EubacteriaDefinitionBacteria are prokaryotic single-celled or

Eubacteria
Definition
Bacteria are prokaryotic single-celled or colonial
microorganisms
Characteristics of Bacteria
Lack Green Pigment Chlorophyll
Reproduce by Transverse Fission
Morphology
Bacteria display a wide diversity of shapes and sizes.
Size
0.5 µm diameter
Length 0.5 µm - 80 µm
Bacterial cells are about one-tenth the size of eukaryotic cells
and are typically 0.5–5.0 micrometers in length. However, a few
species are visible to the unaided eye—for
example, Thiomargarita namibiensis is up to half a millimeter
long] and Epulopiscium fishelsoni reaches 0.7 mm.] Among the
smallest bacteria are members of the genus Mycoplasma, which
measure only 0.3 micrometers, as small as the
largest viruses.] Some bacteria may be even smaller, but
these ultramicrobacteria are not well-studied.
Shape
Spherical – coccus
Rod-shaped - bacillus
Vibrio - Comma shaped
Spiral-shaped -spirillum
Spherical bacteria are known as cocci (singular coccus, Rod-
shaped bacteria are called bacilli. Some bacteria, called vibrio,
are shaped like slightly curved rods or comma-shaped; others
can be spiral-shaped, called spirilla, or tightly coiled,
called spirochaetes. A small number of other unusual shapes
have been described, such as star-shaped bacteria.

Arrangements of Bacterial Cells
Bacteria are unicellular or colonial
Colonial – cells remain together after division
Colony type – depends on plane of cleavage and planes of
successive cleavage.
Bacillus – can only divide in one plane, at right angles to the
long axis of the cell.
Streptobacillus
Diplobacillus – remain in pairs following division. after 4
chain fragments
Spirillum- (spiral) divides in one plane
2 types:
Strepto spirillum
Diplo spirillum
Spherical (coccus) can initially divide in any plane. Great
variation in colony types.
Streptococcus
Cells divide simultaneously
Diplococcus
If after 4 unit, chain fragments into chains of 2 organisms each
– diplococcus
Tetrad Gaffkya
Cells divide at right angles to the preceding division
Sarcina – 3 planes of division. Successive planes are at right
angles
Sarcina colonies are cuboidal. All dimensions are the same.
Staphylococcus – irregular cluster of spherical cells. Cells
divide in any plane. No pattern
Coccus organism –the type of colony is a species characteristic.
It can be used to identify an organism. The colony type is often
indicated by the generic name. This is not true of bacillus or
spirillum. The colony type can be varied by environment or

temperature.
Many bacterial species exist simply as single cells; others
associate in characteristic patterns: Neisseria forms diploids
(pairs), streptococci form chains, and staphylococci group
together in "bunch of grapes" clusters. Bacteria can also group
to form larger multicellular structures, such as the
elongated filaments of Actinobacteria species, the aggregates
of Myxobacteria species, and the complex hyphae
of Streptomyces species. These multicellular structures are
often only seen in certain conditions. For example, when
starved of amino acids, myxobacteria detect surrounding cells in
a process known as quorum sensing, migrate towards each
other, and aggregate to form fruiting bodies up to
500 micrometers long and containing approximately 100,000
bacterial cells.[40] In these fruiting bodies, the bacteria perform
separate tasks; for example, about one in ten cells migrate to the
top of a fruiting body and differentiate into a specialized
dormant state called a myxospore, which is more resistant to
drying and other adverse environmental conditions.
Structure of the Prokaryotic Cell
Structures External to the Cell Wall
Among the structures external to the cell wall are the:
Capsule (slime layer)
Flagella
Axial filaments, and
Pili (fimbriae)Capsule, or Slime Layer
A capsule is a jelly-like coating that surrounds the cells of
certain bacteria.
Chemically, the capsule is composed of a gelatinous polymer of
polysaccharide, polypeptide, or both.Functions:

1.It appears to prevent desiccation (drying) of the organism
under adverse conditions.
2.Capsules often protect pathogenic bacteria from phagocytosis
by cells of the host.
Flagella
Flagella are long threadlike appendages used for locomotion in
certain bacteria.
Bacteria can swim by rotating their flagella.
Structure
The flagellum has three basic parts:
1. The filament, the outer threadlike part composed of the
protein flagellin.
2. Hook – a curved portion attached to the proximal end of the
filament.
3. Basal body – anchors the flagellum to the cell wall and
cytoplasmic membrane.
The structure of the flagellum of bacteria is completely
different from the cilia and flagella of eukaryotic
cells.Mechanism of Movement
In the basal body there is a helical rotor powered by a proton
gradient that pushes the cell by spinning either clockwise or
counter clockwise around its axis.
Axial Filaments

Axial Filaments consist of numerous fibrils that arise from both
poles of the cell and are encased within a sheath.
Axial filaments are found only in the spirochetes. These are
corkscrew-shaped bacteria. One of the best-known spirochetes
is Treponema pallidum, the causative agent of syphilis.
The axial filaments are similar in structure to flagella but
instead of being found outside the cell as flagella are, they are
found inside the cell. They are attached to both poles of the
cell and spiral around the organism between the plasma
membrane and the cell wall.
The function of axial filaments is movement. As they rotate or
contract, the axial filaments cause the spirochete cell to turn in
a corkscrew-like manner.
Pili and Fimbriae
Pili and fimbriae are filamentous projections that extend from
the surface of certain bacteria.
Fimbriae are shorter in length than pili and present in high
numbers. Fimbriae function in the attachment of a bacterium to
a surface. Neisseria gonorrhoeae, the bacterium that causes the
disease gonorrhoeae, uses fimbriae to adhere to the cell it
infects.
Pili function in the process of bacterial conjugation in which
genetic material is exchanged between two bacterial cells. Non-
sex pili also function in attachment of bacteria to surfaces.
The Cell Wall
The cell wall is a semi rigid structure that surrounds the
bacterial cell.

The cell wall protects the cell when it is in a dilute
environment. The high concentration of solute within the
bacterial cell creates a high osmotic pressure that leads to the
entry of water into the cell. The cell wall resists the pressure
created by the inward flow of water preventing the cell from
bursting.
Structure of the Cell Wall
The bacterial cell wall is surrounded by the cell wall, which is
composed of a material called peptidoglycan (also called
murein). Peptidoglycan consists of glycan chains of (poly-N-
acetylglucosamine and N-acetylmuramic acid) cross linked by
way of peptide side chains.
Bacterial cell walls are distinguished from the cell walls
of plants, which are made of cellulose, and fungi, which are
made of chitin. The cell wall of bacteria is also distinct from
that of Achaea, which do not contain peptidoglycan. The cell
wall is composed of S-layers, which can be either protein or
glycoprotein.
The antibiotic penicillin (produced by a fungus
called Penicillium) kills bacteria by inhibiting a step in the
synthesis of peptidoglycan. The Gram Stain
Bacteria can be divided into two large groups on the basis of a
differential staining technique called the gram stain. One large
group is called gram-positive and the other, gram-negative.
Following the gram-staining procedure, gram-positive
organisms will appear purple, gram-negative organisms will
appear pink or red. This staining procedure is based upon
differences in the structure of the cell wall between the two
groups.
Gram-positive bacteria have a thicker peptidoglycan wall. The
cell wall contains polyalcohols called teichoic acids, some of

which are lipid-linked to form lipoteichoic acids. Lipoteichoic
acids link the peptidoglycan to the cytoplasmic membrane.
Gram-negative bacteria contain less peptidoglycan. In the
gram-negative bacteria, a thin layer of peptidoglycan is
sandwiched between the plasma membranes and a second outer
membrane. The outer membrane contains phospholipids and
lipopolysaccharide, lipids with polysaccharide chains attached.
Procedure for the Gram Stain
1.A bacterial smear is prepared and then stained with the purple
stain crystal violet.
2.The slide is washed off with distilled water.
3.The slide is covered with Gram’s iodine, which is a mordant.
The iodine combines with crystal violet to form a compound or
precipitate that remains in gram-positive bacteria, but can be
removed from gram-negative bacteria by washing with ethyl
alcohol.
4.The slide is flooded with ethyl alcohol until the purple dye no
longer appears in the alcohol flowing from the slide. If the
bacteria are gram-positive, they will not be decolorized. The
crystal violet dye will remain in the cells. Gram-negative
bacteria are decolorized by the alcohol, losing the purple color
of the crystal violet.
5.The slide is washed using distilled water, stopping the action
of the alcohol.
6.The bacterial smear is counterstained using the red dye
safranin. Gram-positive bacteria will retain the purple color of
the crystal violet stain. Decolorized gram-negative bacteria will
be stained pink by the safranin.

