The Effectiveness of a Training Program for Advanced Practice Nurses in the Philippines on the Care of Patients with Primary Hypertension

Abstract

Background: The same problems of access to health care due to inadequate and inequitable distribution of human resources for health continue to be present in countries worldwide, including the Philippines. However, these conditions have not stimulated the development of the role on advanced practice nursing (APN) in the country, despite hypertension (HTN) being a prevalent public health problem that can be addressed at the primary care level. Nurses, being the most numerous health professionals, can be trained to fulfill this deficiency. Objective: This study aimed to determine the validity and effectiveness of the investigatordesigned HTN training program for advanced practice nurses. Methods and Design: This was one group, pre-test-post-test design, involving nursing clinics for wellness in a government-subsidized university, located in Manila, the Philippines. Out of the 28 masters-prepared nurses who consented, 24 participants completed the training program and answered the post-training instruments; the majority were females, with a mean age of 32.42 years (standard deviations [SD] = 8.397) and mean the clinical experience of 5.84 years (SD = 3.503). A panel of six experts reviewed and validated the seven modules for the HTN training program. It consisted of lectures, demonstration sessions, small group discussions, oral examination, skill performance evaluation, and clinic visit with a demonstration, totaling 32 h of in-person training. Participants took the written examinations before and after the training program. Results: The expert panel determined that the module content covered the learning objectives adequately. After the training program, the total knowledge score of the participants increased from 33.00 points (SD = 5.25) to 43.08 points (SD = 43.08), which was statistically significant (t = −11.245, P < 0.001). Furthermore, self-efficacy scores increased significantly (t = −6.187, P < 0.001), from 8.08 points (SD = 1.16) to 9.06 (SD = 0.69). Conclusions: The validated HTN training program module effectively equipped the masters-prepared nurses with the required knowledge, skills, and attitudes in providing entry-level APN care for patients with primary HTN, addressing the competencies outlined by the National Organization of Nurse Practitioner Faculty in the United States. Since the positive outcomes on the nurse participants translated to the patient outcomes seen in the advanced practice nurse-led HTN Clinic done after this study, the competencies included in the training program modules should be integrated into the country’s master’s degree curriculum in Adult Health Nursing to provide adequate preparation for entry-level APN care.