One study found that nurse-led care has the potential to provide efficient, effective, and impactful care delivery (Mai et al., 2019, p. 1). Additionally, registered nurses (RNs) endeavor to work at the top of their license, education, and expertise and do so through patient engagement, care coordination, enhanced teamwork, resource reduction, improved access, and quality outcome improvement (Paschke et al., 2017, p. 2). Targeting quality of care enhancement with nurse-led initiatives can be achieved through stringent implementation of the treat-to-target concept, which may lead to a higher percentage of patients reaching their treatment targets, thereby improving patient related outcomes, such as quality of life, functional capacity, and participation. (Mai et al., 2019, p. 1)
Our healthcare organization launched an innovative protocol titled “hypertension medication management protocol for registered nurses.” This strategically designed protocol allows trained RNs to optimize antihypertensive therapy in selected population under the supervision of their providers. The protocol allows the nurse in collaboration with the provider to initiate patient/family education utilizing teach-back method, care coordination, and follow-up and medication titration by ambulatory care registered nurse. Adequate knowledge of hypertension, consequences of uncontrolled hypertension, and treatment regime is essential to achieve blood pressure (BP) control (Himmelfarb, Commodore-Mensah, & Hill, 2016, p. 247).
Since the hypertension medication management protocol for registered nurses launched, in 2019, the nursing leadership team has held nine classes and trained 38 RNs and 65 primary care providers. Nurses have enrolled 265 patients in this innovative nursing-led protocol with a total of 71% achieving maximum benefit. In addition, nursing contribution in ambulatory Ccre is normally viewed as qualitative versus quantitative; this is an example on how nursing has shown a tremendous quantitative impact on outcomes by utilization of the hypertension medication management protocol for registered nurses.
Health care is continuously evolving, and people are living longer with multiple co-morbidities. Patients are being discharged from the hospital sooner requiring ongoing primary care and appropriate follow-up care. The hypertension medication management protocol for registered nurses provides a structured plan of care to help the patients meet their blood pressure goal and maintain optimal level of health. The patients appreciate the visit with the nurse, and this provides a positive patient experience to participate in their care, ultimately directly improving RNs job satisfaction. Opportunities from lessons learned included, but are not limited to, increasing overall engagement in ongoing education, meeting staffing challenges and fluctuating onboarding by adding protocol training into standard new-hire nursing orientation, continuing to increase collaboration between nurses and providers for patients who met eligibility criteria, and improving on streamlining analytics to better capture hypertension protocol nurse visits.