Date of Conferral
8-13-2026
Date of Award
August 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Tracy Andrews
Abstract
Hypertension remains a leading modifiable risk factor for cardiovascular morbidity and mortality, yet blood pressure control remains suboptimal among many adults, particularly those receiving care in rural primary care settings. Reliance on office-based blood pressure measurements may limit opportunities to identify uncontrolled hypertension and actively engage patients in disease self-management. This Doctor of Nursing Practice quality improvement project evaluated the implementation of a standardized self-measured blood pressure (SMBP) program for adult patients with hypertension in a rural primary care practice. The intervention included validated home blood pressure monitors, standardized patient education, teach-back to verify measurement competency, structured home blood pressure monitoring, electronic health record documentation, and clinical follow-up of submitted readings. Participants were instructed to obtain two blood pressure measurements in the morning and evening for seven days, with results reviewed by the clinical team to support hypertension management. Pre- and post-implementation blood pressure measurements were evaluated, and paired-samples t tests were used to assess changes in systolic and diastolic blood pressure. Among 14 participants, 64.3% experienced a reduction in systolic blood pressure, 71.4% experienced a reduction in diastolic blood pressure, and 57.1% demonstrated improvement in both measures. The reduction in systolic blood pressure approached statistical significance, t(13) = −1.90, p = .079, whereas the reduction in diastolic blood pressure was not statistically significant, t(13) = −1.25, p = .233. Although statistical significance was not achieved, potentially because of the small sample size, the observed improvements suggest that a structured SMBP program may provide clinically meaningful benefits while promoting patient engagement and strengthening hypertension management in rural primary care. Continued integration of SMBP into routine clinical workflows may support sustainable, patient-centered hypertension management.
Recommended Citation
Montgomery, Stephanie Marie, "Implementation of a Nurse-Led Self-Measured Blood Pressure Program in Rural Primary Care" (2026). Walden Dissertations and Doctoral Studies. 20501.
https://scholarworks.waldenu.edu/dissertations/20501
