Degree Name
Nursing Practice, DNP
Publication Date
8-3-2026
First Advisor
Lisa Drake
Second Advisor
Alisha McAfee
Abstract
Hypertension remains a leading modifiable risk factor for cardiovascular disease, and inconsistent implementation of evidence-based hypertension management may contribute to variability in patient education, documentation, and follow-up care. This quality improvement project evaluated an evidence-based educational program and a standardized hypertension management workflow, based on the 2025 American College of Cardiology/American Heart Association (ACC/AHA) hypertension guidelines, in an occupational medicine clinic. Guided by the Iowa Model of Evidence-Based Practice, Kotter's 8-Step Change Model, and the Plan-Do-Study-Act framework, the intervention aimed to impact staff self-efficacy, documentation of lifestyle education, and follow-up appointment scheduling. A quantitative quasi-experimental pre-post design was used with six clinical staff participants. Staff self-efficacy was measured using the General Self-Efficacy Scale, and retrospective electronic health record chart audits were conducted to evaluate documentation of lifestyle education and follow-up appointment scheduling. Data were analyzed using descriptive statistics, the Wilcoxon signed-rank test, and McNemar's exact test. Post-intervention General Self-Efficacy Scale scores increased but were not statistically significant (W = 0, exact p = .063). Documentation of lifestyle education and follow-up appointment scheduling improved from 28.6% to 100%; however, McNemar's exact tests were not statistically significant (exact p = .063 for both outcomes). These findings support the feasibility of implementing a standardized hypertension management workflow to improve consistency in evidence-based nursing practice. Future quality improvement initiatives with larger samples and longer implementation periods are recommended.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Duncan, Carolyn, "Standardizing Hypertension Care in an Occupational Medicine Clinic: A Quality Improvement Project" (2026). Doctor of Nursing Practice Projects. 368.
https://arch.astate.edu/dnp-projects/368
