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The effect of a hypertensive toolkit at discharge from the emergency department on 30-day revisit rates for hypertension-related complaints: a pilot project
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Ligowitz, Kristen. The effect of a hypertensive toolkit at discharge from the emergency department on 30-day revisit rates for hypertension-related complaints: a pilot project. Retrieved from https://doi.org/doi:10.7282/t3-tfzc-9s36

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TitleThe effect of a hypertensive toolkit at discharge from the emergency department on 30-day revisit rates for hypertension-related complaints: a pilot project
NameLigowitz, Kristen (author); Miley, Helen (chair); Eskin, Barnet (internal member); Rutgers University; School of Nursing - RBHS
Date Created2019
Other Date2019-05 (degree)
SubjectAdult-Gerontology Acute Care Nurse Practitioner, Hypertension -- Treatment
Extent1 online resource (54 pages) : illustrations
DescriptionPurpose of Project: Elevated blood pressure, or as it is known in the medical field; hypertension, is the number one cause of mortality both globally and domestically with heart disease now the leading cause of death in the United States above cancer (Centers for Disease Control and Prevention, [CDC], 2017). The most common and largest patient care setting in which patients are evaluated and found to be hypertensive is the emergency department (ED) (Niska, Bhuiya, & Xu, 2010). Despite the significant impact that hypertension has on national health, there are currently no standards of care for patients being discharged from the emergency department. This project sought to address this gap in care with the implementation of a hypertension toolkit at the time of discharge from the ED for patients going back into the community.
Methodology: Patients were selected to receive the toolkit based on criteria of two or more blood pressure (BP) readings ≥145/95mmHg, ages 21-90, who were being discharged to home, and had no diagnosed cognitive delays. This patient cohort was then compared to a pre-implementation cohort to determine the effect of the toolkit on 30-day revisit rates for hypertension-related complaints.
Results: At the completion of the two-month implementation period, 11 patients received the toolkit and only two (18%) of them returned to the ED within 30 days. This was compared to a convenience sample of 11 patients from the month of June 2018 from which only one patient (9%) returned within 30 days. A Fischer's Exact test was run to determine if there was any statistical significance between the two patient cohorts and resulted with a p value > 0.999 which was not statistically significant.
Implications for Practice: Limitations and barriers encountered included time constraints, some resistance from ED staff, and some patients that were missed due to the fast-paced ED environment. Despite the results of this project, there is a large amount of evidence supporting hypertensive education at discharge from the ED and clinicians can significantly improve the quality of care given to these patients with the use of this toolkit or similar education interventions.
NoteDNP
NoteIncludes bibliographical references
Genretheses, ETD doctoral
Persistent URLhttps://doi.org/doi:10.7282/t3-tfzc-9s36
LanguageEnglish
CollectionSchool of Nursing (RBHS) DNP Projects
Organization NameRutgers, The State University of New Jersey
RightsThe author owns the copyright to this work.
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