NR 702 Week 1 Discussion: Foundations for Project Design

NR 702 Week 1 Discussion: Foundations for Project Design

Student Name

Chamberlain University

NR-702: DNP Project & Practicum I

Prof. Name

Date

NR 702 Week 1 Discussion: Foundations for Project Design

Reducing Incidences of Uncontrolled Hypertension

PICOT Question

The developed PICOT question is:

In patients diagnosed with high blood pressure (BP) and receiving antihypertensive therapy, how does the adoption of a Dietary Approaches to Stop Hypertension (DASH) program, compared to standard care, affect the incidence of uncontrolled hypertension in a primary care setting over 12 weeks?

Background and Significance of the Problem

Uncontrolled hypertension remains a major clinical concern at the practicum site, where approximately 59% of patients continue to exhibit elevated blood pressure despite ongoing pharmacological management. Persistent hypertension significantly increases the risk of severe cardiovascular and renal complications such as myocardial infarction, stroke, and chronic kidney disease. These conditions not only reduce patient quality of life but also contribute to increased healthcare costs due to frequent hospitalizations and long-term management requirements.

Traditional medication-based treatment often overlooks lifestyle factors such as unhealthy diet, lack of physical activity, and dyslipidemia, which further exacerbate hypertension. Recent evidence underscores the need to integrate pharmacological therapy with lifestyle interventions for better outcomes (Alnooh et al., 2022; Guo et al., 2021). Incorporating dietary and behavioral strategies enables primary care providers to address underlying risk factors, improving cardiovascular health and reducing disease burden.

Project Aim and Objectives

The main aim of this quality improvement project is to evaluate the effectiveness of the DASH diet program in reducing the prevalence of uncontrolled hypertension at the practicum site.

Specific Objectives

1. To implement the DASH program among patients with uncontrolled hypertension.

2. To evaluate changes in cardiovascular risk markers, including total cholesterol, LDL, HDL, and systolic/diastolic BP.

3. To determine whether adherence to the DASH program results in measurable reductions in uncontrolled hypertension over 12 weeks.

4. To identify barriers and facilitators in implementing a structured dietary program within primary care settings.

Why Use the DASH Program?

The Dietary Approaches to Stop Hypertension (DASH) diet is globally recognized as a leading nutritional strategy for managing hypertension. It emphasizes nutrient-dense foods—fruits, vegetables, whole grains, lean proteins, nuts, and low-fat dairy—while limiting sodium, saturated fats, and added sugars. Unlike treatment approaches relying solely on medication, the DASH program fosters sustainable lifestyle modifications that contribute to long-term cardiovascular wellness.

Research indicates that adherence to the DASH diet lowers blood pressure, improves lipid profiles, reduces systemic inflammation, and decreases the risk of metabolic syndrome (Guo et al., 2021). Furthermore, patient compliance with the DASH plan increases when supported by education and consistent follow-up, making it feasible for real-world primary care integration.

Key Elements of the PICOT Question

Anticipated Outcomes

The implementation of the DASH diet is expected to yield several positive outcomes, including:

• Improved dietary adherence: Patients will adopt healthier eating habits leading to sustained behavioral changes.

• Reduced blood pressure: Both systolic and diastolic BP levels are anticipated to decrease within 12 weeks.

• Enhanced lipid control: The program should reduce LDL cholesterol while improving HDL levels.

• Lower rates of uncontrolled hypertension: A significant decline in uncontrolled BP cases is expected at the practicum site.

Through enhanced self-management and nutritional awareness, this intervention is projected to support improved short-term clinical outcomes and long-term cardiovascular health.

Implications for Practice

If successful, integrating the DASH program into standard primary care practice could serve as a scalable model for managing chronic hypertension. Key potential benefits include:

• Reduced hospital admissions resulting from hypertensive emergencies.

• Decreased healthcare expenditures associated with complications such as stroke, heart failure, and kidney disease.

• Empowered patients through self-directed lifestyle management, enhancing satisfaction and quality of life.

Furthermore, incorporating dietary interventions aligns with broader public health initiatives that emphasize prevention and population wellness, supporting the creation of healthier communities.

References

Alnooh, G., Alessa, T., Hawley, M., & de Witte, L. (2022). The use of dietary approaches to stop hypertension (DASH) mobile apps for supporting a healthy diet and controlling hypertension in adults: Systematic review. Journal of Medical Internet Research Cardio, 6(2), e35876. https://doi.org/10.2196/35876

Guo, R., Li, N., Yang, R., Liao, X. Y., Zhang, Y., Zhu, B. F., & Lei, Y. (2021). Effects of the modified DASH diet on adults with elevated blood pressure or hypertension: A systematic review and meta-analysis. Frontiers in Nutrition, 8, 725020. https://doi.org/10.3389/fnut.2021.72502