Staffing, device costs, an escalation protocol and a twelve-month schedule for home blood pressure telemonitoring are set out for one composite rural clinic in the MN690 Unit 9 implementation proposal. Searches like "mn 690 unit 9 assignment example", "mn690 unit 9 sample" and "mn690 unit 9 example" land here.
Program Implementation Proposal: Remote Blood Pressure Monitoring With Nurse-Led Titration for 200 Rural Patients
[Student Name]
Purdue University Global
MN690: Telehealth Application
Unit 9 Assignment
[Instructor Name]
[Date]
The clinic, staffing and all budget figures are composites to be confirmed by the clinic; trials and guidance cited are real.
Executive Summary
About 1,100 of the clinic's adults have hypertension, and roughly 200 have blood pressure above goal on their last two clinic readings. This proposal would enroll those 200 patients in home blood pressure monitoring with cellular cuffs, daily review of readings by a registered nurse and medication adjustment by a nurse practitioner under a titration protocol. First-year cost is estimated at about 156,000 dollars, with partial offset from remote monitoring billing that depends on payer rules revised each year.
Evidence and Adaptation
Self-measured blood pressure monitoring combined with clinical support, such as medication adjustment, counseling or education, has a favorable finding from the federal task force that reviews community interventions (Community Preventive Services Task Force, n.d.). In the HyperLink trial, home telemonitoring with pharmacist case management improved blood pressure control over 12 months compared with usual care (Margolis et al., 2013). In TASMINH4, self-monitoring used for titration lowered systolic blood pressure compared with clinic-based titration, with or without telemonitoring (McManus et al., 2018). HyperLink used pharmacists as case managers; this proposal adapts that role to a nurse practitioner working with a registered nurse, and states the adaptation as untested.
Service Design
Eligibility: adults with hypertension and blood pressure at or above 140/90 on two clinic readings, able to use an upper-arm cuff, not pregnant and not receiving dialysis. Enrollment: 100 patients in month 2 and 100 in month 4. Device: validated upper-arm cuff that transmits readings over the cellular network, so patients without home broadband are not excluded. Protocol: patients take two readings each morning and evening for the first two weeks after each medication change, then twice a week. Readings flow to a monitoring dashboard.
Enrollment and Patient Training
Patients are enrolled at a scheduled clinic visit, where the medical assistant fits the correct cuff size, checks the device against a clinic reading and shows the patient how to rest seated before each reading, with both feet on the floor and the cuffed arm resting on a table at chest height. The patient takes a first reading in the clinic and confirms on the dashboard that it arrived. A one-page card in English, Spanish and Hmong repeats the steps and lists the phone number to call if the cuff stops working or a reading worries them. Patients who cannot manage the device alone may enroll a family member as a helper.
Staffing, Derived From Workload
At 200 enrolled patients, experience from similar programs suggests that about 15 percent will transmit at least one out-of-range reading on a given day, so the RN reviews about 30 alerts daily. At about 10 minutes per alert, including a phone call when needed, that is 5 hours a day, which sets the RN at 0.8 full-time equivalent. The nurse practitioner, at 0.2 full-time equivalent, reviews patients the RN flags for titration, adjusts medication under the protocol and sees patients who need in-person care. A medical assistant at 0.3 full-time equivalent sets up devices, trains patients and troubleshoots transmission failures.
Escalation Thresholds
Systolic reading at or above 180 or diastolic at or above 120: same-day RN call, repeat reading and symptom check. Any reading at that level with chest pain, shortness of breath, weakness, confusion or vision change: advise emergency services, consistent with the definition of hypertensive emergency in current guidance (Whelton et al., 2018). Average of readings above goal for two weeks: NP review for titration. Systolic below 100 or symptoms of low blood pressure: RN call and NP review. No transmission for seven days: medical assistant call.
Budget, First Year
Devices: 200 cellular cuffs at about 120 dollars each, 24,000 dollars. Platform fees: about 10 dollars per patient per month, about 20,000 dollars for the enrollment pattern above. RN at 0.8 full-time equivalent with benefits: about 70,000 dollars. NP at 0.2 full-time equivalent: about 26,000 dollars. Medical assistant at 0.3: about 13,000 dollars. Training and protocol development: about 3,000 dollars. Total: about 156,000 dollars. Revenue: Medicare and some private payers reimburse remote physiologic monitoring and treatment management, but coverage rules and payment amounts are revised annually, so revenue is listed separately as an estimate and not counted against cost until confirmed with the billing office.
