Healthcare Practicum Experiences Reflection

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People I Met and Lessons Learned

This paper highlights my experience during the practicum, evidence-based practices, state policies, and ethics affecting my nursing practice. During the second part of the practicum, I met various individuals with diverse hypertension management methods. These included nurse practitioners, dieticians, physicians, patients and their families, healthcare technology professionals, care coordinators, and community resource providers. I collected information regarding the patient’s or the patient’s family members’ experiences with the signs, symptoms, and effects of hypertension and their management of the illness. I learned the tools used to monitor and manage the condition from healthcare technology professionals, including blood pressure cuffs, pulse oximeters, and glucose monitors. I then discovered some apps for tablets and smartphones that can manage the illness.

I heard about the numerous types of care—including home care, physical therapy, dialysis, and other forms of care—that can be utilized to address the condition of hypertension from the care coordinators. I also gained knowledge about the various types of assistance that may be obtained through support groups, places of worship, and other non-medical forms of care. I learned about the many modes of transportation and other services that can facilitate access to care and other services from community resource providers. Finally, from the medical professionals, I learned about the recommended therapies and precautions and the impacts that hypertension can have on the standard of care and patient safety.

Evidence-Based Practice

The websites and publications I evaluated for this assessment on evidence-based practice (EBP) were mainly concerned with the effects of community resources, care coordination, and healthcare technology on hypertension. They provided a comprehensive understanding of the evidence available about the advancements in managing hypertension. I learned more about the long-term impact of this condition on the standard of care, patient safety, and expenses to the system and the individual through these websites. I learned about the potential contributions that community resources, care coordination, and healthcare technology can make to the fight against hypertension. I learned specifically about the advancements in managing hypertension, including the use of devices to monitor and manage the condition. I also learned about the possible obstacles to using technology, care coordination, and local resources, such as costs.

Experience in Exploring the Effect of Hypertension

I could better comprehend the long-term effects of hypertension by examining the effect of the condition on the standard of care, patient safety, and costs to the system and individual. I learned specifically about the likelihood of poor outcomes if the ailment is not treated and the higher expenses connected with the use of technology, care coordination, and community resources. Furthermore, I understood how timely and efficient management of the ailment can lead to favorable outcomes and lower expenses.

I used three stages to investigate the impact of hypertension on patient safety, healthcare quality, and system and individual costs. The patient’s present health and medical needs must first be evaluated. The patient’s lifestyle, medications, and degree of physical activity should all be evaluated, along with their health history and any present issues. The second step is to create a care plan that uses community resources, care coordination, and healthcare technology. Finally, it is essential to continuously assess how the treatment plan affects the client’s health, the standard of care, patient security, and system and personal costs.

Addressing the Problem

My strategy for resolving the problem was changed because of my experiences. I learned more about the intricacy of the issue and the supportive components necessary to address it successfully through my interactions with the members I met. With the help of the available technology, care coordination techniques, and community resources, I created a plan of care that better fulfilled the patient’s medical needs as a result of this knowledge.

Things That Surprised Me the Most

The extent of the patient’s support and resources, which came from various sources, including healthcare professionals, religious organizations, support groups, and community resources, astonished me the most. This is particularly intriguing because it sheds light on the intricate healthcare system that may be used to offer individuals with chronic illnesses effective, efficient, and all-encompassing care.

Impact

Healthcare technology can significantly enhance the health of patients and their families by offering instruments and resources that can assist in improved chronic health diagnosis, management, and treatment, such as hypertension. Moreover, technology can enhance patient participation and provider-patient communication. Evidence-based methods for monitoring and controlling hypertension have been proven effective, including using blood pressure cuffs, pulse oximeters, glucose monitors, telemedicine, and smartphone apps.

Advantages and Disadvantages of Specific Technologies

Many studies have examined several technologies’ positive and negative aspects for controlling hypertension. For instance, a systematic review of six clinical trials indicated that, compared to standard care or control interventions, telehealth interventions were linked with small but significant reductions in systolic and diastolic blood pressure (Kappes et al., 2023). Similarly, a recent randomized controlled trial discovered that using a smartphone app to track and manage high blood pressure led to statistically significant systolic and diastolic blood pressure drops compared to standard care (Gong et al., 2020). Therefore, telehealth can be effective in managing blood pressure.

There are, however, research papers that offer opposing viewpoints. For instance, a study by Omboni et al. (2019)revealed no evidence of telehealth-based interventions for hypertension to improve blood pressure control significantly. Similar results were reported in a randomized controlled trial using a smartphone app to monitor and manage high blood pressure, which showed no differences in systolic or diastolic blood pressure between those receiving the intervention and those receiving standard care (Persell et al., 2020). Therefore, healthcare practitioners should evaluate the benefits and drawbacks of telehealth before installation.

Nursing Practice

The usage of technology I observe in my nursing practice is typically aligned with the findings from the literature. For instance, I frequently see people using glucose meters, pulse oximeters, and blood pressure cuffs to monitor their blood pressure. In addition to home care, physical therapy, and dialysis, I frequently see telehealth and mobile apps employed as strategies for managing hypertension.

Barriers Associated with Telehealth Technologies

The use of telehealth technologies could come with costs and potential barriers. For instance, telemonitoring equipment can be costly to install and maintain, and it also needs to be used correctly, necessitating a certain amount of technical proficiency. Point-of-care equipment can also be expensive to buy and needs to be more accurate. Third, organizing and incorporating community groups and resources in patient care may take more time and money.

