NURS FPX 6030 Assessment 3 Intervention Plan Design

Name

Capella university

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

Intervention Plan Design

This assessment extends the conversation about the intervention devised for the Population, Intervention, Comparison, Outcome, and Time (PICOT) question. This novel approach has been formulated and explored in the preceding assessments. The PICOT question follows the intervention of implementing telemedicine, especially remote monitoring, and consultations, for managing hypertension among elderly people above 65 and how it improves hypertension management and reduces hospital readmission rates for them. This evaluation explores the intervention strategy and considers pertinent theoretical, ethical, and legal viewpoints.

Intervention Plan Components

The intervention plan for hypertension management in elderly adults aged 65 and above focuses on implementing telemedicine services tailored for remote monitoring and consultation alongside patient education, medication management, and lifestyle modification guidance in the comfort of patients’ homes. These components collectively aim to improve hypertension management outcomes by addressing barriers to care, enhancing patient engagement, optimizing medication adherence, and promoting healthy lifestyle behaviors (Caballero et al., 2023).

Telemedicine services offer convenient access to healthcare, while remote patient education and support empower individuals to manage their condition actively. Medication management through telemedicine ensures optimal drug therapy, and lifestyle modification guidance promotes sustainable behavior changes. Evaluation criteria include blood pressure control rates and a reduction in 30-day hospital readmission compared to baseline data of 8.5% for hypertension-based readmission rates (Brunner-La Rocca et al., 2020). This will enable healthcare providers to assess the effectiveness of the intervention and tailor care to individual patient needs.

Cultural Needs and Characteristics of Population and Setting

The cultural needs and characteristics of the target population, elderly adults aged 65 and above diagnosed with hypertension, significantly influence the development of intervention plan components. These needs can include satisfying elderly individuals with diverse cultural backgrounds, beliefs, and preferences regarding healthcare. Therefore, intervention components such as patient education and support must be culturally sensitive and tailored to meet the unique needs of this population (Forbes & Chakraborty, 2023).

For example, educational materials should be provided in languages understood by the target population, considering literacy levels and preferred modes of communication. Additionally, cultural beliefs surrounding health and illness may influence attitudes toward medication adherence, dietary habits, and lifestyle behaviors. Therefore, lifestyle modification guidance should consider cultural preferences and traditions related to food, physical activity, and stress management. Furthermore, the setting of Senior Health Services must accommodate the cultural needs of elderly adults (Forbes & Chakraborty, 2023). 

Assumptions include acknowledging potential disparities in access to technology and healthcare resources among different cultural groups. Therefore, telemedicine platforms should be user-friendly, with support available for individuals with limited digital literacy or technological proficiency at Senior Health Services (Omboni et al., 2020). The intervention plan components must be culturally competent, considering the target population’s diverse cultural needs and characteristics to ensure its effectiveness and acceptability.

Theoretical Foundations

Theoretical nursing models, like the Chronic Care Model, offer a robust framework for hypertension management interventions in elderly adults over 65. The CCM emphasizes patient-centered care and the use of community resources for managing chronic conditions like hypertension. However, it may not fully address the role of technology, a central component of the intervention plan (Proboningsih, 2023). Strategies from other disciplines, such as information technology and human-computer interaction, provide valuable insights into optimizing telemedicine technologies for remote monitoring and consultation for our target population.

These strategies enhance usability, data security, and privacy protection, addressing weaknesses in theoretical nursing models (Quazi & Malik, 2022). Healthcare technologies like telemedicine platforms and home monitoring devices offer strengths in improving access to care and enhancing patient engagement. Still, disparities in technology access among elderly populations remain challenging (Qian et al., 2022). Collaborative efforts between nursing, technology, and other disciplines are essential for developing integrated intervention plans that maximize strengths and mitigate weaknesses across diverse domains, ultimately improving hypertension management outcomes in elderly adults.

Justification of Major Components of the Intervention Plan

The major components of the intervention plan for hypertension management in elderly adults are justified by contemporary evidence and best practices in the literature. For instance, patient education and support have consistently improved hypertensive patients’ medication adherence, lifestyle modifications, and overall health outcomes (Omboni et al., 2020). Similarly, telemedicine services, including remote monitoring and virtual consultations, have demonstrated effectiveness in improving access to care, patient satisfaction, and clinical outcomes in elderly populations with chronic conditions like hypertension (Caballero et al., 2023).

