Interventions of Managing Hypertension

Evidence-Based Practice Project Proposal: Evaluation Plan
Kieran M Njobe
Grand Canyon University: <590>
Evaluation Plan
Interventions of Managing Hypertension
Program Evaluation: Interventions of Managing Hypertension
Program Background and Expected Outcomes
Management of hypertension requires a very strategic approach in such a way that implementation of change or outcome development is precise and successful, otherwise, it could be mute. The applicable intervention for this health issue is the use of digital technology with social cognitive hence a look at the definition of personal experiences, behavior, and medical behavior environment. Therefore, the outcome of the intervention that is presented is to make sure that there is improvement in the data use to improve patient care and medication in hypertension patients hence reducing deaths and CVDs related complications (Fort et al., 2021).
Evaluation Design
The project completion is determined by a need for monitoring throughout from the point of admission to the outcome determination. As such, the understanding of the change throughout the time will be actualized through the utilization of outcome development within strategy reformation. The long-term applicability of the design for the evaluation allows for progressive determination of caregiving to hypertension patients. Therefore, the evaluation design that would be used in this project will be randomized tests. The randomization involved the control of source for bias in a way that allows confidence in the outcomes from the patients. The aim is to improve the extent of nursing care and thus the involvement of the healthcare practitioners in changing the system in a way that allows leveling up on the change in behavior towards data use in hypertension medication (Patel. et al., 2021).
Evaluation Needs
The program intends to allow for prevention of the diseases that could lead to death. In the utilization of the digital intervention, the development of medication is the end goal within the twelve months. In this way, the use of mixed-methods evaluation procedures that would be employed is the outcome evaluation with the integration of impact evaluation (Huber, 2011). Therefore, looking at the indicators, the outcome evaluation, the aspect to consider are:
· Changes that have occurred during the participation process and can be weighed
· Identification of short-term accomplishment of the program
· Determination of the program effectiveness hence replicable
On the other hand, in looking at impact evaluation, the aspects to consider are:
· Whether there are long term changes of the primary care
· Examination of the extent of change and reduction of the issue generally within a given period
· Questioning of the systemic changes with the degree of confidence attributed
Evaluation Methodology
By considering the questions under the evaluation needs, the randomization will involve a multi-step process with three aspects that would be used in frequency outcome measures (McManus et al., 2021). Since most of the outcomes are tied to the hypertension patients, there will be one after the before and after the intervention and the potential follow-up after several months of the intervention.

Intervention Phase Indicator Monitoring Expected Outcome
Pre-Intervention · Applicable hypertension management
· Type of medication management plan involved
· The success rate of medication management plan involved
· Number of admission and readmission due to poor medication management
· Number of patients developing progressive complications
· The current system is analog
· Stagnant medical management system without data
After Intervention · Identification of change in hypertension management
· Type of medication management plan involved
· The success rate of the medication management plan involved (were there changes over time or did it stick to only one?)
· Number of admission and readmission due to poor medication management
· Number of patients developing progressive complications
· Changes are noted to be on a growing trajectory
· Medication plans are unique to patient data
· The higher success rate in hypertension management (fewer changes in plan with time hence improved precision in quality of care)
· Reduced readmissions resulting from progressed hypertension complications
Follow Up · Change in medication behavior by health practitioners
· Use of the system in improving patient care hence qualitative input
· Number of health practitioners that have integrated the digital intervention
· Success rate observed in medication management using data
· Increase in use of data for medication management
· Increased system use by medical practitioners with increase policy is data use management
· Expansion of the system within the institutions and to others for use by more practitioners

Data Collection Tool
Several methods will be used in the collection of data about the patients and the healthcare practitioners. By integrating the different methods in data collection, there would be several types of qualitative and quantitative data that could be used in comparative analysis and determination f the success rate of the project. Such data collection tools will include interviews, observation, survey, secondary data collection, and archival research. The interview will be used to get an in-depth understanding of the opinion in the healthcare fraternity about their feeling about the use of digital intervention in hypertension medical management. As such, there is direct stakeholder involvement in the process while accounting for the variables that facilitate the success rate in the implementation of the intervention.
