Chronic hypertension is diagnosed when systolic blood pressure consistently exceeds 130 mmHg. Blood tests are needed to determine if secondary hypertension is present. The attending physician decides the need for each test made. Blood tests that may be made to diagnose hypertension include electrolyte levels, blood glucose, thyroid function tests, kidney function tests, and urine tests (Mills et al., 2020). The tests will allow the attending physician to diagnose properly and begin developing an efficient treatment plan.
Aspects of Healthcare Coordination
Healthcare coordination is the interaction between two or more members, including the patient, involved in patient care to facilitate the proper health care services. Team care is a strategy that can be implemented at the health system level to improve patient care by working together with two or more health care providers for each patient. In the context of cardiovascular disease treatment, it often involves an interdisciplinary team working collaboratively.
Patient’s Health Issues, Diagnoses, and Treatment Plan
First of all, it is necessary to determine the hypertension stage to select the correct treatment. Ambulatory monitoring gives a more accurate picture of changes in blood pressure on average during the day and night. In addition, it is necessary to conduct laboratory, to make an electrocardiogram and an echocardiogram. Lifestyle changes can help control and manage high blood pressure. The list of medicines for the treatment of hypertension consists of diuretics, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, and calcium channel blockers (Bakris, 2021). Often the treatment plan changes during the process to find the best strategy.
The Interdisciplinary Team
The interdisciplinary care team necessarily includes doctors and nurses who provide the highest degree of patient care. In addition, the team may include district medics – to monitor the patient’s health after discharge from the hospital. Moreover, in the case of hypertension, the team should include a nutritionist who can help guide the patient’s lifestyle. Introducing a multidisciplinary care system will help achieve the best treatment results.
The CCCR model
The CCCR model can be effective in treating a patient with chronic hypertension. To work effectively, the nurse must be able to identify results. The role of the curator and treatment coordinator becomes important in achieving patient outcomes. The clinical rationale for managing a patient in this way includes skills to coordinate cares to meet the patient’s primary needs. The model meets the basic care coordination needs: conducting a needs assessment, initiating health services and testing, assessing capacity, developing an individualized care plan, educating the patient, monitoring the care plan, and team collaboration (Tyo & McCurry, 2019). This process includes individual systems thinking, group systems thinking, and organizational systems thinking to carefully and effectively manage all aspects of the care of the patients.
The Cost of Managing the Disease
The cost of hypertension care is approximately $900 the first year of treatment, $550 the second year, and $420 per year after that. This amount may not always be available to patients and may not always be covered by insurance. Depending on the deterioration of health, the amount can be significantly increased. The main costs include medicines and the cost of a hospital stay. In addition, the chosen treatment plan and the number of procedures required affect the costs.
Resources to Help with Costs and Other Factors
These costs are directly related to the care the patient receives. They can be divided into direct medical expenses, such as co-payments for doctor visits, tests, medicines, and direct non-medical expenses, such as travel expenses. Good Days helps to pay co-pays for drugs and treatments. The Health Well Foundation provides medical care that is not covered by insurance. Mercy Medical Angels provide free or discounted air, bus, train travel, and gas cards for long- and short-distance travel-related medical care.
The Role of the APRN
The nurse’s role in improving hypertension control has largely expanded in recent years, complementing the physician’s role. The role of practicing nurses in the management of hypertension includes all aspects of care: detection, referral, follow-up, diagnosis and medication, patient counseling, care coordination. A patient-centered multidisciplinary team is a key feature of effective care models that have been found to improve care processes and control rates.
Evaluation of the Care Management: if the Patient Needs a Higher Level of Care
Close psychological contact with the patient is necessary to assess the quality of care provided. This contact is most easily established by the nurse who spends the most time with the patient and is the liaison to the rest of the team. First of all, it is important to pay attention to the patient’s words and psychological state. Of course, it is necessary to look at medical indicators. If they systematically fall, the patient is provided with incorrect or insufficient assistance.
Barriers and Challenges
The main problems that a patient with chronic hypertension may face include fear of drug addiction, reluctance to take medication, and lack of resources. The need for lifestyle changes, stress, and the cost of treatment are the main problems that a patient may face. In addition, the patient may find it difficult to come to terms with the chronic nature of the disease and the necessity for lifelong monitoring.
The Possible Solution
Overcoming patients’ fears and insecurities is important for the successful course of treatment. First, the patient must be provided with reliable and complete information to eliminate the fear of taking medication. In addition, it is necessary to provide a competent level of psychological support to deal with stress. It is necessary to convey to the patient the importance of treatment and guide him all the way.
References
Bakris, G.L. (2021). Drugs for Hypertension. MSD Manual. Hypertension.
Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews Nephrology, 16(4), 223-237.
Tyo, M.B., & McCurry, M.K. (2019). An integrative review of clinical reasoning teaching strategies and outcome evaluation in nursing education. Nursing Education Perspectives, 40(1), 11-17.
