High Blood Pressure Management Program - Research Paper Example

High Blood Pressure Management Program High blood pressure management is an imperative health issue whose effects are felt by majority of the United States’ population. In most instances, high blood pressure can be prevented, or can be controlled and managed to reduce its adverse effects. This program proposal provides details on how high blood pressure can be prevented to avoid illness, controlled, and managed in cases where people have already become ill, within an organizational setting. Therefore, in this proposal, details of the evaluation process, program planning model (MAPP) and the type of assessment used in the program are explained. In addition, the organizational design, data used, staffing needs and the budget are provided in this proposal developed for the program of high blood pressure management. Finally, expected outcomes or results are provided in this proposal. Introduction According to CDC (2013), among the health risk behaviors is poor nutrition, consumption of too much alcohol, use of tobacco and lack of physical activity. These habits lead to illness, most of which are avoidable, and this in turn may lead to early deaths. Among the ten most chronic conditions, high blood pressure tops because more than 50% of the residential care facilities in the United States of America are suffering from high blood pressure (CDC, 2012). Therefore, management of high blood pressure is a community health issue that needs to be addressed systematically. This organizational, high blood pressure management program proposes an evaluation process, program planning model, assessment types, vision of health program, organizational design, data, staffing needs, budget, and expected results of a high blood pressure management program. The program is designed to provide effectual care to those who are in the greatest need. Behavior and lifestyle are among the causes of high blood pressure. Given that the young and old age groups require health care, compared to other groups; this program focuses on adults. The program targets various organizations to have their employees undergo a mandatory blood pressure screening frequently. The program also offers educative sessions which offer information on how those who, upon screening are found to have high blood pressure to change their lifestyles. Such changes of lifestyle include losing weight, quitting use of excessive alcohol and quitting smoking. In cases on need, counseling will be provided. Also, the program will encourage various organizations and institutions to allow blood pressure screening, as well as, make it possible for such organizations and institutions to make referrals for lifestyle counseling for affected employees or staff members. There should be ongoing measurements at appropriate intervals will facilitate a robust evaluation process of the program It is imperative to note that high blood pressure can cause other problems such as kidney diseases, blindness, stroke and cardiovascular diseases (CDC, 2013). Therefore, preventing, control and proper management of the condition will reduce or eliminate all these resultant problems, which in turn reduces the health costs significantly. This is the main reason as to why this program aims at encouraging screening for high blood pressure so that preventive, control and management interventions can be applied for clinical evaluation and treatment. Evaluation Process After carrying out assessment and planning for the control and management of high blood pressure, an evaluation plan is to be developed. This should be done before the implementation of blood pressure screening and management programs. The evaluation process takes into account aspects such as health workers’ performance, associated costs pertaining to health care, expected health outcomes and organizational structure, as well the required organizational change to accommodate the new program. Therefore, the evaluation process includes initial activities of the program, which are measurements and checkups, the process of control and management and appraisal of the outcome of the program. This high blood pressure management program has the main goal of encouraging blood pressure screening and control. However, it includes incentives for prevention of high blood pressure and interventions for the management of the condition, incase patients are reported to have already developed high blood pressure. In evaluating patients who have elevated blood pressure, the main goals will be to determine whether the high blood pressure is secondary to a possible curable cause, whether it is accompanied by other cardiovascular risk factors and whether it is accompanied by target organ damage (Aiyagari & Gorelick, 2011). Ascertaining whether the form of hypertension that a patient has is secondary enables health workers to administer a curative therapy (Aiyagari & Gorelick, 2011). Such therapy may include removal of the removal of adenoma, which may be producing aldosterone and renal artery stenosis guide therapy, as well as, use of medications to correct renal artery stenosis. Determining whether other cardiovascular risk factors, which may be severe, are present enables health workers to avoid using medications that aggravate or cause risk factors (Aiyagari & Gorelick, 2011). It also helps to decide whether to consider administering an additional and more intensive therapy to counter the risk of hypertension, in case it is high. Also, evaluation of the presence of target organ damage among patient helps health workers to determine whether they should shift primary prevention to secondary prevention, as the case may be. For instance, patients with a history of another disease such as stroke are at higher risk compared to patients without such history (Aiyagari & Gorelick, 2011). Identifying and treating the condition early is beneficial. Program Planning Model The program planning model of this high blood pressure management program begins with identification of the organization’s health need, which prevention, detection, control and management of high blood pressure in the work place. The next step involves definition of the objectives and goals of the program. In this case, the goals are to increase the number of blood pressure screens carried out within the workplace, to increase detection cases, enhance lifestyle changes and encourage prevention among employees, control and management of high blood pressure among those who have developed high blood pressure. Ensuring adherence to therapy is also among the goals of the program. The next step involves description of the appropriate