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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
Descriptive
TitleInfo
Title
The effect of a hypertensive toolkit at discharge from the emergency department on 30-day revisit rates for hypertension-related complaints: a pilot project
Name
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Ligowitz
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Kristen
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1989-
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Kristen Ligowitz
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author
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Miley
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Helen Miley
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Advisory Committee
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chair
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Barnet
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Barnet Eskin
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Advisory Committee
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internal member
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Rutgers University
Role
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degree grantor
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School of Nursing - RBHS
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school
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Text
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theses
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2019
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2019-05
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English
Abstract
(type = abstract)
Purpose 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.
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.
Subject
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Topic
Adult-Gerontology Acute Care Nurse Practitioner
Subject
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Topic
Hypertension -- Treatment
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Rutgers University Electronic Theses and Dissertations
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ETD_9553
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text/xml
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1 online resource (54 pages) : illustrations
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DNP
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Includes bibliographical references
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School of Nursing (RBHS) DNP Projects
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rucore10004500001
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doi:10.7282/t3-tfzc-9s36
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(authority = ExL-Esploro)
ETD doctoral
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Rights
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The author owns the copyright to this work.
RightsHolder
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Name
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Ligowitz
GivenName
Kristen
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Permission or license
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2019-02-05 12:05:19
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Kristen Ligowitz
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Rutgers University. School of Nursing - RBHS
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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Embargo
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2019-05-31
DateTime
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2021-05-30
Detail
Access to this PDF has been restricted at the author's request. It will be publicly available after May 30th, 2021.
Copyright
Status
Copyright protected
Availability
Status
Open
Reason
Permission or license
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