1. HYPERTENSION IN DIABETES OUR TEAM APPROACH PRESENTED BY: MARK ROSENBERG, MD KATHY GLANCY, RN,CDE MEGAN CONVERSE, MA

2. TEAM MEMBERS PROVIDERSPROVIDERS NCMNCM MEDICAL ASSISTANTMEDICAL ASSISTANT FRONT DESKFRONT DESK

3. SETTING THE EXPECTATION EMPOWER THE TEAM TO SPEAK TO PATIENTSEMPOWER THE TEAM TO SPEAK TO PATIENTS Meaning of “blood pressure”Meaning of “blood pressure” Risks of uncontrolled hypertensionRisks of uncontrolled hypertension NutritionNutrition Low sodium dietLow sodium diet Exercise and weight lossExercise and weight loss

4. FHSM THE STAFF MA, RN, AND MD MEET WEEKLY TO DISCUSS PATIENTS.MA, RN, AND MD MEET WEEKLY TO DISCUSS PATIENTS. THE STAFF PARTICIPATES IN MONTHLY MEETINGS TO REVIEW MEASURES AND WAYS TO FIND IMPROVEMENT.THE STAFF PARTICIPATES IN MONTHLY MEETINGS TO REVIEW MEASURES AND WAYS TO FIND IMPROVEMENT. MA / DOCTOR BREAKFASTS MONTHLY FOR EDUCATIONAL PURPOSES.MA / DOCTOR BREAKFASTS MONTHLY FOR EDUCATIONAL PURPOSES. INSERVICE ON MOTIVATIONAL INTERVIEWING.INSERVICE ON MOTIVATIONAL INTERVIEWING.

5. RN ROLE RECEIVES REFERRALS FROM PHYSICIANSRECEIVES REFERRALS FROM PHYSICIANS RN ROLE IS TO EDUCATE PATIENTS REGARDING HTN, DIET, AND HEALTHY LIFESTYLE CHANGES.RN ROLE IS TO EDUCATE PATIENTS REGARDING HTN, DIET, AND HEALTHY LIFESTYLE CHANGES.

6. RN ROLE EVALUATION OF THE PATIENT:EVALUATION OF THE PATIENT: REVIEWS MEDICAL HISTORY, LABS, AND CO-MORBIDITIES. REVIEWS HEIGHT, WEIGHT, BMI, AND BP. DIET HISTORY, PHYSICAL ACTIVITY, PSYCHOSOCIAL ISSUES READINESS TO CHANGE

7. TEACHING METHODS AND TOOLS DASH DIET/ VEGETARIAN OPTIONSDASH DIET/ VEGETARIAN OPTIONS CAFFEINE / ALCOHOLCAFFEINE / ALCOHOL READING A FOOD LABELREADING A FOOD LABEL HIDDEN SALTS IN FOODSHIDDEN SALTS IN FOODS INSTRUCTION AND HAND-OUTS FOR HYPERTENSION(5 TH GRADE READING LEVEL)INSTRUCTION AND HAND-OUTS FOR HYPERTENSION(5 TH GRADE READING LEVEL) FAST FOOD GUIDE (BD)FAST FOOD GUIDE (BD) MEDICATION INSTRUCTION, AND ASSESSING INTERACTIONS WITH FOODS AND OTHER MEDICATIONS.MEDICATION INSTRUCTION, AND ASSESSING INTERACTIONS WITH FOODS AND OTHER MEDICATIONS.

8. TEACHING METHODS AND TOOLS HOME BP MONITORING IF WILLING AND PRESCRIBED BY MD.HOME BP MONITORING IF WILLING AND PRESCRIBED BY MD. INSTRUCTION IN CORRECT TECHNIQUES FOR MONITORING. (HANDOUT PROVIDED)INSTRUCTION IN CORRECT TECHNIQUES FOR MONITORING. (HANDOUT PROVIDED) REFERRAL TO YMCA HEALTHY LIFESTYLE PROGRAM IF INTERESTED.REFERRAL TO YMCA HEALTHY LIFESTYLE PROGRAM IF INTERESTED.

9. MA ROLE VITAL SIGNS COMPLETED ON ALL PATIENTS AND COMPARED TO PREVIOUS READINGS.VITAL SIGNS COMPLETED ON ALL PATIENTS AND COMPARED TO PREVIOUS READINGS. USE OF OPEN-ENDED QUESTIONS TO INITIATE DISCUSSION WITH PATIENTS.USE OF OPEN-ENDED QUESTIONS TO INITIATE DISCUSSION WITH PATIENTS. THE MA THEN USES THE PATIENT’S ANSWER TO FOCUS ON EDUCATION SUCH AS DIET, SODIUM, WEIGHT.THE MA THEN USES THE PATIENT’S ANSWER TO FOCUS ON EDUCATION SUCH AS DIET, SODIUM, WEIGHT.

10. MA ROLE MEDICATION RECONCILIATIONMEDICATION RECONCILIATION CHECKS LAST REFILL DATE FOR PATIENT COMPLIANCE.CHECKS LAST REFILL DATE FOR PATIENT COMPLIANCE. DOCUMENTS IN SOAP NOTE ANY CHANGES AND IF ABLE DISCUSSES NEW ISSUES WITH MD PRIOR TO HIM SEEING THE PATIENT.DOCUMENTS IN SOAP NOTE ANY CHANGES AND IF ABLE DISCUSSES NEW ISSUES WITH MD PRIOR TO HIM SEEING THE PATIENT.