interventions, educational and nutritional programs. Within the intervention program, the program encompasses awareness building, proposal for lifestyle changes and creation of behavior change enabling environment. This step is followed by identification of staff needs and data to be used and how it can be collected. The next step is about the budget and the costs that are associated with the program. This helps to identify the real cost of the program. After implementation, the final phase of the program planning is evaluation of the implemented program to determine whether it achieves the expected health outcomes. Determination of whether the program accomplishes the intended goals helps to rank the program, either as a success or a failure. The program involves identification of those who are most likely to have high blood pressure. The aspects that will be taken in account in identifying the people who have the greatest risk of developing high blood pressure include lifestyle factors that may lead to high blood pressure and high blood pressure family history. As for the case lifestyle factors, the program seeks to offer counseling and education, which will encourage changes in lifestyle. Health workers will encourage people to consume foods that have low sodium and calories and high potassium content. In this program also, interventions for lifestyle changes include encouraging physical activity, as well as, moderation of alcohol intake. This requires full participation of health workers in the dissemination of the necessary information through health education. The program seeks to achieve its mission through workplace screening activities. In addition, people who have already been diagnosed with high blood pressure will be monitored to ensure that they adhere to therapy. After detection, education follows. In some situations, the program involves education and referrals for further cardiovascular risk factors management. Further, those who are under therapy are encouraged to adhere to medication so as to reduce the associated effects of high blood pressure such as stroke and organ damage, among other risks. Type of Assessments Used This high blood pressure management program uses employee health surveys as an assessment tool to facilitate implementation of the health program. This is because employee health surveys are useful in the identification of the number of employees who have undertaken blood pressure screening. After obtaining information, the program uses the information to educate employees on nutritional matters, as well as, lifestyle counseling and making follow ups for certain health concerns. Other assessments used include lifestyle and behavior changes in terms of diet, physical exercise, alcohol intake and smoking. Vision of the Health Program Objectives for lifestyle changes to address high blood pressure prevention and control include aspects such as eating behavior, attaining and maintaining an appropriate body weight and controlling blood pressure (Frank, 2007). Eating behavior is characterized by the amount of fat, carbohydrate, fiber, sodium and potassium intake. Also, smoking and alcohol intake may follow under the category of eating habits among people of a given population. It is imperative to create an environment that encourages people to exercise because this aids in controlling body, which is among the determinants of one’s blood pressure. The vision for this high blood pressure management program is to reduce cases of high blood pressure and its associated effects among employees and the American population at large. This will be achieved by advocating for prevention of high blood pressure through lifestyle changes, increased blood pressure screening to facilitate early detections and controlling and managing the condition by adhering to therapy. Proper nutrition and exercising is advocated for by this program, as the program seeks to attain its objective of having people change their eating behavior and also monitor their body weight through exercise. Therefore, the high blood pressure management program seeks to attain its goal of employees with reduced stress, and who take sufficient amounts of potassium. Also, the program has a vision of encouraging the reduction of sodium intake, alcohol consumption and smoking among employees. Organizational Design The program requires support from employers. Therefore, participation of senior executives in this health program will be imperative because it will contribute significantly towards the attainment of the program’s goals. As a result, organizational design should include the incorporation of blood pressure screening. This is among the required changes in the organization’s culture. The design may also include changes in an organization’s programs that affect employees’ lifestyles such as changing foods available the organization’s shops and building areas for exercising for employees within the organization’s premises. These programs have to be integrated properly to achieve efficiency and effectiveness. Blood pressure screens will be carried frequently with the organization. This is enhanced by the construction of three blood pressure screening centers within the organization. These blood pressure screening centers will serve various employees within the organization, whereby one will be used by management and senior staff while the others will be used by other staff members, one for male and the other for female. The blood screening centers will be under the senior community health workers, including senior community health workers. Clinicians will be responsible for the role of performing the blood pressure screens while health workers will offer further advice to employees. Adjacent to each blood pressure screening centre, there will be a counseling centre. After clinicians have carried out a blood screen, they will also collect information pertaining to n employee’s lifestyle in terms of diet, smoking and alcohol consumption, and refer the employee to the counseling centre. At the counseling centre, a team of health workers and clinicians will provide counseling to the employee. For instance, if the employee is diagnosed with high blood pressure, controlling and management intervention interventions will be provided. The employee will be advised to adhere to therapy. In some cases, the employee will be referred to the hospital for further examination to determine whether high blood poses further risks to the employee. Those whose lifestyle and dietary habits may put them at risk of developing high blood pressure will be advised on diet and exercise. In addition, nutritionists will ensure that all the foods available within the