prospective system-based matters that emerge during the course of the plan. Fundamentally, to enhance hypertension management by providers requires professional education. The introduction of professional education resources and interventions that utilize the principles of adult learning, along with an interdisciplinary team approach, is expected to maximize the impact on high blood pressure reduction and control. Developing and disseminating best practice guidelines for hypertension is another essential part of professional education. Participating with RNAO in the Nursing Best Practice Guidelines Program has allowed the High Blood Pressure Strategy the opportunity to augment the implementation of best practices for hypertension management across Ontario. We are especially appreciative of the support of RNAO and the tremendous work of the guideline panel, led by Cindy Bolton. We are pleased to be part of this important initiative and look forward to working with RNAO on future nursing best practice guidelines. Terry Coote Manager, Professional Education Heart and Stroke Foundation of Ontario Nursing Management of Hypertension Disclaimer These best practice guidelines are related only to nursing practice and not intended to take into account fiscal efficiencies. These guidelines are not binding for nurses and their use should be flexible to accommodate client/family wishes and local circumstances. They neither constitute a liability or discharge from liability. While every effort has been made to ensure the accuracy of the contents at the time of publication, neither the authors nor the HSFO or RNAO give any guarantee as to the accuracy of the information contained in them nor accept any liability, with respect to loss, damage, injury or expense arising from any such errors or omission in the contents of this work. The views expressed in this guideline do not necessarily reflect those of the Ministry of Health and Long-Term Care. Any reference throughout the document to specific pharmaceutical products as examples does not imply endorsement of any of these products. Copyright With the exception of those portions of this document for which a specific prohibition or limitation against copying appears, the balance of this document may be produced, reproduced and published, in any form, including in electronic form, for educational and non-commercial purposes, without requiring the consent or permission of the Heart and Stroke Foundation of Ontario or the Registered Nurses’ Association of Ontario, provided that an appropriate credit or citation appears in the copied work as follows: Heart and Stroke Foundation of Ontario and Registered Nurses’ Association of Ontario (2005). Nursing Management of Hypertension. Toronto, Canada: Heart and Stroke Foundation of Ontario and Registered Nurses’ Association of Ontario. Nursing Management of Hypertension 2 3 How to Use this Document This nursing best practice guideline is a comprehensive document providing resources necessary for the support of evidence based nursing practice. The document needs to be reviewed and applied, based on the specific needs of the organization or practice setting/environment, as well as the needs and wishes of the client. Guidelines should not be applied in a “cookbook” fashion but used as a tool to assist in decision making for individualized client care, as well as ensuring that appropriate structures and supports are in place to provide the best possible care. Nurses, other healthcare professionals and administrators who are leading and facilitating practice changes will find this document valuable for the development of policies, procedures, protocols, educational programs, assessment and documentation tools, etc. It is recommended that this nursing best practice guideline be used as a resource tool. Nurses providing direct client care will benefit from reviewing the recommendations, the evidence in support of the recommendations and the process that was used to develop the guidelines. However, it is highly recommended that practice settings/environments adapt these guidelines in formats that would be user-friendly for daily use. This guideline has some suggested formats for such local adaptation and tailoring. Organizations wishing to use the guideline may decide to do so in a number of ways: ■ Assess current nursing and healthcare practices using the recommendations in the guideline. ■ Identify recommendations that will address identified needs or gaps in services. ■ Systematically develop a plan to implement the recommendations using associated tools and resources. The HSFO and the RNAO are interested in hearing how you have implemented this guideline. Please contact us to share your story. Implementation resources are available through the RNAO website to assist individuals and organizations to implement best practice guidelines. The following recommendations, based on the best available evidence, provide direction related to high blood pressure detection, client assessment and development of a collaborative treatment plan, promotion of adherence and ongoing follow-up. Detection and Diagnosis Nurses have an important role to play in the detection and diagnosis of hypertension. Often, nurses are responsible for obtaining, recording and reporting a client’s blood pressure.