Care coordination amongst groups of healthcare professionals can guarantee that patients receive the best treatment possible. Involving organizations and community resources can also offer patients information and services to help them manage their disease better (Elliott et al., 2021. Community-based organizations may offer support groups and other tools to assist patients in better comprehending and managing their condition. Healthcare providers can collaborate with community groups to offer patients more resources and support.

Several studies have been published indicating the benefits of care coordination, while others presented opposing views. According to Elliott et al. (2021), care coordination across teams of healthcare professionals can be linked to better patient outcomes and lower treatment costs for people with hypertension. Sanya et al. (2023) discovered that using support groups and other community-based tools can help to improve patient outcomes and lower treatment costs. However, utilization of community resources may be expensive and time-consuming to coordinate (Singh et al., 2021). Therefore, cost and time should be considered when coordinating care.

The data align with how I view the utilization of care coordination and community services in my nursing practice. To guarantee that people with hypertension receive the best care possible, I envision the need for care coordination across teams of healthcare professionals. In order to give patients more resources and support, I also see healthcare professionals working with community-based organizations. Finally, I have seen the utilization of community-based support groups and other tools to assist patients in better understanding and managing their disease.

The use of care coordination and community services in the setting of hypertension may need to be improved by several factors. More specifically, if there are communication problems across teams of care providers, care coordination may take more time and resources to create and may be challenging. The coordination of the use of community resources can sometimes be expensive and time-consuming. Moreover, utilizing community resources for inpatient treatment may raise privacy concerns.

State Board Nursing Practice Standards

State-by-state variations are set by state boards of nursing practice. The utilization of point-of-care devices and telemonitoring technologies are both mandated by the nurse practice guidelines in my state in order to monitor and coordinate patient care. The nursing practice standards also stipulate that healthcare professionals must possess the abilities and information to coordinate care for hypertensive patients (Kuipers et al., 2021). Furthermore, the standards call for healthcare professionals to collaborate with community-based organizations to provide additional resources and assistance for people with hypertension.

My actions to address care quality, patient safety, and costs to the system and the person shall be guided by these standards and policies. I will specifically use point-of-care equipment and telemonitoring technologies to monitor and oversee patient care. In order to give patients with hypertension the best care possible, I will also collaborate with groups of medical experts. Additionally, I will work with community-based organizations to offer people with hypertension better resources and assistance.

Effect of Local State Policies

The scope of practice for nurses can be significantly impacted by local, state, and federal regulations and laws, particularly regarding medical technology, care coordination, and local resources. For instance, point-of-care devices and telemonitoring technology are subject to laws and regulations in my state. Moreover, some laws and rules control how healthcare professionals employ care coordination and community services in patient care (Allard, 2020). To ensure that I am working within my nursing scope of practice, I must be aware of the laws and regulations in my state.

Nursing Ethics

Nursing ethics will be essential in my approach to addressing the problem. The three guiding principles of autonomy, beneficence, and non-maleficence should inform how I tackle the problem of hypertension. Using the best and least invasive technologies, care coordination, and community services available should be the main points of my approach. My strategy should also respect the patient’s autonomy and ensure that their requirements are considered while making decisions concerning their care.

References

Allard, B. L. (2020). Inspired Healthcare: A Value-Based Care Coordination Model. Sigma Theta Tau.

Elliott, M. N., Adams, J. L., Klein, D. J., Haviland, A. M., Beckett, M. K., Hays, R. D., Gaillot, S., Edwards, C. A., Dembosky, J. W., & Schneider, E. C. (2021). Patient-reported care coordination is associated with better performance on clinical care measures. Journal of General Internal Medicine, 36(12), 3665–3671. Web.

Gong, K., Yan, Y.-L., Li, Y., Du, J., Wang, J., Han, Y., Zou, Y., Zou, X., Huang, H., & She, Q. (2020). Mobile health applications for the management of primary hypertension. Medicine, 99(16), e19715.

Kappes, M., Espinoza, P., Jara, V., & Hall, A. (2023). Nurse-led telehealth intervention effectiveness on reducing hypertension: A systematic review. BMC Nursing, 22(1), 19. Web.

Kuipers, S. J., Nieboer, A. P., & Cramm, J. M. (2021). Easier said than done: Healthcare professionals’ barriers to the provision of patient-centered primary care to patients with multimorbidity. International Journal of Environmental Research and Public Health, 18(11), Article 11. Web.

Omboni, S., Mancinelli, A., Rizzi, F., Parati, G., & TEMPLAR (TEleMonitoring of blood Pressure in Local phARmacies) Project Group. (2019). Telemonitoring of 24-hour blood pressure in local pharmacies and blood pressure control in the community: The templar project. American Journal of Hypertension, 32(7), 629–639. Web.

Persell, S. D., Peprah, Y. A., Lipiszko, D., Lee, J. Y., Li, J. J., Ciolino, J. D., Karmali, K. N., & Sato, H. (2020). Effect of home blood pressure monitoring via a smartphone hypertension coaching application or tracking application on adults with uncontrolled hypertension: A randomized clinical trial. JAMA Network Open, 3(3), e200255. Web.

Sanya, R. E., Johnston, E. S., Kibe, P., Werfalli, M., Mahone, S., Levitt, N. S., Klipstein-Grobusch, K., & Asiki, G. (2023). Effectiveness of self-financing patient-led support groups in the management of hypertension and diabetes in low- and middle-income countries: Systematic review. Tropical Medicine & International Health, 28(2), 80–89. Web.

Singh, S., Kirk, O., Jaffar, S., Karakezi, C., Ramaiya, K., Kallestrup, P., & Kraef, C. (2021). Patient perspectives on integrated healthcare for HIV, hypertension and type 2 diabetes: A scoping review. BMJ Open, 11(11), e054629. Web.

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