7.The slide is washed, blotted dry, and allowed to dry at room
temperature.
Microscopic Examination
This slide is examined microscopically. Gram-positive bacteria
will appear purple. Gram-negative bacteria will appear pink.
Structures Internal to the Cell WallPlasma (Cell) Membrane
The plasma membrane is a thin membrane internal to the cell
wall that encloses the protoplasm of the cell.
It is composed of protein and phospholipid molecules.
Functions of the Cell Membrane
1. It controls the transport of most compounds entering and
leaving the cell.
2.Produces a separation of protons (H+) from hydroxyl ions
(OH-) generating a proton motive force. This force is
responsible for driving functions such as transport, motility, and
synthesis of ATP.
Cytoplasm
Cytoplasm is the substance contained within the cell membrane.
Cytoplasm consists mostly of water. Dissolved and suspended in
the water there are many substances including inorganic ions,
nucleic acids, proteins, carbohydrates, lipids, inorganic ions,
and a variety of compounds of low molecular weight.
There are no membranous organelles in the cytoplasm of a
bacterial cell, but there are ribosomes, internal membranes, a
cytoskeleton, and storage granules.

Internal Membranes
In photosynthetic bacteria, internal membranes within bacteri al
cells may serve as a location for photosynthetic reactions.
Unlike eukaryotic cells, bacteria usually lack large membrane-
bound structures in their cytoplasm such as
a nucleus, mitochondria, chloroplasts and the other organelles
present in eukaryotic cells.
Among the best studied of the bacterial organelles are the
magnetosomes, round structures that build magnetic particles
within their lipid bilayer membranes. The organelles allow
aquatic “magnetotactic” bacteria to navigate vertically along the
Earth’s magnetic fields toward the low-oxygen depths in which
they thrive https://www.quantamagazine.org/bacterial-
organelles-revise-ideas-about-which-came-first-20190612/
Tantalizing examples appear in a group of oval-shaped aquatic
bacteria known as planctomycetes. Some species of
planctomycetes contain a membrane-bound organelle called an
anammoxosome, which sequesters a chemical reaction that
produces nitrogen along with toxic intermediaries.
Anammoxosomes act like energy factories for the bacteria,
much as mitochondria do in eukaryotes, though
anammoxosomes do not seem to be remnants of symbionts as
mitochondria are. https://www.quantamagazine.org/bacterial -
organelles-revise-ideas-about-which-came-first-20190612/
The bacterial phylum Planctomycetes has revealed a number of
compartmentalization features. The Planctomycetes cell plan
includes a intracytoplasmic membranes that separates the
cytoplasm into paryphoplasm (an outer ribosome-free space)
and pirellulosome (or riboplasm, an inner ribosome-containing
space).[27] Membrane-bound anammoxosomes have been
discovered in five Planctomycetes "anammox" genera, which
perform anaerobic ammonium oxidation.
https://en.wikipedia.org/wiki/OrganelleCytoskeleton
The prokaryotic cytoskeleton consists of structural fil aments

within the protoplasm. The Cytoskeleton functions in cell
division, or to produce changes in cell shape.
Storage Granules
Storage granules contain phosphate or sulfur.
Magnetosomes are particles of the iron mineral magnetite –
Fe3O4. They allow bacteria to respond to a magnetic field.
Ribosomes
Ribosomes are small granules that are composed of RNA and
protein.
Ribosomes are the site of protein synthesis.
Ribosomes are numerous in the cytoplasm of bacterial cells.
Observation with the electron microscope shows that the
cytoplasm is quite densely packed with ribosomes.
Several antibiotics, such as streptomycin, neomycin, and
tetracycline exert their antimicrobial effects by inhibiting
protein synthesis.
Nuclear Area
The nuclear area, or nucleoid, of bacterial cells contains a
single, long, circular molecule of DNA, referred to as the
bacterial chromosome. This is the cell’s genetic information.
Unlike the chromosomes of eukaryotic cells, bacterial
chromosomes are not surrounded by a nuclear envelope.
Eukaryotic cells have rod-shaped chromosomes containing
linear DNA bound to special proteins known as histones.
Bacteria often contain, in addition to the bacterial chromosome,

small cyclic DNA molecules called plasmids.
Plasmids
Plasmids are extrachromosomal genetic elements; that is, they
are not connected to the main bacterial chromosome.
Plasmids are used to transfer genetic material from one cell to
another. Plasmids can pass from one cell to another cell by
passing through the cell wall. When it enters the cell that
receives it, it introduces new genetic information into that cell.
Plasmids are now used in Genetic Engineering Research to
introduce genetic material into recipient cells.
Endospores
Endospores are highly durable, dehydrated bodies with a thick
wall.
Endospores are formed by bacterial cells in response to harsh
conditions such as lack of food, lack of water, high
temperatures, freezing temperatures, etc.
They are formed inside the bacterial cell wall.
Since one vegetative cell forms a single endospore, which after
germination remains one cell, sporogenesis in bacteria is not a
means of reproduction. There is no increase in the number of
cells.
Endospore formation is important from a clinical viewpoint,
because endospores are quite resistant to processes that
normally kill vegetative cells. Such processes include heating,
freezing, desiccation, use of chemicals, and radiation. Whereas
temperatures above 70º C kill most vegetative cells, endospores

may survive in boiling water for an hour or more. Endospore-
forming bacteria are a problem in the food industry, since some
species produce toxins that result in food spoilage and disease.
Running Head: INTERVENTIONS OF MANAGING
HYPERTENSION
INTERVENTIONS OF MANAGING HYPERTENSION
Rubric
Synthesis Paragraphs are logically sequenced, connect ideas or
overreaching concepts, and are rewritten to present a fluid and
cohesive paper. Synthesis is excellent. The paper organizes
paragraphs in a logical sequence and connects ideas or
overreaching concepts. The paper is well-developed, fluid, and
cohesive.
Criteria Description
Organizational Culture and Readiness Culture, degree of
readiness, challenges to implementation, strategies for
implementation, stakeholder involvement, communication
strategies.
5. 5: Excellent
10.5 points
The organizational culture and readiness are thoroughly
discussed and insight into the organization challenges is
presented. Clear strategies for communication, stakeholder
involvement, and the implementation of the evidence-based
practice project proposal are presented. Thorough explanations
and strong supporting evidence are provided.
Problem Statement (C5.1a)
5. 5: Excellent
12 points

The problem statement is consistent throughout the paper and
concisely describes the issue using strong evidence-based
support to rationalize and justify the problem.
Literature Review
10.5 points
Literature Review
5. 5: Excellent
10.5 points
The supporting literature from the literature review is organized
and synthesized strategically throughout the paper to provide
convincing evidence. The main components of the articles are
used to provide substantial rationale for how the research
supports the PICOT.
Change Model or Framework
5. 5: Excellent
10.5 points
The selected model or framework and its application for the
proposed implementation are thoroughly described
Plan includes setting/access to subjects; timeline; budget and
resources; research design; methods instruments; process for
delivering intervention; stakeholders; barriers and challenges.
(C5.1b)
5. 5: Excellent
10.5 points
The implementation plan is thoroughly described and provides
the details for the various aspects. Thorough explanations and
strong supporting evidence are provided.
Evaluation Plan Plan includes expected outcomes, data
collection tools, statistical test, methods applied to data
collection tool, strategies for nonpositive outcomes, plans for
maintaining, extending, revising and discontinuing proposed

solution.
5. 5: Excellent
10.5 points
The evaluation plan is thoroughly described and provides the
details for the various aspects. Thorough explanations and
strong supporting evidence are provided.
Associated Documents and Appendix includes consent or
approval form; timeline; budget and resource list; method or
instrument; APA Writing Checklist.
5. 5: Excellent
9 points
The resources are accurate and attached in the appendix. It is
clearly evident by the quality of the paper that the APA Writing
Checklist was effectively used in development of the paper
Thesis is comprehensive and contains the essence of the paper.
Thesis statement makes the purpose of the paper clear.
Interventions of Managing Hypertension
Student’s Name
Institution Affiliation
Course Name
Professor’s Name
Date

