The National Committee for Quality Assurance (NCQA) ensures the quality of client care using defined standards. Healthcare Effectiveness Data and Information Set (HEDIS)Links to an external site. is a performance measurement tool millions of health insurance plans use. HEDIS includes six domains of care:
• Effectiveness of Care
• Access/Availability of Care
• Experience of Care
• Utilization and Risk Adjusted Utilization
• Health Plan Descriptive Information
• Measures Collected Using Electronic Clinical Data Systems
Select one NCQA HEDIS measure Download NCQA HEDIS measureOpen this document with ReadSpeaker docReaderrelated to your future practice area. Use the Nurse Practitioner Quality Measures Worksheet Download Nurse Practitioner Quality Measures WorksheetOpen this document with ReadSpeaker docReaderto complete the assignment.
1. Follow APA grammar, spelling, word usage, and punctuation rules consistent with formal, scholarly writing.
2. Provide reference support from at least three scholarly resources according to program expectationsLinks to an external site.. Include in-text citations in APA format when applicable.
3. Abide by Chamberlain University's academic integrity policy.
Include the following sections (detailed criteria listed below and in the grading rubric).
1. Identification of the Selected Measure
a. Identify the selected performance measure and provide the full description of the measure.
b. Analyze the selected measure for clinical significance and evidence base considering both short term and long-term clinical significance.
c. Describe practical implications for clinical nurse practitioner practice.
d. Provide support from at least one scholarly source as defined by the NP program expectations.
2. Implementation Planning
a. Develop a detailed quality improvement plan for implementing the selected measure in your current or future practice, including:
Nurse Practitioner Quality Measures Analysis: Controlling High Blood Pressure (CBP)
1. Identification of the Selected Measure
a. Identify the Selected Performance Measure and Full Description
Selected HEDIS Measure: Controlling High Blood Pressure (CBP)
Domain of Care: Effectiveness of Care
Full Description of the Measure: The percentage of members 18–85 years of age who had a diagnosis of hypertension and whose blood pressure (BP) was adequately controlled (defined as a BP reading of $<140/90 \text{ mmHg}$) during the measurement year. The measure stratifies results for ages 18–59, 60–74, and 75–85, and often includes a separate control threshold for high-risk populations (e.g., diabetics, typically $<130/80 \text{ mmHg}$) based on current clinical guidelines (NCQA, 2024).
b. Analysis of Clinical Significance and Evidence Base
The CBP measure has profound and extensive clinical significance rooted in strong, evidence-based guidelines.
Evidence Base: The measure aligns directly with guidelines from bodies like the American Heart Association (AHA) and the American College of Cardiology (ACC). Clinical trials, such as the SPRINT trial, have provided robust evidence that aggressive BP control significantly reduces the risk of cardiovascular events and mortality (Whelton et al., 2018).
Short-Term Clinical Significance: In the short term, effective BP control minimizes acute risks associated with uncontrolled hypertension, such as hypertensive urgency/emergency and acute myocardial ischemia. Stabilization of BP contributes to immediate patient well-being and symptom reduction (e.g., reduced headaches or dizziness).
Long-Term Clinical Significance: The primary significance is the reduction of long-term morbidity and mortality. Sustained control prevents or slows the progression of target-organ damage, including:
Cardiovascular Disease: Reduced risk of heart attack (MI), stroke, and heart failure.
Renal Disease: Slowed progression of chronic kidney disease (CKD) and end-stage renal disease (ESRD).
Retinopathy: Reduced risk of vision loss.
Dementia: Emerging evidence links sustained hypertension control to reduced risk of cognitive decline (AHA/ACC, 2017).
c. Practical Implications for Clinical Nurse Practitioner Practice
The CBP measure has critical implications for NP practice, shifting the focus from simply diagnosing hypertension to managing it effectively to achieve the control target.
Comprehensive Assessment: NPs must accurately assess and stage hypertension, identify co-morbidities (diabetes, CKD), and ensure accurate BP measurement techniques are used at every visit.
Therapeutic Management: NPs must be adept at utilizing first- and second-line pharmacologic agents, optimizing medication regimens, and employing combination therapy to reach target goals in a timely manner.
Lifestyle Counseling: NPs must effectively educate patients on therapeutic lifestyle changes, including the DASH diet, sodium restriction, weight management, and physical activity, as these are foundational to BP control and measure compliance (Williams & Arslanian, 2022).
Care Coordination: This measure requires coordinating care between specialists (e.g., cardiology, nephrology) and ensuring robust follow-up to address treatment adherence barriers.
d. Scholarly Support
"The HEDIS measure for Controlling High Blood Pressure serves as an operational mechanism to ensure that clinical practice adheres to established guidelines demonstrating that effective pharmacological and non-pharmacological management significantly lowers cardiovascular risk, thereby reducing preventable hospitalizations and mortality across the lifespan" (Williams & Arslanian, 2022, p. 301).