Antihypertensive Education to Improve Patient Outcomes: A Quality Improvement Project
Introduction/Purpose The purpose of this quality improvement project was to improve compliance with the 2014 American College of Cardiologists/ American Heart Association (ACC/AHA) Joint Task Force Clinical Practice Guidelines recommendation regarding the continuation of prescribed antihypertensive medications throughout the perioperative period by implementing a patient education initiative, which used the teach-back method of instruction, and evaluated the effectiveness of the education as evidenced by the incidence of patients presenting for their endoscopy procedures with hypertension requiring pharmacological intervention, procedure delay, or procedure cancellation. Methods Data was collected from patients’ electronic health records (EHR) using a retrospective cohort design. The preintervention group consisted of data from all endoscopy patients with the diagnosis of hypertension and taking at least one prescribed antihypertensive medication, and having procedures during the six weeks prior to implementation of the 2014 ACC/AHA Joint Task Force Clinical Practice Guidelines. The post intervention group consisted of data from all endoscopy patients with the diagnosis of hypertension and taking at least one prescribed antihypertensive medication, and having procedures during the six weeks following implementation of the guidelines. Results A chi squared analysis was utilized to compare the data from preintervention and postintervention groups regarding the incidence of hypertension significant enough to require pharmacological intervention, case delay, or case cancellation, both before and after Antihypertensive Education to Improve Patient Outcomes: A Quality Improvement Project 4 implementation of the education intervention. The P-value was also calculated using the chi squared analysis, X^2 (1, N=1044) =7.71, p= .00548. No incidence of case delay or cancellation were experienced in either test group. A 70.5% decrease was experienced in the incidence of patients requiring pharmacological intervention during the 6 weeks period when patients were provided the antihypertensive patient teaching via the teach-back method, compared to the previous 6 weeks. The calculated P-value was .00548, indicating a statistically significant improvement. Conclusion The statistically significant decrease in the incidence of patients requiring pharmacological intervention for hypertension supported the need for permanent inclusion of the antihypertensive patient teaching, via the teach-back method, in the preoperative procedures at the project site. The GI clinic has continued to include this patient teaching method in their preoperative patient contacts after completion of the project.