Organizational Culture and Readiness1Benchmark - Evidence-
Based Practice Project Proposal: Organizational Culture and
ReadinessKieran M. NjobeGrand Canyon University: < NUR-
590><10/27/2021>
Organizational Culture and Readiness2Looking at the discussion
in this case, the specific organization that this paper will choose
is john Hopkins hospital. This specific hospital that is located
in Baltimore in Maryland, is an organization that to a larger
extent does support change in its different areas. Its culture is
specifically accommodative to changes and it is flexible in a
way that it can accept and accommodate the changes. The
organization has certain social norms that are considered to play
a very significant roles in this, the organization has shared
health behaviors and believes that do reflect respect, trust,
opportunities and teamwork for both professional and personal
growth. When it comes to organization and leadership structure,
this is always considered to be blended and this has specifically
contributed to the success of the organization’s mission and
vision (Hnizdo et al., 2017). The engagement of staff members
in any decision that is made by the leaders in the organizatio n
also makes this to be very effective and this also makes
employees to embrace any decisions that are to be made by the
leadership. Employee engagement is one of the thing that
contributed significantly to developing the culture of trust and
respect in all levels of the organization and therefore ensuring
that there is no much friction that is experienced if at any time
change is proposed and implemented. It is therefore these
specific attributes and vales that the organization has in its
mission and culture that makes it to be more accommodative
and flexible to changes that might be presented and proposed

for the better of the patients that the organization is serving in
terms of services being provided.The specific readiness tool that
this paper will select and use in the selected organization is the
capacity assessment tool and the management organizational
stability tools. To begin with the capacity assessment tool is a
tool that is specifically used in the process of measuring the
capacity that an organization has, this helps in doing this by
looking at certain specific areas in relation to this, this includes
organizational management, governance, program management,
Organizational Culture and Readiness3human resources and
finance management (Nwanna-Nzewunwa et al., 2019). This
tool is very important in looking at the efficiency of the
organization in developing and implementing the proposed
practice change. On the other hand the management
organizational stability tools basically looks at what
specifically provides stability to the whole organization,
identifying this will help in ensuring that the organization has a
clear picture on the things that are needed for the proposed
practice to be fully and successfully implemented, things such
as consistency, trust, honesty etc. are things that this specific
tool looks at when it comes to the implementation of the
recommendations that have been described and proposed by the
survey (Amparado & Ocariza, 2020). From the survey that was
done in this case, it concluded and observed that the best way to
ensure that hypertension is lowered is by controlling blood
cholestrol levels. If this is controlled then there will be a
significant improvement in mitigating the risks that are
associated with hypertension. The recommendation that was
therefore made by the research is that to successfully control
the hypertension levels of patients an effective management of
the patients knowledge using effectively enforce treatment
would help in this.The culture of the organizatio n in this case
will support the evidence based practice change presented by
the survey results in that, due to the trust and respect that is
already there in the organization, all the stakeholders and the
employees will have less friction in the process of implementing

this as they will be actively. The main strength of the practice
change is that it involves all the partners that are there in the
organization, this therefore means that, everyone won’t feel to
be left out in the process and therefore this will help reduce any
kind of opposition that usually arise as a result of certain
parties being excluded from the whole process (Amparado &
Ocariza, 2020). However one of the weakness that this practice
change will have is the fact that not all patients with
hypertension will be open to the idea, and since the change is
more optional,
Organizational Culture and Readiness4patients might opt not to
involve themselves in the whole process and therefore might
make the change to be hard to implement (Dearing, 2018). The
timing of the change is however very good as the change just
came at a time when the diagnosis of hypertension is increasing
day in day out and methods of reducing the diagnosis are being
tried, this therefore makes the timing for this to be perfect.To
improve the quality, safety and cost effectiveness of the
organization, some of the healthcare process that would be best
for this include keeping patients healthy through things such as
physical fitness, less use of tobacco and other heathy preventi on
measure (Jones et al., 2019). Also designing ways of detecting
health problems is a healthcare process that will help in
reducing risks and therefore reducing costs in the future.To
better facilitate the readiness of the organization especially
when it comes to hypertension, there are certain strategies that
will specifically help in this, among these include frequent
testing of patients who visit the healthcare facility. The patients
who come for different reasons should always be tested and
examined to see if they are at any risk of being exposed to
hypertension or any cardiovascular diseases (Dearing, 2018).
The organization can also decide to carry out a free screening
initiative in the community that surrounds it and encourage
residents to show up for free testing and examination. Getting
this kind of data will help the organization to be ready to face
any situation that they might face and assign resources that will

help deal with the patients with hypertension.In order to
successfully implement the practice change that has been
proposed in this case, there are certain stakeholders that will be
needed to successfully implement this. The first ones are the
patients who are identified, these are the ones who will
specifically decide as to whether the practice change will be
successful or not, their acceptance will determine if the process
will be
Organizational Culture and Readiness5implemented or not. The
organizational management is also another stakeholder, the
management will help in approving the process and assigning
the resources that will be needed for the implementation of the
same.The information and communication technology that will
be needed in this case will be the Electronic Medical Records,
this is very important when it comes to the documenting the
progress of different patients with regards to their blood
cholestrol levels and blood pressure. The EMR will help in
communicating any issue that might arise and also categorize
the patients according to their seriousness and their
improvements in their different geographical locations. This
will help in delivering care to the patients in a way that
following up on the patients who are at a higher risks will be
easier and this will help in delivering quality services to the
patients with less struggle
Introduction
Hypertension is an adverse physical condition that affects
people in terms of their ability to engage in normal daily
activities. Management of hypertension is critical to promote
conformity to physical improvement procedures that people
engage in since this process can generate balance for people
after providing them with reliable change in their health issues.
The proposed intervention method is use of digital technology
with social cognitive since this shall create an accurate method
of analyzing personal experiences, behavior, and medical
behavior environment. Handling of cardiovascular diseases shall

be possible and improve on quality of the intervention after
promote data usage and increase in positive patient care. Taking
medication is imperative in handling patient conditions based
on the ability to selection suitable medication that can reduce
deaths (Fort et al., 2021). This paper shall provide synthesis of
different data related to hypertension management in the current
health environment. Problem Statement
The problem statement is
Management of hypertension is highly imperative in the current
environment since it requires constant data management after
analyzing patients. It is possible to create a reliable strategy
that improves on productive patient handling. Issues when
handling patients occur due to limited knowledge while
monitoring throughout from the point of admission to the
outcome determination when their vital signs get taken.
Hypertension management is crucial and can get handled
constantly after promoting valid healthcare access.
Improvement of healthcare is possible using engagement of staff
members in any decision that is made by the leaders in the
organization. Such healthcare culture promotes effectiveness
and improves on employees to embrace any decisions that are to
be made by the leadership. Employee engagement in healthcare
environment is significantly incorporated to developing the
culture of trust and respect in all levels of the organization and
therefore ensuring that there is no much friction that might
occur when different providers interact. Handling health values
and specific attributes is important to the organization that has a
mission and culture structured to be more accommodative and
flexible to changes. It can be possible to increase valid health
issues management after ensuring interventions get presented
and proposed for the better of the patients that the organization
is serving in terms of services being provided.Organizational
Culture and Readiness
Patient handling for this project’s purpose shall get performed
at John Hopkins hospital in Baltimore in Maryland which is an
organization that supports change in its different areas. There

can be constant improvement in terms of patient management
after promoting change that is directed at supporting patient
healthcare needs. Strategy reformation is crucial yet can result
in healthcare culture that is accommodative to changes and it is
flexible in a way that it can accept and accommodate the
changes. The organization already boasts of respect, trust,
opportunities and teamwork for both professional and personal
growth. It is possible to handle healthcare organization
improvement after promoting valid management of patient
conditions and reliance on their healthcare needs. The
healthcare environment incorporates organization and
leadership structure, this is always considered to be blended and
this has specifically contributed to the success of the
organization’s mission and vision (Hnizdo et al., 2017). It can
be possible to offer engagement among all healthcare
provides.Literature Review
Integration of management organizational stability tools is
focused on analyzing what specifically provides stability to the
whole organization. Another crucial process is identifying areas
that shall help in ensuring that the organization has a deep
understanding of the things that are needed for the proposed
practice to be fully and successfully implemented. Imperative
things are consistency, trust, honesty, and ethics are things that
this specific tool integrates when it comes to the
implementation of the recommendations that have been
described and proposed by the survey (Amparado & Ocariza,
2020). Since a survey got conducted, it was possible to gain
valid data. From the survey, it was concluded that the best way
to ensure that hypertension is lowered is by controlling blood
cholesterol levels. The critical factor must get incorporated to
ensure valid internal processes of mitigating hypertension risks
that are dangerous for different persons’ wellbeing. Using
current treatment knowledges is crucial since it shall facilitate
control of hypertension for different patient issues.
Improvement of patient knowledge related to the condition shall
create better healing.

