Constructing the Written Evidence-Based Proposal

Constructing the written evidence based proposal
Student:
Professor:
Course title:
Date:
Abstract
The identified problem is high blood pressure (HBP) in grownups. Roughly 67 million persons – one in three adults – in America has HBP and only approximately 47 percent of these persons have their HBP condition under control. To address the problem, the proposed solution is for people to be engaged more in physical activities and doing exercises such as swimming, biking, running, jogging, and brisk walking to reduce their blood pressure. For those with hypertension, doing regular exercises could actually help in controlling this ailment. Regular exercises such as jogging and biking walking have been proven to lower a person’s high blood pressure. In evaluating the proposed solution, it would be would be seen as effective if the blood pressure of the patients who regularly engage in physical exercises drops to normal levels. It would also be seen as effective if it helps the patients to manage their body weight and keep fit. Otherwise, it would be seen as ineffective. Disseminating the findings of this research project will be through publication in well-known journals such as Nature Journal, JAMA, Science Journal, and the New England Journal of Medicine. Through the publication of the research results in such renowned medical journals, the wider nursing community and the key stakeholders will be able to access it. In addition, a website will be created in which the findings of this research would be disseminated to the key stakeholders and the wider nursing community. Conferences and forums will also be held to discuss the findings and disseminate the results.
Constructing the written evidence based proposal
1.0 Problem Description
The identified problem is high blood pressure (HBP) in grownups. Grownups are defined as persons who are aged 18 years and above. High Blood Pressure is understood as a serious condition which can bring about kidney failure, stroke, failure of the heart, and coronary heart infection, in addition to other health complications (Jorge & Paula, 2012). Blood pressure in essence, refers to the force of blood which thrusts against the artery walls as blood is pumped by the heart. If this particular pressure stays high over a period of time or increases, it can actually result in damaging of the body in several ways. Roughly 67 million persons – one in three adults – in America has HBP and only approximately 47 percent of these persons have their HBP condition under control (O’Connell, 2014). Since this disease usually has no any warning symptoms or signs, quite a lot of people have it and are not even aware of it hence sometimes it has been referred to as the silent killer.
The settings where high blood pressure can be observed are the primary care settings that focus on caring for adults with this condition. In essence, high blood pressure has been proven as having a substantial impact on the work environment, the quality of care that health professional provide, as well as patient outcomes. According to Jorge and Paula (2012), persons with high blood pressure need long-term care and have to be closely watched in order to identify if they are receiving the right health care and attain their expected health outcomes. High-quality care entails regular screening for blood pressure and awareness of preventive care for hypertension. It also includes active self-management by the individual himself or herself, involvement of other clinical specialties, and proper communication between patients and their health care providers (Cornelissen & Smart, 2013).
Hypertension medicines such as beta-blockers, Angiotensin Converting Enzyme Inhibitors (ACE), and diuretics have quite a lot of side effects that make patients with high blood pressure uncomfortable when using them. Dimeo et al. (2012) stated that ACE Inhibitors are known to cause persistent dry cough, loss of taste, and skin rash. These drugs essentially block the formation of the hormone which makes the blood vessels to become narrow. The side effects that patients with hypertension experience when using beta-blockers include depression, insomnia, erection problems, asthma symptoms, as well as cold hands and feet. These hypertension medications are known to make the heart of the patient to beat more slowly and less forcefully (Fagard & Cornelissen, 2007).
The other popular medicines for hypertension are diuretics. Studies have demonstrated that diuretics bring about extra urination, erection problems, abrupt and severe foot pain, in addition to leg cramps or weakness and fatigue (Jackson, Herber-Gast & Brown, 2014). The medical condition of High Blood Pressure is significant to nursing since nursing staffs are expected to deliver nursing services that will bring about optimal outcomes for people who have hypertension. Since the majority of medications available today that are used in managing this medical condition have some side effects, nursing staffs should advise patients with high blood pressure to engage more in physical activities to control and better manage this condition.