organizational shops are those that do not increase the risk of developing high blood pressure. The organization will include reserved areas where employees can exercise, especially during work breaks and after work. In addition, barriers to blood screening and control within the organization should be identified and eliminated. Data Used Data is very important for the success of this program because it provides crucial information for decision making. For instance, through data, it is possible to ascertain whether high blood pressure or associated illnesses and risks are a major problem within the organization. Therefore, the decision to address high blood pressure within the organization is predetermined by the information available and the inferences made from such data, upon analyzing it. In this high blood pressure management program, various types of data are used. First, the program uses mortality data by getting facts about death as pertains to cause of death and age. This helps to have a really picture about the disease (high blood pressure) among employees and in the population. Mortality data is available from many sources, but the most important source in this case from hospitals. Mortality data is an important quality indicator of health among people (Doran, 2011). Therefore, by knowing whether majority of deaths of some of the employees and other people of the population surrounding the organization was caused by high blood pressure related sicknesses, it is easier to determine the prevalence of the problem. In addition, the health program uses general health information in terms of life expectancy. The health program also uses morbidity data by getting information about types of illness and disability, incidence and prevalence, from hospital records, sickness records and other surveys. Behavior measures such as smoking and alcohol consumption among employees is also used. Finally, the health program uses service information such as employee diseases treated by health services, admission in hospitals and prevention services uptake such as screening and checkups. Staffing Needs There are various staffing and equipment needs associated with the implementation of the high blood pressure management program. For instance, it is expected that employees will change their time to participate in blood pressure screening, education and lifestyle counseling activities during work hours. It is also expected that the organization will incur additional costs associated with physical activity and nutrition. This health program requires senior health workers, health workers, supervising health workers and health workers’ managers. Others include clinicians, clinic coordinators and nutritionists. Senior health workers are responsible for the formulation of health programs and interventions. Supervising healthy workers will ensure that health workers, clinicians and nutritionists work to implement the program. Health workers’ managers will foresee the activities of the health program while clinical coordinators are charged with the responsibility of harmonizing all these staff members and their various roles. Health workers also provide counseling services. Budget The high blood pressure management program is associated with various financial costs. These costs include equipment costs and remuneration of staff of this health program, as shown in the following estimated costs to be incurred in implementation of the health program. High Blood Pressure Management Program Budget Cost in US Dollars ($) per Month Senior Health Worker 50,000 Health Workers’ Manager 70,000 Supervising Health Worker 60,000 Clinic Coordinator 45,000 Clinician 40,000 Nutritionist 40,000 Health Workers 40,000 Equipment 100,000 Transport 65,000 Total 510,000 Outcomes/Results The expected results or outcomes of this high blood pressure management program are to have increased rates of screening within the organization. This will lead to increased incidences of detection rates. In turn, this will lead to participation in activities which will contribute to prevention of developing high blood pressure. As a result of reduced instances of high blood pressure among employees, the organization is expected to record a reduction in the number of sick days taken off by employees. This is because the high blood pressure management program will embrace continuous evaluation among employees to ensure that they take part in high blood pressure preventing activities throughout. In addition, it is expected that lifestyle and eating behaviors will change among employees in favor of prevention of high blood pressure. Other expected outcomes include quitting smoking and moderation of alcohol, which are among the factors that increase the risk of developing high blood pressure. The health program expects to achieve increased potassium intake, reduced sodium intake and observation of diet to control weight among emplyees and the population (Rubin, 2013). It is also expected that through the health program, employees will reduce the amount of calories that they consume and increase their physical activity (Throne, 2004). As far as detection is concerned, it is expected that those who have developed high blood pressure will be put under therapy. This involves curative interventions, which are expected to reduce further damage from high blood pressure. The overall expected outcome of successful implementation and evaluation of the high blood pressure management program is reduced cases of high blood pressure and increased levels of management of the condition, thus decreased mortality rates. References Aiyagari, V., & Gorelick, P. B. (2011). Hypertension and Stroke: Pathophysiology and Management. New York: Humana Press/Springer. CDC. (2013, October 23). Blood Pressure Screening and Control. Retrieved from http://www.cdc.gov/workplacehealthpromotion/evaluation/topics/blood-pressure.html CDC. (2013). Chronic Disease Prevention and Health Promotion. Retrieved from http://www.cdc.gov/chronicdisease/overview/index.htm CDC. (2012, August 10). QuickStats: Ten Most Common Chronic Conditions* Among Persons Living in Residential Care Facilities — National Survey of Residential Care Facilities, United States, 2010. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6131a6.htm Doran, D. (2011). Nursing Outcomes. Sudbury: Jones & Bartlett Learning Press. Frank, G. C. (2007). Community Nutrition: Applying Epidemiology to Contemporary Practice. Sudbury: Jones and Bartlett Learning Press. Rubin, A. L. (2013). High Blood Pressure for Dummies. Hoboken: 2013. Throne, J. (2004). 5th Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. S.l: DIANE Publishing Company. Read More