Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations
Technology and telemedicine have emerged as valuable tools for managing hypertension (Pellegrini et al., 2020). Through the two-hour session with David, I found that technology integration was required to overcome the health challenges posed by the incompetence of nursing practices to treat him. This assessment will be based on figuring out the best-suited technology-led interventions to treat hypertension in patients like David while emphasizing the importance of such technologies.
Impact of Healthcare Technology on Hypertension Management
EHRs, telemedicine, and remote monitoring technologies such as wearable devices have been evaluated to improve patient outcomes by allowing nurses to monitor patients’ blood pressure levels and adjust treatment plans as needed (Pellegrini et al., 2020).
Advantages
Patients can use wearable devices and mobile apps to measure their physiological status. It also provides real-time data to the nurses and facilitators, which can help providers make more informed decisions about treatment (Wu & Luo, 2019). Additionally, telemedicine and remote monitoring technologies can increase access to care for patients who cannot visit the healthcare facility in person (Haleem et al., 2021). Furthermore, digital tools such as mobile apps can help patients adhere to their treatment plans by sending reminders to take medications and encouraging healthy behaviors in hypertension management (Alharbi & Alkhawaji, 2023). Additionally, by enabling remote monitoring and reducing the need for in-person visits, telehealth technology can reduce care costs for patients and hospitals (Snoswell et al., 2020).
Disadvantages
Chenthara et al. (2022) argued that implementing and maintaining technology systems can be expensive due to maintenance costs. It may also require significant investments in infrastructure, equipment, and personnel (Chenthara et al., 2019). A major demerit of using healthcare technology is that EHRs or other digital data are vulnerable to cyberattacks and hacking (Paul et al., 2023). These are likely to risk patients’ personal health information (PHI). Healthcare providers and nurses must take steps to protect patient privacy and ensure data security. Moreover, over-reliance on technology can lead to a lack of nurse-patient engagement, potentially reducing patient satisfaction (Wu et al., 2023).
Potential Barriers
- Lack of Access to Technology : While technology makes care more accessible for some patients, it may also create barriers for others. This includes individuals who need reliable internet connections or are uncomfortable using digital tools (Gajarawala & Pelkowski, 2020).
- Limited Digital Literacy: Patients, particularly those from rural settings, who are unfamiliar with technology or have limited digital literacy may need help using digital health tools effectively (Gann, 2019).
- Data Security Concerns: Patients may have concerns about the security and privacy of their personal health information, which can limit their willingness to use digital health tools (Solomon & Rudin, 2020).
- Provider Resistance: Some healthcare providers may need more training or concerns about the effectiveness of digital health tools (Niazkhani et al., 2020).
- Lack of Reimbursement: In some cases, healthcare providers may not be reimbursed for providing remote monitoring or telehealth services, which can limit their use of digital health tools (Gordon et al., 2020).
Healthcare Technology Cost Concerns
Implementing telehealth can save maximum costs for patients by reducing the expenses of hospital visits, hospitalization, readmissions, and medications. Through telehealth systems, virtual assistance can be provided to patients at the ease of their houses, saving these costs. According to research by Snoswell (2020), telehealth has saved $361 per patient and $8566 in hospital services in six months compared to traditional care programs (Snoswell et al., 2020).
Impact of Technology on Nursing Practices
According to Robert (2019), technology has significantly impacted nursing practices in recent years, changing how nurses deliver care and interact with patients. The use of digital tools helps nurses in reducing errors and increase efficiency by providing real-time access to patient records and ensuring that patients receive the correct medications. Additionally, technology has improved patient safety through decision-support tools and alert systems (Robert, 2019). After having a session with David, it was reported that the nurses needed to upgrade their practices at various points. As indicated by Joint Commission, decision support tools and alert systems could have been used to identify potential medication errors or adverse drug reactions (Rozenblum et al., 2020). I anticipate using these tools for David as they could help prevent the overdosage of ACE inhibitors. Remote monitoring services could have also been used to monitor David’s blood pressure levels regularly and provide ongoing support and education.
Use of Care Coordination and Community Resources for Hypertension Management
According to Patrício et al. (2020), care coordination and utilizing community resources can be powerful tools to address patient, family, or population problems in healthcare (Patrício et al., 2020). Berwick (2019) indicates that one evidence-based care coordination model is the Chronic Care Model (CCM), which focuses on improving healthcare conditions for patients with chronic diseases such as hypertension. In this model, healthcare providers collaborate to deliver comprehensive, coordinated treatment and care tailored to each patient’s requirements. The CCM also emphasizes the importance of self-management support, as patients with chronic conditions often need to be actively involved in managing their health. The model has been shown as patient-friendly and cost-effective, ensuring safe patient outcomes (Berwick, 2019). According to Proboningsih (2023), implementing the CCM in hypertension management can improve blood pressure control, decrease hospitalizations, and reduce healthcare costs (Proboningsih et al., 2023).