The archival research will be used to look at historical data on deaths from hypertension in the healthcare faculty, the interventions that have been done before, and the success rate of previous interventions to determine the conditions and practices that would improve the outcome reachability. As such, the secondary data collection will help in this aspect by allowing room for analysis of data from populations that are inaccessible firsthand. It facilitates the comparative element for a larger demographic to look at a developmental aspect of the intervention’s success.
Statistical Test
The collected data can easily be analyzed using several steps of testing. Using the development of the hypothesis that data-driven intervention would allow for the improvement of medication in hypertension disease. As such the hypothesis would be:
H0: data-driven intervention would allow for the improvement of medication in hypertension disease
H1: data-driven intervention would not allow for the improvement of medication in hypertension disease.
The null hypothesis as a line of belief can be tested and thus a testing procedure can be carried out and constructed such that the risk of rejection of the null hypothesis when met is minimal hence proof of the outcome development (Bain & Engelhardt, 2017). At the same time, it would allow for statistical analysis in which there would be a look at the quantitative value to be aware of the Confidence Interval denoted. At a more than 95% level, the result would be trusted especially with the potential of inactive medical behaviors in the management of high blood pressure with the current system. Correlation analysis will be used to determine the relation of the increase in data usage to the improvement of healthcare delivery.
Part of the Assignment on Nur 590 week 6
Implementing plan interventions of managing hypertension
Hypertension is one of the most dangerous diseases that can easily lead to death if not managed. It occurs due to increased blood pressure, and a continued rise in blood pressure can contribute to other deadly illnesses such as stroke, heart attack, or heart disease. Considering the hypertension problem is expected within the healthcare setting, there is a need to implement change in dealing with the patients to ensure that better strategies of assisting patients in managing the illness are implemented. Therefore, we will discuss how medical practitioners can utilize a digital intervention to develop planned medications to lower their blood pressure. The study will be carried out within twelve months to allow adequate information to be gathered. In addition, mixed-methods evaluation procedures will be used to understand better the effectiveness of the intervention in primary care.
Setting and access to potential subjects
The hypertension patients will be allowed to register in a system of digital intervention known as Help BP. The system is developed using the social cognitive theory; it shows personal experiences, some people’s behaviors, and individual medical behavior environmental aspects. It helps target hypertension patients with inactive medical behaviors of managing their high blood pressure (Rai. et al., 2021). Also, medical practitioners will seek to involve the newly diagnosed patients with hypertension in the system to monitor their capability to follow the outlined intervention plans.
To complete this project successfully, a lot of monitoring is required. It, therefore, means that the project should take a lot of time to allow all the needed data to be collected. Carrying out the study for preferably twelve months will ensure that the project includes all seasons of a year. It will allow a better understanding of how the proposed change can be adequate in different seasons. In a year, all the necessary information would have been recorded and utilized to reform strategies of offering medical care to hypertension patients.
Making sure that medical behaviors can be monitored using the proposed digital intervention will be an expensive change that requires a lot of human and monetary resources. There should be adequate finances to help develop the best efficient system for all end-users, both the patient and the health care workers. It will ensure that any concerns regarding medications that the clients consume are directly reported to the health care practitioners, and the needed responses are passed along smoothly. There are supplies for measuring blood pressure that is to be given to the test subjects. Accessing the required patients’ information can be a big challenge to this project. Therefore there is a need to include consultation costs for any necessary consultations that are to be made. The Budget required for this project is about $15400 in Total. With effective communication, stakeholders can be convinced to make a sufficient amount of donation to meet the expectations. This Budget will be allocated to various departments from the drafted proposed budget/ resource list planner in the Appendix. This is the first draft and will be modified. The list includes the transportation budget for health care workers, supplies that have blood pressure machines, PPE, and other resources. It is quite expensive because due to the effect of the Covid 19 , I will be advocating for the use of disposable equipment such as disposable blood pressure cuffs. Part of the Budget will be allocated to developing user-friendly software and can be customized as needed. This is a twelve-month program, and that’s why more resources will also be directed towards Data accessibility which maybe needs to track and monitor participants ( with their consent, obviously). See the table in the Appendix, which will still be modified.