Remote medication management, another critical component, is supported by evidence indicating the importance of tailored treatment plans and regular medication reviews in optimizing blood pressure control and reducing cardiovascular risk (Morrison, 2022). Additionally, lifestyle modification guidance through telemedicine aligns with recommendations from clinical guidelines and population-based studies, emphasizing the benefits of healthy eating, physical activity, stress management, and smoking cessation in hypertension management (Blumenthal et al., 2021).

Conflicting data and alternative perspectives acknowledge concerns about the effectiveness of telemedicine, particularly in populations with limited digital literacy or access to technology, which may hinder equitable healthcare delivery. Additionally, questions regarding the sustainability of lifestyle changes highlight the need for ongoing support and resources to promote long-term adherence and behavior modification among elderly adults with hypertension (Forbes & Chakraborty, 2023).

Stakeholders, Policy, and Regulations

Stakeholders in telemedicine interventions for hypertension include healthcare providers, patients, technology developers, and policymakers. Each stakeholder has distinct roles and needs. Healthcare providers require training and user-friendly platforms for remote monitoring and consultations, while patients seek convenient access, privacy assurance, and clear instructions. Technology developers must create platforms accommodating elderly users’ needs, and policymakers must establish supportive policies and infrastructure (Hawlik et al., 2021). HIPAA regulations heavily influence telemedicine for our target population, mandating strict data protection measures and staff training (Jin et al., 2020).

As a governing body, the Federal Communications Commission (FCC) aids telemedicine expansion through funding and regulatory support. Through programs like the Rural Health Care Program and the COVID-19 Telehealth Program, the FCC provides financial assistance to healthcare providers for acquiring telecommunication services, broadband connectivity, and telemedicine equipment (Quinton et al., 2021).  Assumptions underpinning this analysis include stakeholders’ collaboration, platform effectiveness, and policy enforcement, shaping the feasibility and success of telemedicine interventions.

Ethical and Legal Implications

Ethical and legal dimensions are pivotal in telemedicine for managing hypertension, encompassing patient confidentiality, informed consent, and fair access to care. Ensuring stringent safeguards for patient privacy while navigating the digital landscape becomes increasingly challenging, particularly concerning elderly individuals who may face barriers to accessing technology (Hawlik et al., 2021). Moreover, legal intricacies surrounding licensure and reimbursement policies pose significant hurdles that necessitate clear regulatory guidance to ensure seamless and compliant telemedicine practice.

Variations in state licensure laws impact providers’ ability to deliver telemedicine services across state lines, necessitating clarity and standardization in regulatory frameworks to facilitate interstate practice. Reimbursement policies must align with telemedicine services’ value and outcomes, ensuring financial sustainability for healthcare organizations while incentivizing quality care delivery (Mabeza et al., 2022).

Addressing these ethical and legal complexities requires a comprehensive understanding of the diverse cultural and social factors influencing telemedicine adoption among elderly populations. Furthermore, there is a pressing need to bridge knowledge gaps concerning telemedicine interventions’ long-term efficacy and cost-effectiveness and their impact on health disparities and patient outcomes (Fujiwara et al., 2022). By exploring these issues further through rigorous research and analysis, healthcare practitioners and policymakers can develop more robust ethical and legal frameworks to support telemedicine initiatives and ultimately enhance the quality and equity of healthcare delivery for hypertensive elderly patients.

Conclusion

In conclusion, the intervention plan designed for hypertension management in elderly adults presents a promising avenue for improving healthcare outcomes and reducing 30-day hospital readmission rates. The strategy leverages telemedicine services tailored for remote monitoring and consultation. Additionally, it addresses critical challenges in accessibility and adherence among this vulnerable population. Lastly, ethical and legal considerations highlight the importance of privacy protection, equitable access, and regulatory clarity in effectively implementing telemedicine interventions.

