Leavitt, Mary Ann

“Out of the 17 million global deaths per year that result from cardiovascular disease, 9.4 million are due to hypertension” (Zinat Motlagh et al., 2016). Hypertension is a chronic disease that has been a major public health concern, leading to further complications including stroke, cardiovascular, and kidney disease. The purpose of this QI project was to both better comprehend hypertension management in the primary care setting and improve patient self-care behaviors. The participants for this project were recruited from a list of patients selected after reviewing patient charts along with the community leader. Those patients who were previously diagnosed with hypertension were specifically selected.
The survey used to assess the patients was the The Hypertension Self-Care Activity Level Effects (H SCALE), which assesses the six prescribed self-care activities recommended by the JNC7: adherence to medication, weight loss or maintenance of ideal body weight, adoption of a low-salt diet, regular physical activity for 30 minutes most days of the week, limiting alcohol intake, and ceasing tobacco use.” (Warren-Findlow & Seymour, 2011). A total of nine individuals participated in this project over the span of three months. Post intervention scores for majority of the participants (88.8%) revealed an overall decrease in blood pressure readings post intervention.

Heart failure (HF) is a global epidemic that affects older populations at an unprecedented rate. It is one of the leading causes of hospital readmission in patients 65 years and older. Although many strategies have been used to properly manage the disease, HF remains a complex condition due to several factors such as disease progression, comorbidities, inadequate patient knowledge, and non-adherence to the treatment plan. Despite the impact of HF on quality of life, morbidity, and mortality in older adults, they have been markedly underrepresented in most major cardiovascular trials. Besides the use of traditional methods for HF management, studies have shown that telehealth can be an effective strategy to provide the necessary education and assistance to patients, reducing the need for unnecessary ER visits. A quality improvement (QI) project involving 10 participants diagnosed with HF was implemented from June to September 2022. The aim of this project was to measure the effect of a telehealth-based HF program on HF knowledge, self-care adequacy, and hospital readmission among patients ≥ 65 years diagnosed with HF. To achieve this objective, a system including remote symptoms monitoring along with weekly education sessions on HF self-management was implemented. After using measurement tools (Dutch Heart Failure Knowledge Scale and Self-Care Heart Failure Index) and analyzing data, a statistically significant improvement (p< .001) in HF knowledge and self-care adequacy, and a decrease overall in hospital readmissions over a 3 month-period was noted. However, due to certain limitations such as small local sample size, unintended bias, and lack of diversity among participants, the results could not be generalized, and further experimental studies were warranted. Although we value the importance of telehealth, we strongly encouraged in-person visits for thorough physical examination, and we educated patients to identify red flags that warrant a visit to the emergency.