Use of evidence-based practice is critical to ensure reliable
change development in the project after learning about how
interconnected components create a valid survey. There can be
constant increase in trust and respect in healthcare
environments after learning how stakeholders and the
employees will collaborate regardless of any personal issues to
promote reliable health improvement. Integration of all
professionals in the healthcare environment shall be possible
and increase reliance when handling healthcare issues and
factors directed to generate change. Exclusion of different
persons when promoting healthcare access is negative but shall
get eliminated using the change tool proposed (Amparado &
Ocariza, 2020). Working with all hypertension patients shal l not
be dependable since some patients might get hostile towards the
idea. Since the change is more optional, some patients’
ignorance might create ineffective handling of the whole
process and thus generate difficulty when dealing with change
development procedures (Dearing, 2018). The timing of the
change is effective since it improves on productive handling of
change that can create a dependable method of increasing
healthcare access with the appropriate resources. Ensuring daily
health improvement is imperative to create feasibility of the
project’s development.
Healthcare process improvement is imperative to handle change
directed at creating reliable patient management. It is possible
to improve quality, safety and cost effectiveness of the
organization after accessing different physical improvement
ideas and using the method to submit impactful change.
Effective methods of handling hypertension can be physical
fitness, reducing tobacco usage, and taking medication as
directed by physicians (Jones et al., 2019). It can be possible to
further detect healthcare issues by learning stuff that trigger
patients and then using the outcome to generate reliable
healthcare improvement methods which reduce risks.
Organizational changes are imperative since they shall create
better access to reforms that are structured to handle impactful

strategies. It can be possible to integrate current strategies
directed at promoting better healthcare access and improving on
better methods of using strategies to increase positive health
outcomes. Quality procedures can include frequent testing of
patients who visit the healthcare facility and creating all
records. Testing all patients who visit healthcare environments
is imperative since hypertension can develop as a result of other
healthcare issues that need to get constantly handled to create
reliable health management and early detection of any
cardiovascular diseases (Dearing, 2018). Creation of free
screening initiatives can encourage members of the public to
use the service since the community will receive impactful
changes. Getting this kind of data will help the organization to
be ready to face any situation that they might face and assign
resources that will help deal with the patients with
hypertension.
Successful implementation of the change that has been proposed
shall involve certain stakeholders that will be needed to
successfully implement the change. Stakeholders involved in the
change are patients, management, and healthcare providers.
Patients who are identified to require hypertension management
will be the ones who shall whether the practice of change will
be successful or not. Patients’ acceptance or hostility shall
determine if the process will be implemented or not. The
organizational management is a key stakeholder involved in
approving the process and assigning the resources that will be
needed for the implementation of the same. In this way, it shall
be possible to increase valid health improvement and access to
crucial resources.
Integration of information and communication technology shall
be required in this case to generate reliable health improvement.
Use of Electronic Medical Records is very important when it
comes to the documenting the progress of different patients with
regards to their blood cholesterol levels and blood pressure. It
is possible to record all crucial data in the process this way
since it produces a reliable method of handling healthcare

dependence and a strong possibility of ensuring change occurs
in the right areas. Communication of different issues in the
healthcare environment shall be possible using the EMR that
promotes valid patient handling procedures. Creating different
categories for patients is the best method of increase accurate
data handling. It shall be possible for the EMR to get used in
many healthcare departments and thus create holistic healthcare
management. Change Model
Excellent outline of the Kotter's change model and the
elaboration on the process for your implementation. Although
the significance is known you have covered various method of
education and reinforcement for the change theory. Unable to
read paper and determine who is implementing change and what
the change is? In proposal for change , I will be using nurses to
implement this changes so try make this connection
The applicable method of improving healthcare access is by
using Kotter’s change model that involves many internal
components which improve on productive handling of
healthcare information. According to Fryar,et al. (2020),
prevalent problem in the healthcare industry hypertension, or
high blood pressure occurs when the pressure in the
bloodstream is above the normal range. Kotter's change model
is applicable when analysing prevalence of the condition and its
impact on nurse professionalism (Mohiuddin,
&Mohteshamuddin, 2020). The condition’s diagnosis can be as
simple as having consistently higher readings than normal.
When a person’s blood pressure levels are consistently high,
one is more likely to suffer from heart disease, heart attack, and
stroke. In this regard, there is importance of implementing a
change model that will; help ensure that the problem is
efficiently addressed.
According to Rajan & Ganesan (2017), Kotter’s change
management plan is imperative to create among all healthcare
providers that interact with patients when they get exposed to
different healthcare conditions. Patient care management is
crucial since it can involve regulatory conditions that support

medical advances structured to improve patient health statuses.
Nurses are imperative healthcare providers since they ensure
patient safety and are involved in disseminating information
among other health care providers. Kotter’s change management
plan is factual since it ensures all professionals assess the
effects of behavioral change and maximize individual abilities
to achieve healthcare goals. There can be a shift change process
which improves on information sharing and improvement of
healthcare goals at all times.
Kotter's change management model can create reliable health
improvement since it incorporates current knowledge related to
patient healthcare access. Kotter's change process provides a
framework for understanding different stages involved in
creating healthcare access and handling environmental health
improvement. Nursing guidance is crucial in management of
patient health conditions since it can improve safety and health
administration. Involvement of leadership and management
teams shall create more reliable healthcare access for patient
populations. It is imperative to handle healthcare access and use
the following steps as provided by Kotter’s change model:
Step 1-Creation of Urgency
According to Carman et al. (2019), there can be improvement in
a healthcare institution's desire for transformation since this is a
critical factor in creating better healthcare access. Involvement
of a lot of drive is crucial to create urgency and zeal in the
organization to improve productivity. As a result, it is possible
to improve the change program's importance and send a clear
message to all stakeholders. Use of information delivery and
creating a sense of urgency for dealing with hypertension shall
offer better handling of the condition. Integration of a clear
explanation of why change is necessary for the organization's
various stakeholders is required to improve reliance on positive
outcomes.
Step 2-Creation of a Strong Coalition
Leadership management is critical to persuade people that
change is highly crucial. Leaders can then get required to guide

directions for change to take place. In this way, it can be
possible to ensure all key stakeholders are fully engaged during
each stage of the change process that promotes dependable
healthcare improvement methods.
Step 3-Creation of a Vision for the Future
Patient health improvement involves ideas and solutions for
dealing with change that can constantly improve expected
outcomes. Creation of a better future and vivid illustration on
how to effectively deal with hypertension will benefit everyone.
After learning about a compelling vision, it shall be possible to
create positive aspects of the change. Problems can develop
when drastic measures such as layoffs or reduced staff get
integrated in healthcare environments. Use of high-quality
communication techniques is imperative since it shall allow
quality methods of delivering messages that serve organizations
and all internal stakeholders.
Step 4-Conveyance of the Vision
Improvement of patient outcomes shall be possible once
interconnected partis get involved in handling healthcare
environment access and a reliable method of ensuring internal
goals get attained. Use of communication is critical since it
ensures constant cohesion with the organizational environment
to improve on productivity for all interconnected healthcare
departments. Using constant repetition is imperative in
healthcare environment since it allows valid access of different
data and a reliable method of ensuring company operations get
understood throughout. Once all stakeholders get involved, it
can be possible to increase productivity and access to accurate
communication data and healthcare information access.
Step 5- Removing Barriers
Staff management is crucial and can become better once they
constantly realize that their motivation is valid for creating
different interconnections among internal operations involved in
healthcare environments. Identification of different processes
for change is possible after checking potential barriers and
finding out how they can create negative outcomes for patients.

It is possible to increase change procedures when different
barriers get known and worked on. The change team must
establish additional rules and processes to deal with unexpected
or forecasted problems.
Step 6-Creation of Short-term Successes
Stakeholders must get connected to ensure successful operations
occur at all times. This procedure is highly imperative since it
conforms to development of an effective basis for handling all
healthcare environment activities. Working with change leaders
is crucial to create victory when dealing with employees who
require change improvement during different periods of time.
Elimination of critics and negative thought processes is crucial
since it shall create an advancement in society. When an
organization gets provided with new techniques of submitting
development, it can be possible to increase quality outcomes.
Step 7- Connecting Different Profitable Outcomes
Kotter’s model noted that change fails due to declaring victory
too early when meaningful and deep change takes time. It is
possible to gain long-term change by constantly analyzing
internal change processes even though they produce short-term
change. After some time, it shall be possible to gain highly
impactful change.
Step 8-Firm Establishment of Change
Implementation of change in all areas is crucial and can become
even more dependable after handling internal organization
development procedures. Change should get constantly
improved on and integrated into organizations since it shall
become an internal norm (Mohiuddin & Mohteshamuddin,
2020). After implementing this, it shall then be possible to
constantly generate productive daily activities which generate a
reliable structure for company activities’ improvement.
Implementation Plan
The proposal does not clearly define what the intervention is
and how you will engage participants. If you could clarify
sections it would be easier to present.. HTN is a killer and
anything to help would be beneficial the patients. This looks

okay to me
Implementation of change in the healthcare environment shall
be possible by using capacity assessment tool and the
management organizational stability tools. Analysis of different
healthcare environments shall be possible and conform to the
capacity assessment tool that gets applied in the process of
measuring the organizations’ capacity for change. It shall be
possible to collect a lot of data in healthcare environments since
it helps by analyzing certain specific areas in relation to this,
this includes organizational management, governance, program
management, human resources and finance management
(Nwanna-Nzewunwa et al., 2019). Integration of knowledge
improvement shall be possible. The tool mentioned is very
important in analyzing the efficiency of the organization in
developing and implementing the proposed practice change.
Hypertension occurs due to increased blood pressure and once
this issue becomes persistent, it can lead to stroke, heart attack,
or heart disease. All healthcare settings need to study
hypertension since this affects reliable health improvement of
all patient conditions. The best process of dealing with
hypertension shall be possible by ensuring that better strategies
of assisting patients in managing the illness are implemented.
The implementation plan shall analyze how medical
practitioners can utilize a digital intervention technique to
develop planned medications to lower their blood pressure. The
study will be carried out within twelve months to allow
adequate information to be gathered. In addition, mixed-
methods evaluation procedures will be used to understand better
the effectiveness of the intervention in primary care. The
following steps are crucial for the implementation plan:
Step 1- Setting Potential Subjects
Registration of hypertension patients in a system of digital
intervention known as Help BP shall be the initial crucial
factor. The system is developed using the social cognitive
theory; and displays personal experiences, people's behaviors,
and individual medical behavior related to environmental

