The Neuman System Model

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

Cooper L.A., & Roter D.L., & Carson K.A., & Bone L.R., & Larson S.M., & Miller E.R. III, & Levine D.M. (2011). A randomized trial to improve patient-centered care and hypertension control in underserved primary care patients. Journal of General Internal Medicine, 26, 1297 â[euro]" 1304. 10.1007/s11606-011-1794-6

Nursing theories serve as thinking guides for nurses to follow in order to reach optimal outcomes for patients. Theories are applied in conjunction with experience one has gained and critical thinking in everyday nursing practice, research, and education. The Neuman Systems Model, which was created by Betty Neuman, is one example of a theory that has been in practice for decades and continues to be modified to reflect new research. When applying the NSM, the nurse focuses on identifying and preventing stressors which are factors that lead to fluctuations in the body that affect daily living.

The concern on whether anti-hypertensive’s should be withheld in patients who are hypertensive has been debatable in the recent past. Generally, the treatment of hypertension among hospitalized patients is basically an opportunity to enhance the recognition and treatment of blood pressure (Axon, Nietert & Egan, 2011, p.246). This is mainly because hypertension is a basic risk factor for heart diseases, stroke, and death whose impact is widespread to nearly 70 million adults in America. There have been numerous educational initiatives and publication of treatment processes to address this condition in the past few decades. Despite these measures, nearly 39 million Americans are at risk of hypertension because they have not reached their desired or optimal blood pressure.

Hypertension is a developing problem worldwide associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%,

The major health problem selected for this project was hypertension (Harrison et al, 2011). It is identified as a cardio vascular disease risk factor such as dementia, chronic kidney disease, coronary heart disease, and stroke (NICE, 2011). It can be missed easily, as in various instances it is asymptomatic as well as it is also known as a silent killer. The Hypertension is thought to be a disease of vascular regulation ensuing from arterial pressure control mechanisms malfunction (extracellular fluid volume, rennin-angiotensin-aldosterone system, and CNS) that results in elevation of BP by means of enhanced peripheral vascular resistance, and cardiac output. There are 2 basic hypertension types. Around 90 to 95 percent of the individuals have primary hypertension which is linked with change in lifestyle as well as needs medical treatment. On the other hand, 5-10% has secondary hypertension which is linked with various other diseases for instance pregnancy, thyroid, and renal (Haslam and James, 2005). It is estimated that around 1 in 20 adults will have increased BP of 160/100 mmHg and above that results in either more than one predisposing aspects (Gemmell et al, 2006).

Hypertension is sometimes referred to as the silent killer (Aycock, Kirkendoll, & Gordon, 2013). Today it is a public health problem. According to the American Heart Association 2013 Statistical Fact Sheet (2013), one out of every three adults has high blood pressure, which is estimated at 77.9 million people (AHA, 2013). High blood pressure is also referred to as hypertension. Hypertension is a prevalent medical condition that carries with it the risk factor for increased chances of heart disease and stroke (Gillespie & Hurvitz, 2013). Hypertension remains one of the top 10 causes of worldwide disability-adjusted life years (as cited in Drenjančević-Perić et al., 2011). For the estimated 348, 102 deaths in 2009, high blood pressure was listed as the primary or contributing cause of death (AHA, 2013). Despite the health risk associated with hypertension, the diagnoses of high blood pressure continue to rise. By 2030, hypertension is expected to increase by 7.2% from 2013 estimates (AHA, 2013).

I have use evidence base practice often in homecare. I had a homecare patient who has hypertension and don’t check his blood pressure regular. I explained to him the important of checking blood pressure daily. Evidence based practice shows self-management of blood pressure is a useful tool in monitor hypertension and preventing stroke (McNamar, Versace, Marriott & Dunbar, 2014). I requested the family to buy an electronic blood pressure cuff. I encouraged patient to record blood pressure daily and record. I also instructed patient to take results to next doctor appointment.