The number of people in America with HBP is expected to drastically increase in the future due to bad lifestyles among a majority of the American population. Moser (2008) reported that many of the victims of high blood pressure have excessive body weight. Furthermore, Moser’s research outlines that women and older people are more vulnerable to hypertension in the society. Lenz (2008) also indicates that the global population experiences about 2 million new infections of high blood pressure each year. He further reported that only 15% of patients suffering from hypertension have the financial ability to finance the cost of medication. As a result, the world loses approximately 300, 000 persons annually due to high blood pressure. Lenz (2008) also stated that poor eating habits, especially the consumption of junk foods, and lack of physical exercises is the leading cause of high blood pressure across the world. Moreover, Lenz (2008) reported that there are actually few cardiologists across the world; hence, many patients with cardiovascular infections, which results from hypertension, do not have the access to the required medical attention in good time.
Based on the above analysis, it is undisputed that the increasing numbers of patients suffering and eventually dying from high blood pressure is a global concern. Furthermore, the number of medical specialists in heart infections is much lower compared to the number of patients suffering from such illnesses. It is equally evident that many persons suffering from hypertension are poor and cannot afford the required treatment. Therefore, in order to effectively, manage hypertension in the society, it is important to embrace physical exercises as a treatment measure. The use of Physical exercises to manage high blood pressure is cheaper and affordable, yet effective. Thus, it is an appropriate scheme for solving the problem of increased number of infections of hypertension throughout the global society.
2.0 Solution Description
2.1 Detailed Explanation of Proposed Solution
To address the problem, the proposed solution is for people to be engaged more in physical activities and doing exercises such as swimming, biking, running, jogging, aerobic exercises, and brisk walking in order to reduce their blood pressure. Padilla, Wallace and Park (2005) pointed out that there is a connection between physical inactivity and developing high blood pressure. For those with hypertension, doing regular exercises could actually help in controlling this ailment. Regular exercises such as jogging and biking walking have been proven to lower a person’s high blood pressure.
The Center for Advancement of Health (2007) noted that engaging regularly in exercises and physical activities makes one’s heart to be stronger. This is important considering that a heart that is stronger is able to pump more blood with use of less amount of effort. If the heart could work less in pumping blood, then the force on the arteries will reduce, and this way the blood pressure of that person reduces (Guimaraes et al., 2014). It is of note that by engaging in regular exercises and physical activities, a person’s systolic blood pressure can be decreased by an average of 4 mm Hg to 9 mm Hg, which is actually as good as some drugs used for high blood pressure. Kokkinos et al. (2008) noted that for some people, exercises is adequate to reduce the need for blood pressure medicines. In addition, regular exercises and physical activity helps a person to maintain a healthy weight, something that is also of great importance in controlling and managing blood pressure.
According to numerous medical researches across the world, persons who do not engage their bodies to regular physical exercises are more vulnerable to cardiovascular infections, which consequently lead to high blood pressure. Physical inactivity brings about a number of blood vessel infections such as arteriosclerosis and thrombosis, which eventually affects the flow of blood from the heart to the rest of the body. The blood vessel infections often lead to the blockage of the blood channels, a factor that makes the heart pump blood with extremely high pressure in an attempt to enable the flow beyond the obstacles. In the process, the heart develops a number of infections and high blood pressure is the most dominant of all heart-related illnesses (Lenz, 2008).
However, engaging in regular physical exercises contributes enormously in cleaning up the blood vessels. A person that engages in appropriate physical exercises is bound to experience a smooth flow of blood through his or her veins and arteries. He or she is unlikely to experience infections of the blood vessels, which block the flow of blood throughout the body. Moreover, physical exercises reduce diastolic pulses, which eventually reduce the probability of one to contract hypertension (Lenz, 2008).
2.2 The Advantages of Using Physical Exercises to Treat High Blood Pressure
The use of physical exercises in treating hypertension has a number of advantages to both the patients and medical practitioners. Although engaging in regular physical exercises could be tiresome, it is clear that it cleans up the blood vessels to prevent infections such as thrombosis and arteriosclerosis, which lead to hypertension. As a result, physical exercises reduce the probability of a person contracting several cardiac-related infections and kidney infections apart from high blood pressure. The use of physical exercises to treat and manage high blood pressure also helps in controlling one’s body Weight. Excessive body weight leads to a number of health conditions including obesity. Hence, engaging in regular physical exercises will not only help in the management of hypertension, but also would be playing a vital role in keeping one’s body fit (Moser, 2008). The use of physical exercises to manage high blood pressure is definitely cheaper. The treatment of hypertension using medicine is very expensive. However, the use of physical exercises in managing the infections requires very little resources or even none. Mostly, it does not require the guidance of specialists, as one can engage in such activities as jogging and biking.
