Abstract WP493: Benefit of an Advanced Practice Nurse-Led Stroke Telemonitoring Program

Abstract

Introduction: Hypertension (HTN) remains the leading modifiable risk factor for stroke. Recently updated guidelines from the American Heart Association support a blood pressure (BP) goal of ≤ 130/80 mmHg and home blood pressure monitoring (Benjamin et al., 2017). The purpose of this evidence-based practice change project was to implement a new home blood pressure telemonitoring (HBPT) program for stroke patients with HTN, promote self-care management and reduce secondary stroke risk. Methods: An advanced practice nurse (APN) led 16-week HBPT pilot project was implemented to monitor blood pressure (hospital admission, discharge, 7-days HBPT and 30-days post discharge) and perception of the HBPT experience. Eligibility for HBPT was determined by the stroke team in collaboration with case management. Home care nurses assured home delivery of the HBPT device and educated the patient/family on device management. Daily readings were transmitted to the home care dashboard and monitored for alerts. Patients returned to the stroke office 30-days post discharge for evaluation of BP and HBPT experience. Results: Sixteen out of 112 patients were eligible for HBPT. The mean age was 71 years-old; 54% males; 55% females. Stroke types included 67% ischemic and 33% hemorrhagic. A significant change (improvement) in BP was noted from: admission to discharge (P = 0.007) and admission to 30-days post-discharge (P < 0.001). All patients achieved target BP at discharge and 30-day post-discharge. All patients reported a positive HBPT experience. Conclusion: An HBPT program can be beneficial in promoting secondary stroke risk reduction and enhancing patient self-care management skills.