calls for nurses to give a detailed report concerning the patients’ problem and how it can be managed rather than giving a complicated prescription using medical terms. This will help in the case of those patients with hypertension as they are able to understand what hypertension is, its signs and symptoms, especially when they are serious and call for urgent medical attention. The John Hopkin’s evidence-based change model prioritizes the stages of inquiry, information gathering, and translation of this data into improved medical practices that are subject to continuous analysis. Similarly, the organization’s mission and vision focus on the improvement of current procedures through the simplification and clarity f these processes for the benefit of the patients.

Who are the participants in this project?

The project targets hypertension patients and those who are at risk of getting the disease as well. It will source participants of different levels, each level with a representative. For the children, their caregivers, such as parents and guardians, will represent them. As for the adults, individuals of a given age and gender will be chosen. Still, gender balance will be put into consideration because hypertension affects both men and women. The said patients should have been having the disease for at least a year and a half so that they would be able to share enough experiences about the condition. The chosen participants should be able to communicate in English as well to avoid the problem of a language barrier.

Estimated Period

The hypertension control training cannot be a one-day thing. The DIP will therefore need a four-week period for the movement, and accordingly planning is essential in this project. The training period will as well be organized into sessions of 45 minutes, taking occasional breaks in between. In a short session, the Nursing team will be taken through the importance of the project to ensure effective content delivery. The organization’s support staff will print posters and flyers with a guide on the project’s timetable. This will ensure that there will be effective coordination of events between the participants and the organizers.

In the first week, the DPI will be taking the participants’ data. This will include running practical tests such as blood and diabetes tests. The patients will be issued with forms with the obtained information, which will be filled and filed for assessment throughout the four weeks’ period. The DPI team will assist the participants in filling the forms. The patients will be asked to provide some information on their illness experience, how they realized that they were hypertensive, their daily routine on managing the disease, and the problems they have been experiencing concerning the condition.

In the second week, the participants will be enlightened on what hypertension is. They will be taken through a vivid explanation of what the disease is, its causes, and its symptoms. They will be taken through the likely factors contributing to the development of the disease, which includes age, that is, the more one grows old, the more likely they are to become hypertensive.

In the third week, the nurses enlighten the patients on how the disease can be controlled. They will be taken through a guideline on proper dieting, inspiring them on the foods that they are supposed to take to lower hypertension and those that they are supposed to avoid. The participants will as well be provided with a guideline routine on the activities, for example, what exercises to be done at what time, either in the morning or in the evening.

In the final week, the patients will be given feedback on the training session. The DPI team will be testing their understanding as well by asking them relevant questions to test their knowledge of the lessons on hypertension management and control. In the end, the data before intervention and after the intervention will be outlined and analyzed to keep a record of the outcome. The documents will be securely held at the clinic as the DPI puts the patients’ confidentiality into account.

Vision

The vision of the project is to provide a hypertension-free community. Using the above-mentioned procedure in choosing the participants of the project, the organization will have established fair distribution and solutions to the problem of hypertension. For example, in the case of the caregivers, they will in return give the information to the other caregivers of the hypertensive children, and the chosen representatives of the different age groups will provide the information for their age mates through the preferred methods, either by creating hypertension care study centers or organizing seminars on hypertension awareness and control methods (Tatsumi & Ohkubo, 2017). The organization aims at establishing adherence to medication and prescription of hypertension patients; therefore, the above approaches will help with the same. The DPI employs the vision of improving hypertension awareness and management by transitioning from traditional teaching to health literacy tools applied in a teach-back method. The improving technology should be well utilized by the patients and the caregivers to make sure the hyper-tension is not a threat to lives anymore.

Pulling it Together

The teach-back method is, therefore, when applied in educating a patient, it has shown without a doubt to upgrade the knowledge and improve the communication between the health care provider and the patient (Miller 2016). The importance of increasing patients’ literacy on their health is to make the patients know their condition better, thus helping in their coherence to the laid down plans on treatment since they understand their shape better. The patients should first understand the significant role played by information about themselves concerning his/her health status. In conclusion, the teach-back method is an effective method of improving hypertension through education and assessing its significance in society.

Conclusion

The case study observed the implications of interventions in incidents of hypertension with the introduction of several evidence-based models and exterior factors such as religion. The teach-back method, which was selected as the most effective tool in decreasing hypertension through educational means, can be applied to the mission and vision statements of the organizations. They prioritize the improvement of care quality and engaging with patients in clear ways regarding medical procedures. Similarly, it will be directly related to raising awareness regarding common issues within hypertension. As such, the teach-back method aims to meet both criteria effectively.

References

Miller, T.A. (2016). Health literacy and adherence to medical treatment in chronic and acute illness: A meta- analysis. Patient Education and Counseling, 99, 1079–1086.

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237.

Tatsumi, Y., & Ohkubo, T. (2017). Hypertension with diabetes mellitus: significance from an epidemiological perspective for Japanese. Hypertension Research, 40(9), 795-806.

Taylor, S. G., Katherine Renpenning, M., & Renpenning, K. M. (2018). Self-care science, nursing theory and evidence-based practice. Springer Publishing Company.

Wang, C., Lang, J., Xuan, L., Li, X., & Zhang, L. (2017). The effect of health literacy and self-management efficacy on the health-related quality of life of hypertensive patients in a western rural area of China: a cross-sectional study. International journal for equity in health, 16(1), 1-11.

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