References

Blumenthal, J. A., Hinderliter, A. L., Smith, P. J., Mabe, S., Watkins, L. L., Craighead, L., Ingle, K., Tyson, C., Lin, P.-H., Kraus, W. E., Liao, L., & Sherwood, A. (2021). Effects of lifestyle modification on patients with resistant hypertension: Results of the TRIUMPH randomized clinical trial. Circulation, 144(15), 1212–1226. https://doi.org/10.1161/circulationaha.121.055329 

Caballero, M. Q. -, García, A. C., Peña, S. C., Caballero-Mateos, A. M., Martín, O. F., Cañadas-De la Fuente, G. A., & Romero-Bejar, J. L. (2023). Telemedicine in elderly hypertensive and patients with chronic diseases during the COVID-19 pandemic: A systematic review and meta-analysis. Journal of Clinical Medicine, 12(19), 6160. https://doi.org/10.3390/jcm12196160 

Forbes, M., & Chakraborty, J. (2023). The effect of socio-cultural determinants on designing inclusive telemedicine tools for the aging population. Springer EBooks, 50–58. https://doi.org/10.1007/978-3-031-28528-8_6 

Fujiwara, T., McManus, R. J., & Kario, K. (2022). Management of hypertension in the digital era: Perspectives and future directions. Hipertensión Y Riesgo Vascular, 39(2), 79–91. https://doi.org/10.1016/j.hipert.2022.01.004 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Hawlik, M. H., Moran, A., Zerihun, L., Usseglio, J., Cohn, J., & Gupta, R. (2021). Telemedicine interventions for hypertension management in low- and middle-income countries: A scoping review. PLOS ONE, 16(7), e0254222. https://doi.org/10.1371/journal.pone.0254222 

Jin, M. X., Kim, S. Y., Miller, L. J., Behari, G., & Correa, R. (2020). Telemedicine: Current impact on the future. Cureus, 12(8), e9891. https://doi.org/10.7759/cureus.9891 

Li, Q., Yang, L., Zheng, T., Han, S., Yang, S. X., Lin, P., Liang, J., Zhang, T., Liu, S., Zhang, W., & Zhen Jian-cun. (2022). Pharmacist-led telemedicine disease management based on mobile application for elderly patients with hypertension: A self-controlled case series study. Research Square. https://doi.org/10.21203/rs.3.rs-2019517/v1 

Mabeza, R. M. S., Maynard, K., & Tarn, D. M. (2022). Influence of synchronous primary care telemedicine versus in-person visits on diabetes, hypertension, and hyperlipidemia outcomes: A systematic review. BMC Primary Care, 23(1). https://doi.org/10.1186/s12875-022-01662-6 

Morrison, C. H. (2022). The use of telemedicine in primary care to improve medication adherence: Quality improvement project. DNP Projects. https://digitalcommons.sacredheart.edu/dnp_projects/19/ 

Omboni, S., McManus, R. J., Bosworth, H. B., Chappell, L. C., Green, B. B., Kario, K., Logan, A. G., Magid, D. J., Mckinstry, B., Margolis, K. L., Parati, G., & Wakefield, B. J. (2020). Evidence and recommendations on the use of telemedicine for the management of arterial hypertension. Hypertension, 76(5), 1368–1383. https://doi.org/10.1161/hypertensionaha.120.15873 

NURS FPX 6030 Assessment 3 Intervention Plan Design

Proboningsih, J. (2023). Chronic care model based nursing interventions improve hypertension patient’s medication compliance by preventing patients forget and fear. International Journal of Advanced Health Science and Technology, 3(1). https://doi.org/10.35882/ijahst.v3i1.156 

Qian, A. S., Schiaffino, M. K., Nalawade, V., Aziz, L., Pacheco, F. V., Nguyen, B., Vu, P., Patel, S. P., Martinez, M., & Murphy, J. D. (2022). Disparities in telemedicine during COVID‐19. Cancer Medicine, 11(4), 1192–1201. https://doi.org/10.1002/cam4.4518 

Quazi, S., & Malik, J. A. (2022). A systematic review of personalized health applications through human–computer interactions (HCI) on cardiovascular health optimization. Journal of Cardiovascular Development and Disease, 9(8), 273. https://doi.org/10.3390/jcdd9080273 

Quinton, J. K., Ong, M. K., Vangala, S., Tetleton-Burns, A., Webb, A., Sarkisian, C., Casillas, A., Kakani, P., Han, M., & Pirtle, C. J. (2021). The association of broadband internet access and telemedicine utilization in rural western tennessee: An observational study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06746-0