Telehealth can be another helpful strategy in hypertension management in fostering care coordination. According to Santos et al. (2022), patients can use mobile apps and wearable devices to track their blood pressure and report the data to their nurses. Nurses utilize this information to make more informed treatment decisions. Telehealth can also facilitate remote consultations, allowing nurses and physicians to communicate with patients regardless of location (Santos et al., 2022).
Role of Community Resources in Care Coordination
Community resources play an essential role in care coordination by providing access to various services and support outside traditional healthcare settings (Patrício et al., 2020). Resources such as pharmacies, home health services, and community health clinics can play a central role in hypertension management (Hoehns et al., 2020). According to Vedanthan et al. (2019), community health clinics often offer blood pressure screenings and education on hypertension management, which can help individuals understand their condition and take steps to manage it. Additionally, community health clinics may offer nutrition counseling and exercise programs to help individuals make lifestyle changes to lower their blood pressure (Vedanthan et al., 2019). The Center for Disease Control and Prevention (CDC) is a valuable community resource for hypertension management (Stupplebeen et al., 2019). According to Ritchey (2020), CDC’s Million Hearts initiative is centered on preventing one million strokes and heart attacks until 2022, applying strategies such as hypertension management. The CDC offers blood pressure measurement protocols, clinical practice guidelines, and patient education materials on hypertension (Ritchey, 2020).
Potential Barriers
According to Morrison et al. (2021), patients may need more financial resources to access necessary care or medications. This can lead to poor adherence to treatment and uncontrolled hypertension. Additionally, nurses may have a high workload and limited time with patients making it difficult to coordinate care effectively. It also leads to missed opportunities for education, follow-up, and monitoring.
Expected Outcomes and Effectiveness
In the case of David, the use of community resources and collaborative care play a crucial role in addressing his hypertension management and preventing further complications. Based on the evaluation of the practicum session with David, I suggested joining support groups and educational programs that can provide him with information about lifestyle management and skills to manage his hypertension effectively. These programs can also offer referrals to specialists in case of complicated hypertension management issues (Tavakoly Sany et al., 2020).
State Board Nursing Policies of Technology Use for Hypertension Management
There are several policies and standards in the US that guide nursing practices regarding the use of technology in interventions, particularly for hypertension management.
- Health Insurance Portability and Accountability Act (HIPAA): The law administered by federal authorities establishes standards to keep the personal health information (PHI) of patients protected and secure. This law requires nurses to protect the privacy and security of patients’ medical information, including EHRs and other digital health technologies (Moore & Frye, 2019).
- Nursing Practice Scope and Standards by American Nurses Association (ANA) Nursing Informatics : This document outlines the value and requirements of nursing informatics, which refers to integrating computer science, nursing science, and information science to manage the data and communicate the knowledge in nursing practice. This policy guides nurses in using technology and information management in their practice (Kreitzer et al., 2022).
- Institute for Healthcare Improvement (IHI) – The IHI is a non-profit organization focusing on improving healthcare quality and patient safety. It has developed evidence-based guidelines and tools for hypertension management and other health conditions that nurses can use to improve their practice and patient outcomes (Bolen et al., 2023).
- Medicare & Medicaid Services Centers (CMS) Quality Payment Program (QPP): This program provides financial incentives for nurses who use technology efficiently to improve patient outcomes. This includes the management of severe conditions such as hypertension (Mendel et al., 2020).
- The Joint Commission Nursing Standards: These standards guide healthcare organizations regarding the use of technology in patient care. It requires healthcare organizations to implement and maintain systems for monitoring and improving patient outcomes, including the management of hypertension (The Joint Commission, 2023).
Ethical Considerations in Nursing Practices
Monroe (2019) explained that the American Nurses Association (ANA) had set an ethical code demonstrating ethical considerations for nursing practice. These ethical considerations are based on the core values of integrity, trust, respect, and compassion. Concerning hypertension management, the ANA guidelines highlight the importance of promoting the well-being of patients and providing care that is free from harm. Nurses are ethically obliged to advocate for their patients and ensure appropriate care (Monroe, 2019).
Through the practicum session with David, I found that the nurse needed to adequately educate him on the importance of proper medication adherence and regularly monitoring his blood pressure levels. This represents a breach of ethical obligations, as the nurse did not provide appropriate care or advocate for the patient’s well-being (Monroe, 2019). The ANA guidelines suggest that the nurse should have taken a more active role in managing David’s hypertension and ensuring he received the needed care.
Conclusion NURS FPX 4900 Assessment 3 Assessing the Problem Technology, Care Coordination, and Community
Technology has brought about significant changes in nursing practice, particularly in hypertension management. The use of telehealth and care coordination guided by appropriate community resources is effective in improving patient outcomes. However, barriers to care coordination, such as lack of access to resources and financial constraints, must be addressed to ensure optimal care for patients with hypertension. In addition, ethical considerations and administrative standards should guide nurses in their practice to ensure patient safety and promote ethical conduct.
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