High blood pressure increases your risk for heart disease and stroke, two leading causes of death for both Florida and the United States (Centers for disease control, 2017). High blood pressure, also called hypertension, is known as the “silent killer” because it often has no warning signs or symptoms, and many people do not know they have it. Hypertension damages blood vessels in the organs, reducing their ability to work properly (National institute of diabetes and digestive and kidney diseases, 2016). About 1 of 3 U.S. adults—or about 75 million people—have high blood pressure. Only 54% of these people have their high blood pressure under control (Centers for disease control, 2017). Hypertension education, which focuses on controlling the disease with medication, diet, and losing weight, is important in preventing or delaying the progression of serious complications. Most people diagnosed with hypertensive disease will need to see a medical professional who will recommend lifestyle changes to help you control and prevent high blood pressure (Ignatavicius & Workman, 2006, p. 1742).

Bosworth, Olsen, Grubber, Powers, and Oddone (2012) conducted a three-arm randomized controlled trial to determine the differences in AAs and Caucasians in two self-management hypertension interventions (N=636; non-whites n=328, and whites n=308). The subjects were randomly placed in the usual care (UC), home BP monitoring (HBPM), a tailored behavioral self-management intervention (TBSMI), and the two groups combined (TBSMI + HBPM). Data collection was done at the initiation of the research, 12 months, and 24 months from the control and intervention groups. BP results on whites at the baseline and intervention groups did not differ, but there was significantly reduction in the systolic BP of 7.5 mm Hg in AAs. This study denotes that a home BP monitoring in combination of nurse-administered telephone behavioral intervention was most effective in BP control in AAs.

Nursing theories serve as thinking guides for nurses to follow in order to reach optimal outcomes for patients. Theories are applied in conjunction with experience one has gained and critical thinking in everyday nursing practice, research, and education. The Neuman Systems Model, which was created by Betty Neuman, is one example of a theory that has been in practice for decades and continues to be modified to reflect new research. When applying the NSM, the nurse focuses on identifying and preventing stressors which are factors that lead to fluctuations in the body that affect daily living.

The impact of nursing theories continues to provide a framework for guidance for patient centered care. Nurses continue to use these theories to provide beneficial knowledge in advancing their profession. Kearney-Nunnery (2012) describes the function of the conceptual model as a reference point and has been used to supply information to nursing scholars. One of these scholars that uses this model is Betty Neuman with the development of Neuman’s Systems Model. Neuman’s Systems Model refers to the individual, family, group and community as the client system and how they react when confronted with stress (Kearney-Nunnery, 2012). The purpose of this paper is to provide an understanding into to Neuman’s Systems Model, how it can improve patient care, and how it is used in nursing practices.

According to Shi and Singh (2015) states that Donabedian model is considered a wide known means of measure that is used to give an understanding in measuring quality in healthcare organizations. In this model three domains that are hierarchical and are closely linked Donabedian would examine the quality of healthcare through structure, process and outcomes. In this model structure is considered the foundation of quality healthcare, and in order to have good process a good structure must be in place. If there is deficiencies within the structure then healthcare delivery process will be compromised (p. 494). Shi and Singh outlines the results of the domains beginning with outcome which focuses on patient satisfaction such as health status

Approximately one in every three adult’s ages 20 years old and older are diagnosed with high blood pressure or hypertension. Hypertension affects 78 million people in the United States and is equally prevalent in both men and woman (Crabtree et al., 2013). Hypertension is a major risk factor for cardiovascular disease (Hajjar & Kotchen, 2003). It can lead to stroke, myocardial infarction, renal failure, heart failure, neurological issues, and death if not detected early and not treated properly (James, Oparil, Carter, & et al., 2014). Approximately 9.4 million deaths in 2010 were attributed to high blood pressure (Angell, De Cock, & Frieden, 2015). About 54% of strokes, 47% of coronary heart disease, and 25 % of other cardiovascular diseases are attributed to high blood pressure (Arima, Barzi, & Chalmers, 2011).

The two major types of hypertension are primary and secondary. Primary hypertension accounts for more than 90% of all cases and has no known cause, although it is hypothesized that genetic factors, hormonal changes, and the altercations in sympathetic tone all may play a role in its development. Secondary hypertension develops as a consequence of an underlying disease or condition. The prevention and treatment of hypertension is a major public health issue. When blood pressure is controlled, cardiovascular, renal disease, and stroke may be prevented. The JCN, reported more than 122 million individuals in American are overweight or obese, consume large amounts of dietary sodium and alcohol, and do not eat adequate amounts of fruits and vegetables; less than 20% exercise regularly. Both modifiable and non-modifiable factors play a role in the development of hypertension