aspects. The system shall focus on hypertension patients with
inactive medical behaviors of managing their high blood
pressure and how their personal lives get affected (Rai. et al.,
2021). Medical practitioners can handle newly diagnosed
patients with hypertension in the system to monitor their
capability to follow the outlined intervention plans.
Step 2-Timeline
Using a period of twelve months shall improve on quality
healthcare access and facilitate productive change improvement
towards all internal healthcare access procedures. The proposed
time shall create better understanding of how the proposed
change can be adequate in different seasons. In a year, all the
necessary information would have been recorded and utilized to
reform strategies of offering medical care to hypertension
patients.
Step 3-Budget
The Budget required for this project is about $15400 that
involves effective communication, stakeholders can be
convinced to make a sufficient amount of donation to meet the
expectations. Allocation to different departments and include all
transactions related to the transportation budget for health care
workers, supplies that have blood pressure machines, PPE, and
other resources. Purchase of different equipment creates a lot of
expenses yet this can get handled by offering healthcare access.
Part of the Budget will be allocated to developing user-friendly
software and can be customized as needed. Data accessibility is
mandatory to allow constant health improvement and handling
of internal activities.
Step 4- Data Collection
Involvement of data from different departments is crucial since
it allows proper information access and reliability when dealing
with healthcare access. The quantitative design will ensure that
numerical values are included in the research. It will allow an
easy understanding of the results from the study and ensure that
generalization operations can be conducted efficiently. The
qualitative design will ensure that questions that the numerical

data cannot explain are put into consideration. It will permit the
project to use questionnaires and surveys to acquire the needed
data. Mixed methods shall get used during the data collection
procedure and improve on constant quality access to
information in the healthcare environemtn while ensuring that
accurate quantitative data is portrayed. Since the project shall
deal with diverse clients, implementation of mixed methods will
help broaden the findings (McManus. et al., 2021). It will allow
analyzing the data that the participants provide deeply.
Step 5-Use of Instruments for Implementation of Proposed
Solution
s
Randomized tests that include health care practitioners and their
daily activities shall be imperative to improve on quality
healthcare access. It is imperative to include data from nurses,
health care assistants, general practitioners, and nurse-
prescribers that interact with patients firsthand. Randomized
controlled trials will allow the study to be monitored closely,
and the extent to which the nurses can provide the needed care
is determined. Use of questionnaires for the clients will help
identify the changes the new system is bringing. It will allow
easy identification of the level at which the proposed solution
has enabled them to change their medical behaviors, such as
taking hypertension medications (Patel. et al., 2021). Working
with a group of 30 practitioners and 30 clients shall be

imperative for the study. They will be selected using the random
probability sampling method to ensure the availability of
participants willing to be part of this study.
Step 6-Techniqe of Delivering the Intervention
Collaboration with healthcare providers is mandatory
since it creates a reliable method of handling healthcare
environment needs. Management of the hypertension condition
requires the health care workers to be willing to offer
substantial information on how to control the illness and the
best medications to use to suppress this pressure. Working with
willing clients is imperative to create dependable health
improvement. To allow efficient and convenient use of the
proposed system, both the clients and the workers will undergo
training to provide them with the confidence to manage
hypertension better. After training, the necessary practices will
be allowed using the prototype of the website.
Step 7-Stakeholders
Stakeholder interactions can create issues for healthcare
environments due to limited possibility of ensuring patient
needs get focused on at all times. The project shall integrate
different practitioners like experts in the medical field, and the
patients (Fort. et al., 2021). The data from these stakeholders
will be used to distinguish the appropriate adaptation of the
implemented change and the non-adherence that could be
present. The processes for medical escalation in responding to

the proposed treatment should explain the positive contribution
of health care practitioners in enforcing procedures of
maintaining normal blood pressure. The implemented change's
practicality is made possible by allowing patients to have
autonomy control of their medical behaviors while ensuring
accessible information.
Feasibility of the Implementation Plan
The implementation plan shall operate effectively after allowing
data access to different areas and creating better health
knowledge improvement. Use of an accurate communication
system should be done by allowing the inclusion of emails and
other social platforms in the system. Improving clients’ health
remotely is imperative to ensure quality healthcare access and
improvement of wellbeing. There is a need to encourage face-
to-face interactions between patients and health care providers
to help further analyze the diagnosis made and determine the
most suited treatment plan. The proposed intervention plan can
be applied to monitor clients' safety while they are away from
the hospital. It should be reinforced by frequent visits to the
medical centers to guarantee the success of the intervention plan
in the long run.Evaluation Plan
Strategies for nonpositive outcomes
Please make sure that there is Plans to maintain, extend, revise,
and discontinue a proposed solution after implementation are

not discussed.
The project completion process shall get determined by a need
for monitoring throughout from the point of admission to the
outcome determination. Creation of interconnected operations
during all internal activities shall generate reliable internal
management and a dependable method of creating healthcare
dependability. Use of different strategies shall be possible and
promote valid access to ideas structured to increase healthcare
access and increase in productivity. The plan can create long-
term productivity as it constantly integrates patient
improvement based on their issues. Hypertension patients can
get supported and improve on reliable handling of their needs
which constantly generate healthcare access. Use of a high-
quality design shall create an accurate internal procedure of
ensuring change gets structure to increase healthcare access.
Nursing care will improve on productive change for all patient
needs and involvement of the healthcare practitioners in
changing the system in a way that allows leveling up on the
change in behavior towards data use in hypertension medication
(Patel. et al., 2021). Nursing care techniques shall get handled
effectively at all times.
Evaluation of different patient data shall be possible after using
accurate data collection procedures. Use of different methods
structured to create information access shall improve on

collection of data about the patients and the healthcare
practitioners. Integration of a mixed method for performing data
collection shall be possible by using qualitative and quantitative
data which shall get improved on the future of healthcare
management procedures. Finding out the success rate of the
project shall be possible by using comparative analysis and
determination of the success rate of the project. Appropriate
data collection tools will include interviews, observation,
survey, secondary data collection, and archival research. Us e of
interviews will be used to get an in-depth understanding of the
opinion in the healthcare fraternity about their feeling about the
use of digital intervention in hypertension medical management.
Collaboration with stakeholders’ involvement in the process
shall be possible and create an accurate method of accounting
for the variables that facilitate the success rate in the
implementation of the intervention.
Analysis of data collected from patients is crucial to determine
reliable health improvement. Use of different steps for
performing tests is imperative to ensure quality health
improvement and reliability when handling cases of reducing
negative health outcomes. Integration of hypothesis and data-
driven interventions is crucial to facilitate productive handling
of hypertension issues. The appropriate hypothesis shall be as
follows:
H0: data-driven intervention would allow for the improvement

of medication in hypertension disease
H1: data-driven intervention would not allow for the
improvement of medication in hypertension disease.
The null hypothesis as a basis of the project shall tested using
existent data. A testing procedure can get performed and
constructed to match the existent health information processes
which improve on quality statistical management of healthcare
data which shall improve on valid healthcare access (Bain &
Engelhardt, 2017). Statistical analyses are crucial to determine
quality increase in positive healthcare management. It is
imperative to handle confidence levels involved in different
healthcare environments since this data is imperative in
handling healthcare environment access and positive outcomes.
When a confidence level is more that 95%, it is possible to trust
all the data collected during research. Management of
healthcare environment factors shall be possible and increase
reliance on the level of healthcare information use and access
procedures. Current systems can facilitate increase in
productive change management and integration of current
research methods for quality heath input. Use of correlation
analysis shall create a better outcome for all hypertension
management activities.
Analysis of historical data on deaths from hypertension in the
healthcare faculty shall generate reliable healthcare increase
and productive outcomes directed at ensuring the entire

healthcare environment operates in high standards. Using the
interventions that have been done before is crucial to determine
valid techniques of addressing hypertension issues that are
common in different areas. Integration of success rate of
previous interventions to determine the conditions and practices
that would improve the outcome of all health improvement
measures. Use of secondary data collection will help in this
aspect by allowing room for analysis of data from populations
that are inaccessible in initial stages. Using this method, it is
possible to create analysis of healthcare issues for persons in
larger demographics.
Analysis of the program is imperative to ensure quality access
of healthcare improvement procedures. Prevention of chronic
diseases that could lead to death is imperative during the
healthcare management process. When using digital
intervention, the development of medication is the end goal
within the twelve months to create strong cohesion positive
health management. Integration of mixed-methods evaluation
procedures is imperative to generate positive outcome
evaluation with the integration of impact evaluation as an
accurate tool (Huber, 2011). After analyzing all these
interconnected components, the outcome evaluation shall
involve:
· Changes that occurred during the participation process and
those that can get measured

