Student Name

Capella University

NURS-FPX9000 Doctor of Nursing Practice 1

Professor Name

Submission Date

Project, Preceptor, and Practicum Interest Form (PPPIF)

Project Site Description

This project will be undertaken at a primary care clinic in the USA, offering a full suite of primary care services and chronic disease management. Outpatient family practices at this clinic focus on the prevention and control of long-term conditions. Evidence-informed care is promoted, with the aim of improving health. There are around 25 staff, from physicians to assistants (Nurse Manager, personal communication, April 28, 2026). Chronic conditions such as hypertension are managed through regular check-ups and follow-ups with a primary care provider. The clinic receives around 40 to 50 patients a day, with an approximate weekly total of 250 patient encounters (Nurse Manager, personal communication, April 28, 2026). Each encounter is made up of a measurement of vital signs, a review of current medications, and a level of patient education. The context allows the innovation of standard procedures to be incorporated that are in line with scientific recommendations for managing hypertension.

Identified Problem or Gap in Practice

The problem noted in this practicum site is uncontrolled blood pressure of hypertensive patients who do not follow up or adhere to standard treatment protocols. The actual practice of care delivered to patients (i.e., current practice) deviates from recommended guideline-based care, and a gap is present. The internal audits identified evidence that supported this problem. Using EHRs for baseline data collection, at this site, there were 180 adult patients diagnosed with hypertension in March 2026. Of these 180 adult patients, 72 (40%) achieved the target blood pressure (BP) of <140/90 mmHg, while 108 patients had uncontrolled hypertension. The further chart audits showed that 90 out of 180 (50%) charts had documentation of lifestyle counseling, and 75 (42%) had a documented plan for follow-up in the electronic health record (EHR). According to the American Heart Association (2025), national data show that when standardized protocols are used, control rates should exceed 60%. Given the wide gap and target control rates, there is a high risk and high need for intervention. Cardiovascular outcomes will improve if leadership addresses this issue.

Quality Improvement and Intervention Approach

Hypertension quality improvement at the site enhances patient outcomes through evidence-based improvement processes. According to O’Donnell & Gupta (2023), quality improvement management refers to an organized approach to continuously monitor, assess, and improve the healthcare delivery process to safeguard, optimize, and enhance the quality of healthcare. The outcomes established by Brown et al. (2026) demonstrated that employing protocols to treat hypertension, such as the American Heart Association (AHA) and American College of Cardiology (ACC) guidelines, will help to better control levels of hypertension and lower the level of cardiovascular risk in the primary care setting. The guidelines suggest the need to improve the way blood pressure is measured, medication is optimized and adjusted, and the management is individualized to each patient. The implementation of these protocols ensures that all patients receive the same evidence-based care, regardless of the provider.

Complete hypertension protocol includes standardized procedures for blood pressure measurement, optimal blood pressure medication titrations, education, lifestyle modifications, and routine follow-up/tracking. Structured systems and procedures minimize clinical perturbations and allow for early identification and control of uncontrolled hypertension (Jones et al., 2025). EHR (electronic health record) alerts and reminders support providers and enable timely decisions in care. Improved, coordinated, team-based care is the focus of the quality improvement undertaking, incorporating diverse branches of medicine to provide comprehensive care, management of medications, lifestyle modification, and follow-up (Jones et al., 2025). Team-based intervention facilitates closure of care delivery gaps, increased responsibility, improved communication, and ultimately, hypertension management. In addition, and most importantly, patient empowerment through education and informed treatment decisions reinforces adherence.

The successful application of a project relies on properly educating staff with essential competencies. Training will focus on improving knowledge on the hypertension guidelines and blood pressure measurement, medication titration, and patient counseling (Brown et al. 2026). Competency-based training in healthcare allows clinicians to best utilize evidence-based practice to decrease the margin of error, ultimately improving the quality of clinical care. Additionally, training will promote standardization among staff to ensure consistency in the management of hypertension. Of the many interventions that will employ standardized instructions, the use of EHR, integrated, and team-based care, and competency-based training, all combined, will have the greatest influence on positively impacting the control of hypertension, improving risk factors of chronic cardiovascular disease patients (Brown et al. 2026). The greatest focus will be on the sustainability of the primary healthcare model.

Additional Information for Mentor and Site-Based Learning Team

Other required data for the mentor and learning team onsite include baseline hypertensive control data, as well as the current workflow and existing personnel competency data at the identified site. This includes current documentation practices, documentation patterns, medication adjustment, and follow-up scheduling practices and systems in the clinic. The data helps identify care delivery gaps and plan necessary interventions. Readiness and support from management, staff, and access to the EHR system are some factors that will influence the execution of the plan. The measure of the interventions’ success will be reflected in patient engagement, appointment attendance, and follow-up and lifestyle behavior modification adherence (Brown et al., 2026). Providing evidence-based guidelines and benchmarking information will help align clinical practice to the national standard. This will assist in the design, implementation, and evaluation of the quality improvement project.

Population Description

The focus group is Registered Nurses/Nurse Practitioners at the designated Primary Care site. They can manage chronic health problems and monitor medications for patients educated on hypertension, coordinating their follow-up care. The group uses standardized protocols, which provide staff clinicians with improved pathways for clinical decisions that yield better results for patients. Nurses especially need to be involved when addressing hypertension and provide significant responsibility for blood pressure control through assessment and education, along with timely action. The registered nurse and the nurse practitioner have the responsibility for implementing the hypertension treatment protocol, which is standardized and includes accurate blood pressure taking, medication titration support, lifestyle counselling, and follow-up. A staff competency training program will support the education and skills of nurses by providing evidence-based care in the management of hypertension and ensuring standardization of the use of clinical guidelines, allowing nurses to feel confident in their ability to deliver care to patients. Training will also help to ensure that documentation is accurate and communication among members of the care team is improved. Healthcare workers, especially nurses, who are the frontline in patient care and management, are critical targets because they play a vital role in adherence to guidelines, patient engagement, and general control of hypertension in the healthcare system.

1. Within the near future, you will be having a Virtual Check-In with you, your mentor, and your preceptor. Please list dates and blocks of time available with your preceptor. Your mentor will then use this to send out a Zoom meeting link.