Data collection
Having sufficient data for the completion of this project requires the utilization of mixed methods of collecting data. The quantitative design will ensure that numerical values are included in the research. It will allow an easy understanding of the results from the study and ensure that generalization operations can be conducted efficiently. The qualitative design will ensure that questions that the numerical data cannot explain are put into consideration. It will permit the project to use questionnaires and surveys to acquire the needed data. The subjectivity of the findings will be embraced by using mixed methods while ensuring that accurate quantitative data is portrayed. We will be dealing with a vast array of clients, and therefore utilizing these mixed methods will help broaden the findings (McManus. et al., 2021). It will allow analyzing the data that the participants provide deeply.
Methods and instruments of monitoring implementation of the proposed solution
Randomized tests that include health care practitioners such as practice nurses, health care assistants, General Practitioners, and nurse-prescribers will help monitor closely how efficient the proposed method will be. Randomized controlled trials will allow the study to be monitored closely, and the extent to which the nurses can provide the needed care is determined. Questionnaires for the clients will help identify the changes the new system is bringing. It will allow easy identification of the level at which the proposed solution has enabled them to change their medical behaviors, such as taking hypertension medications (Patel. et al., 2021). A group of 30 practitioners and 30 clients will be allowed to take part in the study. They will be selected using the random probability sampling method to ensure the availability of participants willing to be part of this study.
Process of delivering the intervention
Health care workers have always been able to use their educational resources to apply the needed interventions when handling varying cases with clients. Management of the hypertension condition requires the health care workers to be willing to offer substantial information on how to control the illness and the best medications to use to suppress this pressure. However, the clients ought to be willing to participate in implementing the changes they are told by the professional. To allow efficient and convenient use of the proposed system, both the clients and the workers will undergo training to provide them with the confidence to manage hypertension better. After training, the necessary practices will be allowed using the prototype of the website. After the
Challenges in the proposed approaches can be overcome by ensuring that the obstacles recorded during the process of studying the results change do not hinder the overall activities. Among the stakeholders who are included in the project will be the practitioners, experts in the medical field, and the patients (Fort. et al., 2021). The data from these stakeholders will be used to distinguish the appropriate adaptation of the implemented change and the non-adherence that could be present. The processes for medical escalation in responding to the proposed treatment should explain the positive contribution of health care practitioners in enforcing procedures of maintaining normal blood pressure. The implemented change’s practicality is made possible by allowing patients to have autonomy control of their medical behaviors while ensuring accessible information.
Feasibility of the implementation plan
The study will offer valuable information which will help establish the best means for managing and treating cases of hypertension. The implemented plan is only valid when a patient has confirmed the blood pressure measurements to be high; the client trusts that the readings offered by the system can be relied on, and the client can access medical attention easily. Considering that one has to deal with numerous patients with various backgrounds, it can be difficult to offer uniform help because the underlying factors resulting in treatment are different. The system of recording the blood pressure and determining the time when one has to take medication can be easy to the educated and well-informed patients while other patients with varying educational classification may find it difficult to understand when to measure their blood pressure level and the subsequent medications to take (Petersen. et al., 2021). Carrying out operations such as collecting home readings of blood pressure levels without following up with the necessary medical options can be classified as clinical inactivity. Therefore, the patients must ensure that they record their blood pressure level readings and take necessary treatment choices to utilize the proposed change to bring positive outcomes fully.
Therefore, it is crucial to have a system that has a tow way interaction capability to ensure that patients can request help from practitioners and the health care providers can follow up to ensure medications are taken correctly. Establishing a communication system should be done by allowing the inclusion of emails and other social platforms in the system. Helping clients remotely is crucial in enforcing their medical care behaviors but cannot be utilized independently. There is a need to encourage face-to-face interactions between patients and health care providers to help further analyze the diagnosis made and determine the most suited treatment plan. The proposed intervention plan can be applied to monitor clients’ safety while they are away from the hospital. It should be reinforced by frequent visits to the medical centers to guarantee the success of the intervention plan in the long run.