2.3 The Disadvantages of Using Physical Exercises to Treat High Blood Pressure
Many specialists in medical services argue that physical exercises cannot single-handedly manage high blood pressure. Lenz (2008) pointed out that the method requires complementary medication such as the use of pharmaceutical medicines in order to effectively, manage hypertension. In addition, engaging in physical exercises regularly is tiresome. Due to the fatigue and pains in the muscles that result from this method, many people end up giving up on using it.
2.4 The Rationale for Selecting the Use of Physical Exercises in the Treatment of Hypertension
The use of physical exercises to control high blood pressure has numerous advantages, which forms the basis of its preference to other methods of treating the same. Among the main advantages of this method of treatment are; lower costs, helping in managing body weight and keeping fit, requires less to no assistance from specialists, and helps in the prevention of blood vessel infections such as arteriosclerosis and thrombosis, which may lead to cardiovascular infections and kidney illnesses (Moser, 2008).
3.0 Implementation Plan
The use of physical exercises as a method for managing hypertension does not require so much resources and/or expertise. It only requires a comprehensive research on its efficiency, which should entail suggestions and supportive evidence from valid medical reports, books, and journals. The management of the organization – the medical facility – together with its entire staff should adopt physical exercises as a primary method with which to manage hypertension among its patients. The medical facility should purchase equipment for exercises such as weights with which to engage patients in this system of treatment. The hospital’s staffs should also encourage patients to keep engaging their bodies in appropriate physical exercises more regularly even after they are discharged from the hospital (Lenz, 2008).
3.1 Resources Required In the Embracement of the Use of Physical Exercises in the Treatment of Hypertension
The use of physical exercises in the management of hypertension does not require many resources; rather, it requires self-discipline and determination from the patients to adhere to exercise routine. Patients will mostly do the exercises by themselves without any professional guidance or supervision. However, the medical facility can invest slightly in the purchasing of gym equipment to facilitate easier and more objective exercises for patients admitted at the hospital (Moser, 2008).
4.0 Incorporating the theory
4.1 Health promotion theory (HPT)
The health promotion theory focuses on individual characteristics, behavior and behavioral outcomes, as these factors influence health outcomes (Piper, 2009). Even though, exercise therapy is designed as an intervention, it is through health promoting behavior that patents with hypertension can reduce risks of the condition. At the same time, health promoting behaviors improve quality of life.
4.2 How the theory supports proposed solution.
Nursing action can promote patients’ health since nurses are well placed to utilize health promotion practices. Patients with high blood pressure and hypertension are at a high risk of heart failure than the general population and this highlights the need for intervention (Kallistratos et al., 2012). Nonetheless, nurses need to have confidence on their efforts to have a positive effect on hypertensive patients. Through patient education programs that integrate health promotion practices, nurses can influence patient behavior. It is expected that there will be positive emotions associated with exercise therapy over time, and this will increase commitment of the patients to improve their health. Equally, friends, family members and care providers can have positive influence on the patients’ commitment in health promoting behavior.
Patient education should emphasize on health promotion practices, and hence the theory is relevant to influence the behavior of hypertensive patients. Some patients may be skeptical about the relevance of patient education, and they need to be mentally prepared when using the exercise therapy intervention. In order to incorporate the theory, assisting the patients in using exercise therapy is essential (Kallistratos et al., 2012). However, to ensure that the theory is effective and beneficial, patient education will include highlights on nutrition, impact of lifestyle choices on health, and psychological well-being.
