Exploration And Practice Of Primary Hypertension Management Model Involving Nurse Practitioners

Objective:To explore the effect of nurse practitioners' participation in community hypertension management and provide some reference for the management of primary hypertension patients.Methods:Anhui province draw lessons from international experience,that nurse practitioners sink into city community health service center,relying on the innovation of urban medical union platform.They Set up nursing clinics in the community and conduct the management of "three people and four diseases"(elderly people,pregnant women and infants,and hypertension,diabetes,stroke and mental illness).Taking hypertension as an example,this study explored the effect of nurse practitioners in grade A hospitals on the management of hypertension patients in grass-roots communities.120 eligible hypertensive patients were selected from the team of family doctors in two community health service centers in hefei.The community with a hypertensive care clinic was used as the experimental group,while the other community was used as the control group,intervention time was February 2018-February 2019.The experimental group and the control group each selected 60 patients with hypertension as the research objects.The experimental group received the management of nurse practitioners on the basis of family doctor contract,including one-to-one evaluation and nursing outpatient service,collective intervention and regular follow-up.The control group received routine management from the family physician contract team,and the family physician conducted regular follow-up and guidance for the hypertensive patients in this group.And basic information questionnaires,high blood pressure questionnaires,high blood pressure knowledge questionnaires,behavior questionnaires and patient satisfaction questionnaires were adopted to collect knowledge of general demographic data,high blood pressure,high blood pressure in patients with health behavior,satisfaction of community,blood pressure levels and blood pressure control.Then compare the two groups in the 12 months before and after the intervention:aware of knowledge about hypertension,high blood pressure in patients with healthy behaviors,satisfaction of community,the change of blood pressure levels and blood pressure control rates.Statistical software SPSS 23.0 was used for data analysis.Independent sample t test was used for quantitative data in two groups,and chi-square test was used for qualitative data in two groups.Results:In this study,a total of 130 eligible hypertensive patients were investigated,8 failed follow-up patients were excluded,and 120 valid data(92.3%)were finally included.There were 60 cases in the experimental group and 60 cases in the control group,and there was no significant difference in the general demographic data of hypertensive patients between the two groups(P>0.05).The knowledge degree is low,and the community satisfaction is also not high before the intervention in two groups of patients with high blood pressure,there was no statistically significant difference between two groups(P>0.05),and 12 months after intervention,the experimental group subjects knowledge of hypertension awareness,for the community satisfaction improved significantly compared with control group,and the difference between groups was statistically significant(P<0.05).There was no significant difference in the health behaviors of hypertensive patients between the two groups before the intervention(P>0.05).After 12 months of intervention,the compliance of hypertensive patients in the experimental group was significantly improved compared with the control group,and the difference was statistically significant(P<0.05).There was no significant difference in blood pressure level and blood pressure control rate between the two groups before intervention(P>0.05).After 12 months of intervention,the blood pressure level and blood pressure control rate of the experimental group were improved compared with the control group.Conclusion:The grass-roots hypertension management mode with the participation of nurse practitioners can improve the knowledge rate of hypertension patients in the community,improve their health behaviors and satisfaction,and improve their blood pressure control level and blood pressure control rate.Getting nurse practitioners to work in grassroots communities can relieve the pressure of the shortage of general practitioners in China to a certain extent.,and provide certain reference for the management of chronic diseases including hypertension at the grassroots communities in China.