Paper
Friday, 21 July 2006
This presentation is part of : ADHCC Research Collaborative: Long Term Healthcare Solutions in Short Term Reimbursement Environments
Transcultural Nursing Promotes Engagement with Ebp Diabetes Initiatives
Christine M. Fitzpatrick, BA, MS, NY Association of Homes and Services for the Aging, Adult Day Health Care Council, Albany, NY, USA
Hypertension (HTN) affects between 85 – 90% of Adult Day Health Center’s clients, upon admission.  Another 5 – 8% will be identified with HTN during their length of stay.  HTN affects all races and ethnic groups, however, certain groups at ADHC are more heavily burdened.  For example, African American, Hispanic, Native American and the economic poor who have fewer health care resources and options.  These populations have greater risk for stroke, heart attack and end-stage renal disease. The role of the collaborative is to disseminate care strategies to the ADHC community, inorder to reduce risk of complications related to uncontrolled HTN. The nurse-team leader model was utilized in designing care plans that incorporated the Joint National Committee 7 Report (JNC 7) recommended outline of features.  The nurse determines areas that pose barriers to treatment goals and then makes appropriate referrals within the interdisciplinary team. 

Clients and their support system are educated as to Blood Pressure goals, frequency of follow-up visits and monitoring, risk factors, treatment options and lifestyle modifications.  Pharmacological anti-hypertensive strategies were based on the individual’s compelling indicators.  The indicators reflect strong research evidence (1a or A) level that given a particular co-morbid factor such as previous heart attack or diabetes, that a B-Blocker or Angiotensin Converting Enzyme Inhibitor is recommended.  
Quality Management tracked a total of 60 medical emergency events.  Twenty-two involved uncontrolled HTN (37% of total emergencies).  Of the total HTN events, 27% had acute care hospitalizations, and 73% were treated by urgent visits to the prescribing provider and did not require hospitalization. Early identification, engaging clients in care and expedited treatment were factors preventing heart attack, stroke, and renal failure with these individuals.

See more of ADHCC Research Collaborative: Long Term Healthcare Solutions in Short Term Reimbursement Environments
See more of The 17th International Nursing Research Congress Focusing on Evidence-Based Practice (19-22 July 2006)