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Designed for the Unique Needs
of Homecare Providers
This site provides homecare clinicians with access to chronic care management models, best practices and downloadable resources for homecare patients.
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"The body of knowledge that serves as the rationale for nursing practice determines the areas of specialty to develop as well as the manner in which that knowledge is organized, tested and applied." -Carper, 1978
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Hypertension is one of the most common risk factors for coronary artery disease (CAD). Hypertension also increases the risk of developing heart failure by two fold in men and by three fold in women (Levy, Larson, Vasan, Kannel and Ho, 1996). Hypertension promotes hypertrophy, myocardial fibrosis and loss of contractility of the heart muscle. Blood pressure (BP) lowering also leads to a regression in left ventricular hypertrophy. The benefit of treating hypertension to the specified goal of < 130/85 mmHg or < 130/80 mmHg for those with diabetes is very clear (Chobanian, Bakris, Black, Cushman, Green, Izzo, et al, 2003). According to the ACC/AHA Guidelines for Heart Failure, pre-hypertension is a systolic pressure from 120-139 mmHg or a diastolic pressure from 80-89 mmHg.
According to US Department of Health and Human Services’ Healthy People 2010 (2008) and 2020 (2010), the achievement of adequate blood pressure is a major goal for the nation.
HDS HP2020–4: |
Increase the proportion of adults with high blood pressure whose blood pressure is under control. |
HDS HP2020–5: |
Increase the proportion of adults who have had their blood pressure measured within the preceding two years and can state whether their blood pressure was normal or high. |
HDS HP2020–13: |
Reduce the proportion of persons in the population with hypertension. |
HDS HP2020–14: |
Increase the proportion of adults with pre-hypertension who meet the recommended guidelines for:
a. Body mass index (BMI)
b. Saturated fat consumption
c. Sodium intake
d. Physical activity
e. Moderate alcohol consumption
Data Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
Action: Retained but modified Healthy People 2010 objective 12-11. |
HDS HP2020–15: |
Increase the proportion of adults with hypertension who meet the recommended guidelines for:
a. BMI
b. Saturated fat consumption
c. Sodium intake
d. Physical activity
e. Moderate alcohol consumption
Data Source: National Health and Nutrition Examination Survey (NHANES), CDC, NCHS.
Action: Retained but modified Healthy People 2010 objective 12-11. |
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| Assess
(4 documents) |
| It is especially important to evaluate the patient's verbalized and demonstrated knowledge, behavior and status. |
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| Plan
(9 documents) |
| The plan of care should include measurable, specific goals that are realistic. The patient and/or caregiver needs to have an understanding of the components of and how to implements their self-care plan. |
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| Implement
(65 documents) |
| When implementing a monitoring program for a patient, consider individualized symptoms as well as target values. Also, consider other co-morbidities that alter risk such as diabetes, dyslipidemia, etc. |
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| Evaluate
(3 documents) |
| Continually update progress by assessing measurable outcomes. The goals and response to interventions need to be evaluated regularly and revised to achieve desired health outcomes. |
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Monitoring
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