NURS FPX 8004 Assessment 1 Professional Practice Report

As pressure in the arteries that move the blood from the heart to the lungs rises, the blood is not able to flow through them, and they cannot be as effective at delivering oxygen to the body—this is called pulmonary hypertension (PH) and can also result in poor health outcomes. (E) This condition can be associated with a number of underlying disorders, including conditions affecting the lungs, heart, and liver, and is associated with connective tissue disorders and some chronic infections. While the PH can happen to people of all ages more often seen in people with autoimmune diseases, those living at high altitudes, and those with congenital heart problems. While still hard to detect early, better management is difficult, but reducing the susceptibility by modifying other risk factors, such as systemic hypertension, chronic respiratory diseases, and smoking, is possible. There is no cure; the treatment consists of treating the symptoms with pharmacologic treatments, supplemental oxygen and diuretics. The level of public awareness and understanding, early diagnosis, and specific management strategies will be essential to improving the outcomes and Quality of Life of individuals with the PH issue.

From the practice setting, patient reported outcome measures (PROMs) and staff comments revealed the following issues related to a delay in the diagnosis and variable management of PH: (1) difficulties with recognition, (2) burden of the disease (physical and mental), and (3) issues related to treatment. During the period of January 2023 to March 2024, 39% of all the patients with PH were in the critically ill group, where the delay of diagnosis was more than 20% (it is important to note that this diagnostic delay is at least 2 times more than the international benchmark suggested by the American Thoracic Society in 2024). The data revealed that those diagnosed later were, on average, in the ICU for 9.2 days while those diagnosed timely were in the ICU for 5.6 days. Not having a standardized screening tool for the ICUs and not having a uniform application of evidence-based interventions were identified as a concern by the nursing staff (personal communication, Executive Nurse, 15th April 2026). The lack of practices is a significant missed opportunity to either timely identification of children at risk and/or proper treatment of children.

While multidisciplinary team management is encouraged in American Thoracic Society (ATS) and European Respiratory Society (ERS) guidelines, it is recognized that practices with such functionality aren’t necessarily in place (ATS, 2024). This is not an isolated problem, as the mean of less than 30% of patients arriving in an ICU with PH receive the correct treatment in the first 48 hours after the start of PH treatment (Zuin, 2024). A delay in diagnosis has been proven to have a negative impact on patients’ quality of life, prolong the length of stay, and cause a cost to the health care system. As the stays are lengthy, and often indefinite, in the presence of the patient and the family, along with the invasive, diagnosis disrupting nature of the process in general, the impact on the family is deep and distressing. Advanced, consistent outcomes and compliance with best practice standards should be the primary goals of an early diagnosis and interdisciplinary approach quality improvement program (QIP) to be implemented at the health care service. There will be standardized procedures in the first instance, and the program will take this form from there on.