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HYPERTENSION IN
DIABETES
OUR TEAM APPROACH
PRESENTED BY:
MARK ROSENBERG, MD
KATHY GLANCY, RN,CDE
MEGAN CONVERSE, MA
TEAM MEMBERS
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PROVIDERS
NCM
MEDICAL ASSISTANT
FRONT DESK
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
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.
RN ROLE
• RECEIVES REFERRALS FROM
PHYSICIANS
• RN ROLE IS TO EDUCATE
PATIENTS REGARDING HTN,
DIET, AND HEALTHY LIFESTYLE
CHANGES.
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
TEACHING METHODS
AND TOOLS
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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.
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.
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.
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.