5.0 Evaluation Plan
Prior to the implementation of the proposed intervention, which involves engaging in regular physical exercises in order to treat and manage high blood pressure, the blood pressure of the patients would be measured and recorded. These would then be compared with the blood pressure of the patients after the implementation of the intervention. Basically, the proposed solution would be would be seen as effective if the blood pressure of the patients who regularly engage in physical exercises drops to normal levels. It would also be seen as effective if it helps the patients to manage their body weight and keep fit. Equally important, it would also be considered to have been effective if the patients who engage in physical exercises regularly do not develop blood vessel infections such as arteriosclerosis and thrombosis that may lead to cardiovascular infections as well as kidney illnesses. On the other hand, the proposed solution would be seen as ineffective if the blood pressure of the patients remains high or reduces by a negligible margin after they engage in regular physical exercises of appropriate amounts. It would also be seen as ineffective if the patients develop health conditions such as arteriosclerosis and thrombosis that increase their likelihood of getting heart diseases and kidney diseases even after engaging in regular physical exercises.
Another method that would be used in evaluating the effectiveness of the proposed solution will be to compare the proposed solution with a population in which the proposed solution was not provided. This basically means that there will be two groups of patients. One group will engage regularly in physical exercises whilst the other group will not engage in regular physical exercises. Participants in both groups will have high blood pressure before the commencement of the project. Six months later, blood pressure would be compared between the two groups. The regular physical exercise intervention would be seen as a success and effective if the blood pressure of patients in the intervention group is lower in comparison to the blood pressure of patients in the group that did not engage in regular physical exercise. If not, it will be considered as ineffective.
5.1 Variables to be assessed when evaluating project outcomes
5.1.1 Perceptions and attitudes of staff members
This variable is imperative since the effectiveness as well as success of the proposed intervention depends very much on the hospital’s employees views and stance on the proposed change. This means that if they have a positive attitude and positive standpoint regarding the proposed change, then it is very likely to succeed since they would be amenable and receptive to it. If they have a positive attitude and perception toward it then there would be no resistance and this will ensure its success. On the other hand, if the hospital employees do not have a positive attitude toward the proposed change and perceive it negatively, then they may exhibit resistance to the change and may impede its implementation. Consequently, this would affect the success and effectiveness of the proposed change.
5.1.2 Perceptions and attitudes of patients
The other variable that would be measured when evaluating the project outcomes is the attitudes and the perceptions of the patients who have high blood pressure. Patients will engage in regular physical exercises only if they have a positive toward it and if they like it. No patient with hypertension would be compelled to regularly do physical exercises in order to reduce his/her blood pressure. If the patients have a positive attitude toward the proposed intervention, it is likely to succeed, otherwise, it may not be successful.
5.2 Tools to educate project participants and to evaluate the project outcomes
Tools to educate participants: the educational tools to be used are booklets and pamphlets, which will contain the relevant content for the purposes of educating the participants about regular physical exercises and its significance in the reduction of blood pressure (Appendix A). Tools to assess the project: Interview – four interviews would be conducted to evaluate the outcomes of this project (Appendix B). Questionnaire – this would comprise 7 questions. The questionnaire could be easily completed within a period of 15 minutes (Appendix C).
6.0 Dissemination Plan
According to Beard & Gulledge (1999), exercise therapy is a proven method of managing high blood pressure. Hypertension, which is highly connected to excessive body weight, has remained to be a deadly malady among millions of people across the world. In as much as medical specialists have developed various treatment measures for this medical condition, it is undisputed that the use of exercise therapy is among the most reliable method with which to manage high blood pressure (Moser, 2008). The engagement in appropriate, yet regular physical exercises plays a huge role in the reduction of hypertension. Physical exercises have been shown to help in the maintenance of pulses at rates that lower high blood pressure. Moreover, the use of physical therapy in the management of hypertension is cheaper compared to any other therapy, as it only requires commitment and consistency from the patients. Physical therapy also helps to manage body weight, which consequently reduces the probability of contracting other cardiovascular infections and kidney failure (Lenz, 2008).
Physical therapy for reducing hypertension also clears up the blood vessels, which eventually manages illnesses such as thrombosis and arteriosclerosis (IDEA Health & Fitness Association, 2000). Hence, creating awareness on the effectiveness and advantages of using physical therapy to reduce hypertension among key stakeh...