· Identification of short-term outcomes of the program
· Creation of the program’s effectiveness for major change
Analysis of the impact evaluation includes, the following
aspects:
· Analysis of long-term changes involved in primary care
· Analysis of how change occurred in very deep methods that
affected improvement procedures during all data management
procedures.
· Analysis of any systemic changes with the degree of
confidence attributed
Analysis of different questions under the evaluation needs, the
randomization will involve a multi-step process with three
aspects that would be used in frequency outcome measures
(McManus et al., 2021). Since most of the outcomes are tied to
the hypertension patients, there will be one after the before and
after the intervention and the potential follow-up after several
months of the intervention. Table 1 below involves different
aspects involved in promoting internal change
Table 1
Intervention Phase
Indicator Monitoring
Expected Outcome
Pre-Intervention
· Suitable hypertension management depending on patient issues
· Type of medication management plan provided by physicians

· Extent to which the management plan promotes positive
healthcare after involving medication
· Cases of hospital admission and readmission after lacking
quality healthcare improvement
· Analysis of patients that developed complications during their
healthcare access procedures
· Use of an analog system for healthcare management
· Limited improvement of medical data management without
accessing accurate data
After Intervention
· Checking to determine change in hypertension management
· Analysis of medication management processes
· Collection of data to determine healthcare environment
success rate after determining medication processes
· Analysis of occurrence of different types of change and their
possibility of occurring
· Cases of patient admission or readmission based on poor
management of healthcare policies
· Number of patients exposed to progressive complications
· Analysis of changes indicates a growing menace on patients’
health
· Medication plans are unique to patient data
· Use of medication plans creates unique healthcare access and
improvement needs
· Handling of different success rates promotes better healthcare

access and management of patient issues
· Progressed hypertension issues can get handled to reduce
cases of hypertension complications and reducing readmissions
Follow Up
· Healthcare practitioners can create better change by involving
in change in medication methods
· Constantly taking qualitative input to improve healthcare
system methods
· Using digital intervention to improve healthcare practitioners’
expertise
· Data management procedures which improve on healthcare
productivity after learning about healthcare access rates
· Integration of healthcare data to create better health outcomes
· Ensuring productive improvement in medical practitioners’
expertise can increase accuracy of handling healthcare
environment needs
· Use of a highly impactful system shall generate a reliable
process of using healthcare system expansion methods structure
to increase quality access at all times

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2
4
Evidence-Based Practice Project Proposal: Evaluation Plan
Kieran M Njobe
Grand Canyon University: <590>
<11/23/2021>
Running head: ASSIGNMENT TITLE HERE
1
Evaluation Plan

Program Evaluation: Interventions of Managing Hypertension
Program Background and Expected Outcomes
Management of hypertension requires a very strategic approach
in such a way that implementation of change or outcome
development is precise and successful, otherwise, it could be
mute. The applicable intervention for this health issue is the use
of digital technology with social cognitive hence a look at the
definition of personal experiences, behavior, and medical
behavior environment. Therefore, the outcome of the
intervention that is presented is to make sure that there is
improvement in the data use to improve patient care and
medication in hypertension patients hence reducing deaths and
CVDs related complications (Fort et al., 2021).
Evaluation Design
The project completion is determined by a need for monitoring
throughout from the point of admission to the outcome
determination. As such, the understanding of the change
throughout the time will be actualized through the utilization of
outcome development within strategy reformation. The long-
term applicability of the design for the evaluation allows for
progressive determination of caregiving to hypertension
patients. Therefore, the evaluation design that would be used in
this project will be randomized tests. The randomization
involved the control of source for bias in a way that allows

confidence in the outcomes from the patients. The aim is to
improve the extent of nursing care and thus the involvement of
the healthcare practitioners in changing the system in a way that
allows leveling up on the change in behavior towards data use
in hypertension medication (Patel. et al., 2021).
Evaluation Needs
The program intends to allow for prevention of the diseases that
could lead to death. In the utilization of the digital intervention,
the development of medication is the end goal within the twelve
months. In this way, the use of mixed-methods evaluation
procedures that would be employed is the outcome evaluation
with the integration of impact evaluation (Huber, 2011).
Therefore, looking at the indicators, the outcome evaluation, the
aspect to consider are:
· Changes that have occurred during the participation process
and can be weighed
· Identification of short-term accomplishment of the program
· Determination of the program effectiveness hence replicable
On the other hand, in looking at impact evaluation, the aspects
to consider are:
· Whether there are long term changes of the primary care
· Examination of the extent of change and reduction of the issue
generally within a given period
· Questioning of the systemic changes with the degree of
confidence attributed

Evaluation Methodology
By considering the questions under the evaluation needs, the
randomization will involve a multi-step process with three
aspects that would be used in frequency outcome measures
(McManus et al., 2021). Since most of the outcomes are tied to
the hypertension patients, there will be one after the before and
after the intervention and the potential follow-up after several
months of the intervention.
Intervention Phase
Indicator Monitoring
Expected Outcome
Pre-Intervention
· Applicable hypertension management
· Type of medication management plan involved
· The success rate of medication management plan involved
· Number of admission and readmission due to poor medication
management
· Number of patients developing progressive complications
· The current system is analog
· Stagnant medical management system without data
After Intervention
· Identification of change in hypertension management
· Type of medication management plan involved
· The success rate of the medication management plan involved
(were there changes over time or did it stick to only one?)

· Number of admission and readmission due to poor medication
management
· Number of patients developing progressive complications
· Changes are noted to be on a growing trajectory
· Medication plans are unique to patient data
· The higher success rate in hypertension management (fewer
changes in plan with time hence improved precision in quality
of care)
· Reduced readmissions resulting from progressed hypertension
complications
Follow Up
· Change in medication behavior by health practitioners
· Use of the system in improving patient care hence qualitative
input
· Number of health practitioners that have integrated the digital
intervention
· Success rate observed in medication management using data
· Increase in use of data for medication management
· Increased system use by medical practitioners with increase
policy is data use management
· Expansion of the system within the institutions and to others
for use by more practitioners
Data Collection Tool
Several methods will be used in the collection of data about the

patients and the healthcare practitioners. By integrating the
different methods in data collection, there would be several
types of qualitative and quantitative data that could be used in
comparative analysis and determination f the success rate of the
project. Such data collection tools will include interviews,
observation, survey, secondary data collection, and archival
research. The interview will be used to get an in-depth
understanding of the opinion in the healthcare fraternity about
their feeling about the use of digital intervention in
hypertension medical management. As such, there is direct
stakeholder involvement in the process while accounting for the
variables that facilitate the success rate in the implementation
of the intervention.
The archival research will be used to look at historical data on
deaths from hypertension in the healthcare faculty, the
interventions that have been done before, and the success rate of
previous interventions to determine the conditions and practices
that would improve the outcome reachability. As such, the
secondary data collection will help in this aspect by allowing
room for analysis of data from populations that are inaccessible
firsthand. It facilitates the comparative element for a larger
demographic to look at a developmental aspect of the
intervention's success.
Statistical Test
The collected data can easily be analyzed using several steps of

testing. Using the development of the hypothesis that data-
driven intervention would allow for the improvement of
medication in hypertension disease. As such the hypothesis
would be:
H0: data-driven intervention would allow for the improvement
of medication in hypertension disease
H1: data-driven intervention would not allow for the
improvement of medication in hypertension disease.
The null hypothesis as a line of belief can be tested and thus a
testing procedure can be carried out and constructed such that
the risk of rejection of the null hypothesis when met is minimal
hence proof of the outcome development (Bain & Engelhardt,
2017). At the same time, it would allow for statistical analysis
in which there would be a look at the quantitative value to be
aware of the Confidence Interval denoted. At a more than 95%
level, the result would be trusted especially with the potential
of inactive medical behaviors in the management of high blood
pressure with the current system. Correlation analysis will be
used to determine the relation of the increase in data usage to
the improvement of healthcare delivery.
Part of the Assignment on Nur 590 week 6
Implementing plan interventions of managing hypertension
Hypertension is one of the most dangerous diseases that
can easily lead to death if not managed. It occurs due to

increased blood pressure, and a continued rise in blood pressure
can contribute to other deadly illnesses such as stroke, heart
attack, or heart disease. Considering the hypertension problem
is expected within the healthcare setting, there is a need to
implement change in dealing with the patients to ensure that
better strategies of assisting patients in managing the illness are
implemented. Therefore, we will discuss how medical
practitioners can utilize a digital intervention to develop
planned medications to lower their blood pressure. The study
will be carried out within twelve months to allow adequate
information to be gathered. In addition, mixed-methods
evaluation procedures will be used to understand better the
effectiveness of the intervention in primary care.
Setting and access to potential subjects
The hypertension patients will be allowed to register in
a system of digital intervention known as Help BP. The system
is developed using the social cognitive theory; it shows personal
experiences, some people's behaviors, and individual medical
behavior environmental aspects. It helps target hypertension
patients with inactive medical behaviors of managing their high
blood pressure (Rai. et al., 2021). Also, medical practitioner s
will seek to involve the newly diagnosed patients with
hypertension in the system to monitor their capability to follow
the outlined intervention plans.
Timeline

