Improving Blood Pressure Control Among Hispanic Patient Population by Enhancing Providers\u27 Attention to Culturally Competent Solutions Aimed at Increasing Self-Care and Treatment Adherence At and Post Hospital Discharge: A Quality Improvement Project

Abstract

Background and Review of Literature: Hypertension is a primary, preventable risk factor for coronary heart disease, heart failure, and stroke. However, despite advances in preventive care and treatment modalities related to blood pressure control, the prevalence of hypertension in the United States remains at an undesirable level and disproportionately affects Hispanic patients. Purpose: The purpose of this quality improvement (QI) project was to determine if a culturally sensitive, multifaceted intervention focused on promotion of hypertension awareness and self- management strategies increases treatment compliance and blood pressure control among Limited English Proficiency (LEP) Hispanics. Design/Methods: The DNP project included a QI protocol with an education evaluation design aimed at improving blood pressure control and hypertension self-management in the LEP Hispanic patient population. Implementation Procedures: The DNP student lead a QI team to identify hypertensive LEP Latinos upon admission to an inpatient medical surgical unit. LEP Hispanic patients received language concordant education related to hypertension and self-management including home blood pressure monitoring paired with post discharge health coaching. Access to outpatient follow up care was ascertained to facilitate treatment continuum. Results/Interpretation: Ninety percent of participants (n=18) reported timely primary care follow up. Forty percent (n=8) attended the three month follow up and demonstrated 74% increase in medication adherence scores and 43% improvement in knowledge related to hypertension and self-management. Seven participants in the follow up group met target blood pressure goal and majority (n=6) verbalized interest in future health coaching opportunities. Implications: The multifactorial QI measure resulted in improved blood pressure control and engagement and in self-care and among LEP Latinos