HYPERTENSION IN DIABETES OUR TEAM APPROACH

1. HYPERTENSION IN DIABETESOUR TEAM APPROACH PRESENTED BY: MARK ROSENBERG, MD KATHY GLANCY, RN,CDE MEGAN CONVERSE, MA

2. TEAM MEMBERS • PROVIDERS • NCM • MEDICAL ASSISTANT • FRONT DESK

3. SETTING THE EXPECTATION • EMPOWER THE TEAM TO SPEAK TO PATIENTS • Meaning of “blood pressure” • Risks of uncontrolled hypertension • Nutrition • Low sodium diet • Exercise and weight loss

4. FHSM THE STAFF • MA, RN, AND MD MEET WEEKLY TO DISCUSS PATIENTS. • THE STAFF PARTICIPATES IN MONTHLY MEETINGS TO REVIEW MEASURES AND WAYS TO FIND IMPROVEMENT. • MA / DOCTOR BREAKFASTS MONTHLY FOR EDUCATIONAL PURPOSES. • INSERVICE ON MOTIVATIONAL INTERVIEWING.

5. RN ROLE • RECEIVES REFERRALS FROM PHYSICIANS • RN ROLE IS TO EDUCATE PATIENTS REGARDING HTN, DIET, AND HEALTHY LIFESTYLE CHANGES.

6. RN ROLE • EVALUATION OF THE PATIENT: REVIEWS MEDICAL HISTORY, LABS, AND CO-MORBIDITIES. REVIEWS HEIGHT, WEIGHT, BMI, AND BP. DIET HISTORY, PHYSICAL ACTIVITY, PSYCHOSOCIAL ISSUES READINESS TO CHANGE

7. TEACHING METHODS AND TOOLS • DASH DIET/ VEGETARIAN OPTIONS • CAFFEINE / ALCOHOL • READING A FOOD LABEL • HIDDEN SALTS IN FOODS • INSTRUCTION AND HAND-OUTS FOR HYPERTENSION(5TH GRADE READING LEVEL) • FAST FOOD GUIDE (BD) • MEDICATION INSTRUCTION, AND ASSESSING INTERACTIONS WITH FOODS AND OTHER MEDICATIONS.

8. TEACHING METHODS AND TOOLS • HOME BP MONITORING IF WILLING AND PRESCRIBED BY MD. • INSTRUCTION IN CORRECT TECHNIQUES FOR MONITORING. (HANDOUT PROVIDED) • REFERRAL TO YMCA HEALTHY LIFESTYLE PROGRAM IF INTERESTED.

9. MA ROLE • VITAL SIGNS COMPLETED ON ALL PATIENTS AND COMPARED TO PREVIOUS READINGS. • USE OF OPEN-ENDED QUESTIONS TO INITIATE DISCUSSION WITH PATIENTS. • THE MA THEN USES THE PATIENT’S ANSWER TO FOCUS ON EDUCATION SUCH AS DIET, SODIUM, WEIGHT.

10. MA ROLE • MEDICATION RECONCILIATION • CHECKS LAST REFILL DATE FOR PATIENT COMPLIANCE. • DOCUMENTS IN SOAP NOTE ANY CHANGES AND IF ABLE DISCUSSES NEW ISSUES WITH MD PRIOR TO HIM SEEING THE PATIENT.