To complete this project successfully, a lot of
monitoring is required. It, therefore, means that the project
should take a lot of time to allow all the needed data to be
collected. Carrying out the study for preferably twelve months
will ensure that the project includes all seasons of a year. It will
allow a better understanding of how the proposed change can be
adequate in different seasons. In a year, all the necessary
information would have been recorded and utilized to reform
strategies of offering medical care to hypertension patients.
Budget
Making sure that medical behaviors can be monitored
using the proposed digital intervention will be an expensive
change that requires a lot of human and monetary resources.
There should be adequate finances to help develop the best
efficient system for all end-users, both the patient and the
health care workers. It will ensure that any concerns regarding
medications that the clients consume are directly reported to the
health care practitioners, and the needed responses are passed
along smoothly. There are supplies for measuring blood
pressure that is to be given to the test subjects. Accessing the
required patients' information can be a big challenge to this
project. Therefore there is a need to include consultation costs
for any necessary consultations that are to be made. The Budget
required for this project is about $15400 in Total. With
effective communication, stakeholders can be convinced to

make a sufficient amount of donation to meet the expectations.
This Budget will be allocated to various departments from the
drafted proposed budget/ resource list planner in the Appendix.
This is the first draft and will be modified. The list includes the
transportation budget for health care workers, supplies that have
blood pressure machines, PPE, and other resources. It is quite
expensive because due to the effect of the Covid 19 , I will be
advocating for the use of disposable equipment such as
disposable blood pressure cuffs. Part of the Budget will be
allocated to developing user-friendly software and can be
customized as needed. This is a twelve-month program, and
that's why more resources will also be directed towards Data
accessibility which maybe needs to track and monitor
participants ( with their consent, obviously). See the table in the
Appendix, which will still be modified.
Data collection
Having sufficient data for the completion of this project
requires the utilization of mixed methods of collecting data. The
quantitative design will ensure that numerical values are
included in the research. It will allow an easy understanding of
the results from the study and ensure that generalization
operations can be conducted efficiently. The qualitative design
will ensure that questions that the numerical data cannot explain
are put into consideration. It will permit the project to use
questionnaires and surveys to acquire the needed data. The

subjectivity of the findings will be embraced by using mixed
methods while ensuring that accurate quantitative data is
portrayed. We will be dealing with a vast array of clients, and
therefore utilizing these mixed methods will help broaden the
findings (McManus. et al., 2021). It will allow analyzing the
data that the participants provide deeply.
Methods and instruments of monitoring implementation of the
proposed solution
Randomized tests that include health care practitioners
such as practice nurses, health care assistants, General
Practitioners, and nurse-prescribers will help monitor closely
how efficient the proposed method will be. Randomized
controlled trials will allow the study to be monitored closely,
and the extent to which the nurses can provide the needed care
is determined. Questionnaires for the clients will help identify
the changes the new system is bringing. It will allow easy
identification of the level at which the proposed solution has
enabled them to change their medical behaviors, such as taking
hypertension medications (Patel. et al., 2021). A group of 30
practitioners and 30 clients will be allowed to take part in the
study. They will be selected using the random probability
sampling method to ensure the availability of participants
willing to be part of this study.
Process of delivering the intervention
Health care workers have always been able to use their

educational resources to apply the needed interventions when
handling varying cases with clients. Management of the
hypertension condition requires the health care workers to be
willing to offer substantial information on how to control the
illness and the best medications to use to suppress this pressure.
However, the clients ought to be willing to participate in
implementing the changes they are told by the professional. To
allow efficient and convenient use of the proposed system, both
the clients and the workers will undergo training to provide
them with the confidence to manage hypertension better. After
training, the necessary practices will be allowed using the
prototype of the website. After the
Stakeholder
Challenges in the proposed approaches can be overcome by
ensuring that the obstacles recorded during the process of
studying the results change do not hinder the overall activities.
Among the stakeholders who are included in the project will be
the practitioners, experts in the medical field, and the patients
(Fort. et al., 2021). The data from these stakeholders will be
used to distinguish the appropriate adaptation of the
implemented change and the non-adherence that could be
present. The processes for medical escalation in responding to
the proposed treatment should explain the positive contribution
of health care practitioners in enforcing procedures of
maintaining normal blood pressure. The implemented change's

practicality is made possible by allowing patients to have
autonomy control of their medical behaviors while ensuring
accessible information.
Feasibility of the implementation plan
The study will offer valuable information which will help
establish the best means for managing and treating cases of
hypertension. The implemented plan is only valid when a
patient has confirmed the blood pressure measurements to be
high; the client trusts that the readings offered by the system
can be relied on, and the client can access medical attention
easily. Considering that one has to deal with numerous patients
with various backgrounds, it can be difficult to offer uniform
help because the underlying factors resulting in treatment are
different. The system of recording the blood pressure and
determining the time when one has to take medication can be
easy to the educated and well-informed patients while other
patients with varying educational classification may find it
difficult to understand when to measure their blood pressure
level and the subsequent medications to take (Petersen. et al.,
2021). Carrying out operations such as collecting home readings
of blood pressure levels without following up with the
necessary medical options can be classified as clinical
inactivity. Therefore, the patients must ensure that they record
their blood pressure level readings and take necessary treatment
choices to utilize the proposed change to bring positive

outcomes fully.
Therefore, it is crucial to have a system that has a tow way
interaction capability to ensure that patients can request help
from practitioners and the health care providers can follow up
to ensure medications are taken correctly. Establishing a
communication system should be done by allowing the inclusion
of emails and other social platforms in the system. Helping
clients remotely is crucial in enforcing their medical care
behaviors but cannot be utilized independently. There is a need
to encourage face-to-face interactions between patients and
health care providers to help further analyze the diagnosis made
and determine the most suited treatment plan. The proposed
intervention plan can be applied to monitor clients' safety while
they are away from the hospital. It should be reinforced by
frequent visits to the medical centers to guarantee the success of
the intervention plan in the long run.
References

interventions to improve hypertension management in the
public health care system in India. BMC health services
research, 21(1), 1-11.
Petersen, I., Fairall, L., Zani, B., Bhana, A., Lombard, C., Folb,
N., ... & Lund, C. (2021). Effectiveness of a task-sharing
collaborative
References
Bain, L. J., & Engelhardt, M. (2017). Statistical analysis of
reliability and life-testing models: theory and methods.
Routledge.

Huber, S. G. (2011). The impact of professional development: a
theoretical model for empirical research, evaluation, planning
and conducting training and development
programmes. Professional Development in Education, 37(5),
837-853.
interventions to improve hypertension management in the public
health care system in India. BMC health services research,
21(1), 1-11.
Part of the work on Nur 590
EVIDENCE-BASED PRACTICE CHANGE MODEL
KOTTER'S CHANGE MODEL
Hypertension, or high blood pressure, is when the pressure in
the bloodstream is above the normal range. This is a very
prevalent problem in the healthcare industry (Fryar,et al.,
2020). Diagnosing high blood pressure can be as simple as
having consistently higher readings as normal (or hypertension).

If the blood pressure levels are high, one is more likely to
suffer from heart disease, heart attack, and stroke. This shows
the importance of implementing a change model that will; help
ensure that the problem is efficiently addressed. Kotter's change
model is useful to understand better the prevalence of the
condition and its impact on nurse professionalism (Mohiuddin,
&Mohteshamuddin, 2020). This paper provides a review of
Kotter’s Change Model as a possible model to address
hypertension in healthcare.
An effective solution for changing care approaches can be found
in John Kotter's change management plan (Rajan, &Ganesan,
2017). Some of the proposed regulatory conditions support
medical advances that have a significant impact on patient care.
Nurses are responsible for ensuring patient safety. Nursing
professionals play an important role in disseminating
information among other health care providers. As stated by
Kotter, change management plans must monitor the effects of
behavioral change and maximize individual abilities to achieve
achievable goals. As revealed by the improvement process, the
change management model accommodates the enormous
responsibility for information sharing during the shift change
process. There are numerous learning opportunities for nurses in
Kotter's change management model. Many assumptions are
made in the theory's early stages. Kotter's change process
provides a framework for understanding the multiple stages of

change supported by shareholders and administrators in an
environmental context. Safety and Health Administration serves
as the primary source of nursing guidance. Management and
leadership teams play a significant role in changing how care is
delivered to different populations. The following are the steps
followed:
Creating urgency is the first step in the process.
An institution's desire for transformation is a critical factor in
making it happen, creating a sense of urgency and igniting a fir e
under the organization to get things moving. As a result, we
elevate the change program's importance and send a clear
message (Carman, et al., 2019). A clear explanation of why
change is necessary for the organization's various stakeholders
is required for this to work. Credibility as a change agent is
essential if we are to succeed in instilling a sense of urgency. In
this case, it is vital to start by ensuring that we create a sense of
urgency around the issue of hypertension.
The second step is to put together a strong coalition.
Strong leadership is critical to persuade people that change is
necessary. Leaders are needed to guide the way for change to
take place. Making sure all key stakeholders are fully engaged
throughout each stage of the change process is essential.
Creating a vision for the future is the third step in the process.
Ideas and solutions for dealing with change need to be tied to a
larger vision that people can understand and remember. With an