Fort, M. P., Mundo, W., Paniagua-Avila, A., Cardona, S., Figueroa, J. C., Hernández-Galdamez, D., & Ramirez-Zea, M. (2021). Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework. BMC Health Services Research, 21(1), 1-14.
McManus, R. J., Little, P., Stuart, B., Morton, K., Raftery, J., Kelly, J., & Yardley, L. (2021). Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial. bmj, 372.
Patel, S. A., Vashist, K., Jarhyan, P., Sharma, H., Gupta, P., Jindal, D., … & Tandon, N. (2021). A model for national assessment of barriers for implementing digital technology interventions to improve hypertension management in the
public health care system in India. BMC health services research, 21(1), 1-11.
Petersen, I., Fairall, L., Zani, B., Bhana, A., Lombard, C., Folb, N., … & Lund, C. (2021). Effectiveness of a task-sharing collaborative
Bain, L. J., & Engelhardt, M. (2017). Statistical analysis of reliability and life-testing models: theory and methods. Routledge.
Fort, M. P., Mundo, W., Paniagua-Avila, A., Cardona, S., Figueroa, J. C., Hernández-Galdamez, D., & Ramirez-Zea, M. (2021). Hypertension in Guatemala’s Public Primary Care System: A Needs Assessment Using the Health System Building Blocks Framework. BMC Health Services Research21(1), 1-14.
Huber, S. G. (2011). The impact of professional development: a theoretical model for empirical research, evaluation, planning and conducting training and development programmes. Professional Development in Education37(5), 837-853.
McManus, R. J., Little, P., Stuart, B., Morton, K., Raftery, J., Kelly, J., & Yardley, L. (2021). Home and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trial. bmj372.
Patel, S. A., Vashist, K., Jarhyan, P., Sharma, H., Gupta, P., Jindal, D., … & Tandon, N. (2021). A model for national assessment of barriers for implementing digital technology interventions to improve hypertension management in the public health care system in India. BMC health services research21(1), 1-11.
Part of the work on Nur 590
Hypertension, or high blood pressure, is when the pressure in the bloodstream is above the normal range. This is a very prevalent problem in the healthcare industry (Fryar,et al., 2020). Diagnosing high blood pressure can be as simple as having consistently higher readings as normal (or hypertension). If the blood pressure levels are high, one is more likely to suffer from heart disease, heart attack, and stroke. This shows the importance of implementing a change model that will; help ensure that the problem is efficiently addressed. Kotter’s change model is useful to understand better the prevalence of the condition and its impact on nurse professionalism (Mohiuddin, &Mohteshamuddin, 2020). This paper provides a review of Kotter’s Change Model as a possible model to address hypertension in healthcare.
An effective solution for changing care approaches can be found in John Kotter’s change management plan (Rajan, &Ganesan, 2017). Some of the proposed regulatory conditions support medical advances that have a significant impact on patient care. Nurses are responsible for ensuring patient safety. Nursing professionals play an important role in disseminating information among other health care providers. As stated by Kotter, change management plans must monitor the effects of behavioral change and maximize individual abilities to achieve achievable goals. As revealed by the improvement process, the change management model accommodates the enormous responsibility for information sharing during the shift change process. There are numerous learning opportunities for nurses in Kotter’s change management model. Many assumptions are made in the theory’s early stages. Kotter’s change process provides a framework for understanding the multiple stages of change supported by shareholders and administrators in an environmental context. Safety and Health Administration serves as the primary source of nursing guidance. Management and leadership teams play a significant role in changing how care is delivered to different populations. The following are the steps followed:
Creating urgency is the first step in the process.
An institution’s desire for transformation is a critical factor in making it happen, creating a sense of urgency and igniting a fire under the organization to get things moving. As a result, we elevate the change program’s importance and send a clear message (Carman, et al., 2019). A clear explanation of why change is necessary for the organization’s various stakeholders is required for this to work. Credibility as a change agent is essential if we are to succeed in instilling a sense of urgency. In this case, it is vital to start by ensuring that we create a sense of urgency around the issue of hypertension.
