Question

Flowchart the Hypertension Management program identified using basic flow charting symbols.

Case: Hypertension Patient Education Program

Hypertension is a serious condition that can damage the heart and blood vessels, and can eventually lead to several other conditions, including stroke, heart failure, heart attack, kidney failure, and vision problems. Hypertension is typically treated by making changes in lifestyle, and with drug therapy. Lifestyle changes include losing weight, stopping smoking, eating a healthy diet, and getting enough exercise.Because individuals with uncontrolled hypertension are frequent patients, it is important to educate them in monitoring their diet, exercise, and medication use in order to reduce inpatient admission and cost of health care. A Transitional Care Program for individuals who have been admitted to the hospital with hypertensive crisis has been developed. Hypertensive crisis is a state in which blood pressure becomes so high that it is causing immediate danger and needs to be reduced rapidly. It is a transitional program because the care and education a patient receives in an inpatient hospital setting is provided in an outpatient and home environment.

Program coordinators have to initially identify patients who would be appropriate for this program. This means that a patient must be recently diagnosed to qualify. Patients are identified by examining the medical charts in such units as the Emergency Room or ICU. Once the patients have been identified, their demographic, drug, and vital signs information are entered into the hypertension database. While the patient is still in the hospital, the coordinator will visit the patient and provide an initial education session which includes giving an instructional booklet and watching a video tape. Before the patient is discharged, a 1:1 meeting is scheduled for 2 weeks after discharge. The purpose is to do another follow-up check-up, including weight, blood pressure, and dietary intake measurements. If the patient is discharged to their home, then the patient qualifies for the 1:1 meeting. If the patient is discharged to any other facility such as a nursing home or hospice care, he or she does not qualify for this program (those facilities have round-the-clock nurses). During the 1:1 encounter, vitals signs are taken again and the information is documented in the patient’s chart (manual) and entered into the database. Lastly, within 2 weeks of the 1:1 meeting, a group meeting is organized for individuals to talk about their educational program and what they have learned. Attendance information is entered into the database. Once a patient successfully completes the initial education session, the 1:1 meeting and the group meeting, he or she is no longer eligible for the Transitional Care Program.