eye toward the future and a clear picture of how effectively
dealing with hypertension will benefit everyone, a compelling
vision sells the positive aspects of the change. The difficulty
arises when drastic measures such as layoffs or reduced staff
are implemented. Simply because bad news is difficult to
convey, organizations must have a high level of communication
expertise to convey a compelling vision, regardless of the
content of the message.
The fourth step is to convey the vision.
The success of a change project will be determined by what the
organization wants to achieve after creating it, such as
improved patient outcomes, low cost, among others. Everyday
communication within the organization is likely to compete with
this message for attention, so it must be repeated frequently and
powerfully to become embedded in all aspects of company
operations. Keeping everyone informed is critical. Various
change-related topics must be reinforced repeatedly in the
communication strategy.
Removing barriers is the fifth step.
The staff should be motivated to get to work and realize the
benefits that have been touted. We need to plan to ensure
smooth operations by defining process changes and identifying
potential barriers to implementation. The change team must
establish additional rules and processes to deal with unexpected
or forecasted problems.

Create short-term successes
When it comes to leading change, those in charge must provide
all the stakeholders with a taste of success as early as possible
in the process. Change leaders are looking for "quick wi ns" that
employees can see and feel within a short period. As a result,
negative thinkers and critics could jeopardize the advancement
of society. The new culture is anchored in the organization, and
the new norm is established by celebrating victories.
Step 7: consolidating the gains made through the transformation
He claims that change fails due to declaring victory too early
when true and lasting change takes time. Achieving short-term
results is just the beginning of the process of bringing about
long-term change. As a result, he advises not to celebrate too
soon and keep the change momentum going before healthcare
workers get tired.
The final step is to make sure that the changes in the company's
culture are firmly established.
Making changes stick requires that they become part of an
organization's DNA (Mohiuddin,&Mohteshamuddin, 2020). The
vision value must be reflected in the day-to-day activities of the
company.

References
Carman, A. L., Vanderpool, R. C., Stradtman, L. R., &
Edmiston, E. A. (2019). Peer Reviewed: A Change-Management
Approach to Closing Care Gaps in a Federally Qualified Health
Center: A Rural Kentucky Case Study. Preventing chronic
disease, 16. retrieved from: Peer Reviewed: A Change-
Management Approach to Closing Care Gaps in a Federally
Qualified Health Center: A Rural Kentucky Case Study
(nih.gov)
Mohiuddin, S., &Mohteshamuddin, K. (2020). Combination
model for sustainable change by utilizing the Kotter's change

model and the Hersey & Blanchard's leadership model for
improving medication errors reporting. Journal of Medical &
Allied Sciences, 10(1), 25-32. retrieved from:
https://www.researchgate.net/profile/Shaik-Mohiuddin-
3/publication/339241193_Combination_model_for_sustainable_
change_by_utilizing_the_Kotter's_change_model_and_the_Hers
ey_Blanchard's_leadership_model_for_improving_medication_e
rrors/links/5e45bcaa92851c7f7f37a90d/Combination-model-for-
sustainable-change-by-utilizing-the-Kotters-change-model-and-
the-Hersey-Blanchards-leadership-model-for-improving-
medication-errors.pdf
Work from Nur 590
Looking at the discussion in this case, the specific organization
that this paper will choose is john Hopkins hospital. This
specific hospital that is located in Baltimore in Maryland, is an
organization that to a larger extent does support change in its
different areas. Its culture is specifically accommodative to
changes and it is flexible in a way that it can accept and
accommodate the changes. The organization has certain social
norms that are considered to play a very significant roles in
this, the organization has shared health behaviors and believes
that do reflect respect, trust, opportunities and teamwork for
both professional and personal growth. When it comes to
organization and leadership structure, this is always considered

to be blended and this has specifically contributed to the
success of the organization’s mission and vision (Hnizdo et al.,
2017). The engagement of staff members in any decision that is
made by the leaders in the organization also makes this to be
very effective and this also makes employees to embrace any
decisions that are to be made by the leadership. Employee
engagement is one of the thing that contributed significantly to
developing the culture of trust and respect in all levels of the
organization and therefore ensuring that there is no much
friction that is experienced if at any time change is proposed
and implemented. It is therefore these specific attributes and
vales that the organization has in its mission and culture that
makes it to be more accommodative and flexible to changes that
might be presented and proposed for the better of the patients
that the organization is serving in terms of services being
provided.
The specific readiness tool that this paper will select and us e in
the selected organization is the capacity assessment tool and the
management organizational stability tools. To begin with the
capacity assessment tool is a tool that is specifically used in the
process of measuring the capacity that an organization has, this
helps in doing this by looking at certain specific areas in
relation to this, this includes organizational management,
governance, program management, human resources and finance
management (Nwanna-Nzewunwa et al., 2019). This tool is very

important in looking at the efficiency of the organization in
developing and implementing the proposed practice change. On
the other hand the management organizational stability tools
basically looks at what specifically provides stability to the
whole organization, identifying this will help in ensuring that
the organization has a clear picture on the things that are needed
for the proposed practice to be fully and successfully
implemented, things such as consistency, trust, honesty etc. are
things that this specific tool looks at when it comes to the
implementation of the recommendations that have been
described and proposed by the survey (Amparado & Ocariza,
2020). From the survey that was done in this case, it concluded
and observed that the best way to ensure that hypertension is
lowered is by controlling blood cholestrol levels. If this is
controlled then there will be a significant improvement in
mitigating the risks that are associated with hypertension. The
recommendation that was therefore made by the research is that
to successfully control the hypertension levels of patients an
effective management of the patients knowledge using
effectively enforce treatment would help in this.
The culture of the organization in this case will support the
evidence based practice change presented by the survey results
in that, due to the trust and respect that is already there in the
organization, all the stakeholders and the employees will have
less friction in the process of implementing this as they will be

actively. The main strength of the practice change is that it
involves all the partners that are there in the organization, this
therefore means that, everyone won’t feel to be left out in the
process and therefore this will help reduce any kind of
opposition that usually arise as a result of certain parties being
excluded from the whole process (Amparado & Ocariza, 2020).
However one of the weakness that this practice change will have
is the fact that not all patients with hypertension will be open to
the idea, and since the change is more optional, patients might
opt not to involve themselves in the whole process and therefore
might make the change to be hard to implement (Dearing,
2018). The timing of the change is however very good as the
change just came at a time when the diagnosis of hypertension
is increasing day in day out and methods of reducing the
diagnosis are being tried, this therefore makes the timing for
this to be perfect.
To improve the quality, safety and cost effectiveness of the
organization, some of the healthcare process that would be best
for this include keeping patients healthy through things such as
physical fitness, less use of tobacco and other heathy prevention
measure (Jones et al., 2019). Also designing ways of detecting
health problems is a healthcare process that will help in
reducing risks and therefore reducing costs in the future.
To better facilitate the readiness of the organization especially
when it comes to hypertension, there are certain strategies that

will specifically help in this, among these include frequent
testing of patients who visit the healthcare facility. The patients
who come for different reasons should always be tested and
examined to see if they are at any risk of being exposed to
hypertension or any cardiovascular diseases (Dearing, 2018).
The organization can also decide to carry out a free screening
initiative in the community that surrounds it and encourage
residents to show up for free testing and examination. Getting
this kind of data will help the organizatio n to be ready to face
any situation that they might face and assign resources that will
help deal with the patients with hypertension.
In order to successfully implement the practice change that has
been proposed in this case, there are certain stakeholder s that
will be needed to successfully implement this. The first ones are
the patients who are identified, these are the ones who will
specifically decide as to whether the practice change will be
successful or not, their acceptance will determine if the pr ocess
will be implemented or not. The organizational management is
also another stakeholder, the management will help in
approving the process and assigning the resources that will be
needed for the implementation of the same.
The information and communication technology that will be
needed in this case will be the Electronic Medical Records, this
is very important when it comes to the documenting the
progress of different patients with regards to their blood

cholestrol levels and blood pressure. The EMR will help in
communicating any issue that might arise and also categorize
the patients according to their seriousness and their
improvements in their different geographical locations. This
will help in delivering care to the patients in a way that
following up on the patients who are at a higher risks will be
easier and this will help in delivering quality services to the
patients with less struggle.
References
Amparado, M. A. P., & Ocariza, R. D. P. (2020). Assessing the
Health Education and Literacy Needs of Partner Communities.
Retrieved from: https://link.springer.com/chapter/10.1007/978-
3-030-75385-6_26
Dearing, J. W. (2018). Organizational readiness tools for global

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