The second step is to put together a strong coalition.
Strong leadership is critical to persuade people that change is necessary. Leaders are needed to guide the way for change to take place. Making sure all key stakeholders are fully engaged throughout each stage of the change process is essential.
Creating a vision for the future is the third step in the process.
Ideas and solutions for dealing with change need to be tied to a larger vision that people can understand and remember. With an eye toward the future and a clear picture of how effectively dealing with hypertension will benefit everyone, a compelling vision sells the positive aspects of the change. The difficulty arises when drastic measures such as layoffs or reduced staff are implemented. Simply because bad news is difficult to convey, organizations must have a high level of communication expertise to convey a compelling vision, regardless of the content of the message.
The fourth step is to convey the vision.
The success of a change project will be determined by what the organization wants to achieve after creating it, such as improved patient outcomes, low cost, among others. Everyday communication within the organization is likely to compete with this message for attention, so it must be repeated frequently and powerfully to become embedded in all aspects of company operations. Keeping everyone informed is critical. Various change-related topics must be reinforced repeatedly in the communication strategy.
Removing barriers is the fifth step.
The staff should be motivated to get to work and realize the benefits that have been touted. We need to plan to ensure smooth operations by defining process changes and identifying potential barriers to implementation. The change team must establish additional rules and processes to deal with unexpected or forecasted problems.
Create short-term successes
When it comes to leading change, those in charge must provide all the stakeholders with a taste of success as early as possible in the process. Change leaders are looking for “quick wins” that employees can see and feel within a short period. As a result, negative thinkers and critics could jeopardize the advancement of society. The new culture is anchored in the organization, and the new norm is established by celebrating victories.
Step 7: consolidating the gains made through the transformation
He claims that change fails due to declaring victory too early when true and lasting change takes time. Achieving short-term results is just the beginning of the process of bringing about long-term change. As a result, he advises not to celebrate too soon and keep the change momentum going before healthcare workers get tired.
The final step is to make sure that the changes in the company’s culture are firmly established.
Making changes stick requires that they become part of an organization’s DNA (Mohiuddin,&Mohteshamuddin, 2020). The vision value must be reflected in the day-to-day activities of the company.
Carman, A. L., Vanderpool, R. C., Stradtman, L. R., & Edmiston, E. A. (2019). Peer Reviewed: A Change-Management Approach to Closing Care Gaps in a Federally Qualified Health Center: A Rural Kentucky Case Study. Preventing chronic disease, 16. retrieved from: Peer Reviewed: A Change-Management Approach to Closing Care Gaps in a Federally Qualified Health Center: A Rural Kentucky Case Study (
Mohiuddin, S., &Mohteshamuddin, K. (2020). Combination model for sustainable change by utilizing the Kotter’s change model and the Hersey & Blanchard’s leadership model for improving medication errors reporting. Journal of Medical & Allied Sciences, 10(1), 25-32. retrieved from:’s_change_model_and_the_Hersey_Blanchard’s_leadership_model_for_improving_medication_errors/links/5e45bcaa92851c7f7f37a90d/Combination-model-for-sustainable-change-by-utilizing-the-Kotters-change-model-and-the-Hersey-Blanchards-leadership-model-for-improving-medication-errors.pdf
Work from Nur 590
Looking at the discussion in this case, the specific organization that this paper will choose is john Hopkins hospital. This specific hospital that is located in Baltimore in Maryland, is an organization that to a larger extent does support change in its different areas. Its culture is specifically accommodative to changes and it is flexible in a way that it can accept and accommodate the changes. The organization has certain social norms that are considered to play a very significant roles in this, the organization has shared health behaviors and believes that do reflect respect, trust, opportunities and teamwork for both professional and personal growth. When it comes to organization and leadership structure, this is always considered to be blended and this has specifically contributed to the success of the organization’s mission and vision (Hnizdo et al., 2017). The engagement of staff members in any decision that is made by the leaders in the organization also makes this to be very effective and this also makes employees to embrace any decisions that are to be made by the leadership. Employee engagement is one of the thing that contributed significantly to developing the culture of trust and respect in all levels of the organization and therefore ensuring that there is no much friction that is experienced if at any time change is proposed and implemented. It is therefore these specific attributes and vales that the organization has in its mission and culture that makes it to be more accommodative and flexible to changes that might be presented and proposed for the better of the patients that the organization is serving in terms of services being provided.
