Degree Name
Nursing Practice, DNP
Publication Date
10-2-2026
First Advisor
Sandy King
Second Advisor
Leigh Swartzendruber
Abstract
Hypertension is a major modifiable risk factor for cardiovascular morbidity and mortality, yet timely follow-up after elevated blood pressure (BP) readings is not consistently documented in primary care. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether a standardized hypertension screening follow-up protocol improved provider initiation or documentation of guideline-concordant follow-up within 14 days. The faculty-approved PICOT population was primary care providers in a primary care clinic; we used eligible electronic health record (EHR) encounters as the analytic records to observe provider performance. We used a quantitative pre/post design and retrospectively reviewed 30 eligible EHR encounters: 15 pre-implementation and 15 post-implementation. The approved PICOT timeframe was six months; the completed evaluation covered six weeks and therefore represents an initial QI evaluation. The intervention standardized documentation expectations, BP reassessment or confirmation when appropriate, home BP monitoring recommendations, medication review when indicated, patient education, and timely follow-up scheduling. Descriptive statistics and Pearson’s chi-square test were conducted using IBM SPSS Statistics. Guideline-concordant follow-up increased from 2 of 15 records (13.3%) before implementation to 12 of 15 (80.0%) after implementation, an absolute increase of 66.7 percentage points. The association was statistically significant, χ²(1, N = 30) = 13.39, p < .001, with φ = .67. Given the small, single-site, nonrandomized pre/post design, findings demonstrate an association and initial QI evidence rather than definitive causal evidence. Continued auditing, staff education, leadership engagement, and longer-term evaluation are recommended.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Williams, Stella, "Implementation of a Standardized Protocol to Improve Provider Documentation and Initiation of Guideline-Concordant Hypertension Follow-Up within 14 Days in Primary Care" (2026). Doctor of Nursing Practice Projects. 395.
https://arch.astate.edu/dnp-projects/395
