Improving Outpatient Follow Up for Hypertensive Patients Post Emergency Department Visit Using a Staff Education and Telephone Referral Intervention

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Jordan Braniff Final DNP PROPOSAL _5-17-18.docx (2.88 MB)
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http://hdl.handle.net/11603/10777

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SU DNP Projects

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Author/Creator ORCID

Date

2018-05-17

Type of Work

doctoral projects
dissertations
Text

Department

Nursing

Program

Doctor of Nursing Practice

Citation of Original Publication

Rights

Attribution-NonCommercial-NoDerivs 3.0 United States

Subjects

Hypertension
Outpatient Follow-up
Emergency Department
Rural health
Population health
Underserved region

Abstract

Problem Statement: Americans are increasingly using the Emergency Department (ED) for primary treatment of hypertension, a significant chronic health problem which requires primary care follow-up. Previous studies have shown that between 24-50% of ED patients are lost to ambulatory follow-up. Purpose: The purpose of this DNP project was to determine if primary care provider (PCP) follow-up and utilization rates increased in patients with hypertension who did not have a PCP after receiving an educational intervention and being given a scheduled appointment with a PCP while in the ED. Methods: A quasi-experimental pilot project was implemented with two phases, a pre-intervention data collection phase (phase one) and an intervention phase (phase two). A convenience sample of ED patients who were English speaking, 18 years or older, without a PCP with a discharge diagnosis of hypertension were included. Participants were provided with education on hypertension and given a follow-up appointment with a PCP geographically close to their home at ED discharge. A reminder phone call was placed one day prior to the appointment. Overall percentage of compliance with PCP follow up was assessed. Results: A total of 16 patients were identified for phase one. Fourteen of fifteen patients identified for inclusion in the project participated in phase two. Of the sixteen patients identified for phase one, two of the sixteen followed up as compared to five of the fourteen in phase two. Follow-up improved between phase one and phase two (12.5% to 35.7%), although the differences were not significant (p > .05). Significance: This pilot project among hypertensive adults in a rural, underserved healthcare environment showed improvement in patient follow-up. Although results were not statistically significant, this could be a useful intervention for patients with chronic diseases.