The specific readiness tool that this paper will select and use in the selected organization is the capacity assessment tool and the management organizational stability tools. To begin with the capacity assessment tool is a tool that is specifically used in the process of measuring the capacity that an organization has, this helps in doing this by looking at certain specific areas in relation to this, this includes organizational management, governance, program management, human resources and finance management (Nwanna-Nzewunwa et al., 2019). This tool is very important in looking at the efficiency of the organization in developing and implementing the proposed practice change. On the other hand the management organizational stability tools basically looks at what specifically provides stability to the whole organization, identifying this will help in ensuring that the organization has a clear picture on the things that are needed for the proposed practice to be fully and successfully implemented, things such as consistency, trust, honesty etc. are things that this specific tool looks at when it comes to the implementation of the recommendations that have been described and proposed by the survey (Amparado & Ocariza, 2020). From the survey that was done in this case, it concluded and observed that the best way to ensure that hypertension is lowered is by controlling blood cholestrol levels. If this is controlled then there will be a significant improvement in mitigating the risks that are associated with hypertension. The recommendation that was therefore made by the research is that to successfully control the hypertension levels of patients an effective management of the patients knowledge using effectively enforce treatment would help in this.
The culture of the organization in this case will support the evidence based practice change presented by the survey results in that, due to the trust and respect that is already there in the organization, all the stakeholders and the employees will have less friction in the process of implementing this as they will be actively. The main strength of the practice change is that it involves all the partners that are there in the organization, this therefore means that, everyone won’t feel to be left out in the process and therefore this will help reduce any kind of opposition that usually arise as a result of certain parties being excluded from the whole process (Amparado & Ocariza, 2020). However one of the weakness that this practice change will have is the fact that not all patients with hypertension will be open to the idea, and since the change is more optional, patients might opt not to involve themselves in the whole process and therefore might make the change to be hard to implement (Dearing, 2018). The timing of the change is however very good as the change just came at a time when the diagnosis of hypertension is increasing day in day out and methods of reducing the diagnosis are being tried, this therefore makes the timing for this to be perfect.
To improve the quality, safety and cost effectiveness of the organization, some of the healthcare process that would be best for this include keeping patients healthy through things such as physical fitness, less use of tobacco and other heathy prevention measure (Jones et al., 2019). Also designing ways of detecting health problems is a healthcare process that will help in reducing risks and therefore reducing costs in the future.
To better facilitate the readiness of the organization especially when it comes to hypertension, there are certain strategies that will specifically help in this, among these include frequent testing of patients who visit the healthcare facility. The patients who come for different reasons should always be tested and examined to see if they are at any risk of being exposed to hypertension or any cardiovascular diseases (Dearing, 2018). The organization can also decide to carry out a free screening initiative in the community that surrounds it and encourage residents to show up for free testing and examination. Getting this kind of data will help the organization to be ready to face any situation that they might face and assign resources that will help deal with the patients with hypertension.
In order to successfully implement the practice change that has been proposed in this case, there are certain stakeholders that will be needed to successfully implement this. The first ones are the patients who are identified, these are the ones who will specifically decide as to whether the practice change will be successful or not, their acceptance will determine if the process will be implemented or not. The organizational management is also another stakeholder, the management will help in approving the process and assigning the resources that will be needed for the implementation of the same.
The information and communication technology that will be needed in this case will be the Electronic Medical Records, this is very important when it comes to the documenting the progress of different patients with regards to their blood cholestrol levels and blood pressure. The EMR will help in communicating any issue that might arise and also categorize the patients according to their seriousness and their improvements in their different geographical locations. This will help in delivering care to the patients in a way that following up on the patients who are at a higher risks will be easier and this will help in delivering quality services to the patients with less struggle.\
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