Evaluation Measures
Primary: the proportion of enrolled patients whose average home blood pressure is below 130/80 at month 12, compared with the proportion at goal on clinic readings at enrollment. Process: transmission rate, meaning the share of expected readings actually received; time from an out-of-range alert to RN contact; and the number of medication changes made by protocol. Balancing: episodes of symptomatic low blood pressure and emergency visits for any cause among enrolled patients.
Schedule
Month 1: protocol approval, device purchase, staff training. Month 2: first 100 patients enrolled. Month 4: go or no-go review comparing enrollment, transmission rates, alert workload and early blood pressure change with the plan's assumptions; second 100 enrolled if the review supports it. Months 5 to 12: full operation. Month 12: evaluation of the proportion of patients at goal, compared with their baseline.
References
Community Preventive Services Task Force. (n.d.). Cardiovascular disease: Self-measured blood pressure monitoring interventions for improved blood pressure control, when combined with additional support [Task force finding]. The Community Guide. https://www.thecommunityguide.org/findings/cardiovascular-disease-self-measured-blood-pressure-with-additional-support.html
Margolis, K. L., Asche, S. E., Bergdall, A. R., Dehmer, S. P., Groen, S. E., Kadrmas, H. M., Kerby, T. J., Klotzle, K. J., Maciosek, M. V., Michels, R. D., O'Connor, P. J., Pritchard, R. A., Sekenski, J. L., Sperl-Hillen, J. M., & Trower, N. K. (2013). Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: A cluster randomized clinical trial. JAMA, 310(1), 46-56. https://doi.org/10.1001/jama.2013.6549
McManus, R. J., Mant, J., Franssen, M., Nickless, A., Schwartz, C., Hodgkinson, J., Bradburn, P., Farmer, A., Grant, S., Greenfield, S. M., Heneghan, C., Jowett, S., Martin, U., Milner, S., Monahan, M., Mort, S., Ogburn, E., Perera-Salazar, R., Shah, S. A., ... Banerjee, T. (2018). Efficacy of self-monitored blood pressure, with or without telemonitoring, for titration of antihypertensive medication (TASMINH4): An unmasked randomised controlled trial. The Lancet, 391(10124), 949-959. https://doi.org/10.1016/S0140-6736(18)30309-X
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., MacLaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., ... Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065
How this MN690 Unit 9 example is structured
The proposal answers the drawer line's three verbs in order, cost, staff and schedule, after a short evidence section that says what the model borrows and what it changes. HyperLink used pharmacist case managers, so the proposal adapts that role to a nurse practitioner working with an RN and states the adaptation as untested. Staffing is derived from workload rather than asserted: at 200 patients, with roughly 15 percent transmitting an out-of-range reading on a given day, the RN reviews about 30 alerts daily, which sets the full-time equivalent. Escalation thresholds are explicit, a systolic reading above 180 prompting a same-day call and symptoms prompting emergency advice. The budget separates certain costs from uncertain revenue. The schedule includes a go or no-go review at month four, when enrollment, transmission rates and alert workload are compared with the plan's assumptions.
Get an MN690 Unit 9 example written to your instructions
Describe the service you are proposing, the population and the staff available; a budget template, if the course supplies one, belongs with the Unit 9 prompt and rubric. The proposal returns costed, staffed from a workload estimate and scheduled with a go or no-go point, figures bracketed for your organization to confirm. First custom sample free; 24-48h. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
MN690 Unit 9 questions, answered
How detailed should the budget be?
Detailed enough that a manager could check each line: device purchase or lease, platform fees, staff time by role, training and supplies, each with its assumption stated. Exact prices belong in brackets unless a quote exists. Revenue deserves the most caution, since reimbursement for remote monitoring depends on payer rules that change, so presenting it as a range with its conditions is more credible than a single projected figure.
Why cellular devices instead of Bluetooth or Wi-Fi?
Because they transmit without home internet or a paired smartphone. For a rural population with broadband gaps and older patients less comfortable with apps, that choice decides who can enroll. Cellular devices usually cost more and depend on mobile coverage, which the proposal checks against coverage maps. The decision links directly to barriers identified in an access analysis.
Does the proposal need to cite trial evidence?
Yes, briefly and accurately. A remote monitoring program rests on the claim that home readings with clinical support improve control, and published recommendations and trials support that claim under specific conditions. The proposal should note where its design departs from those conditions, such as a different staff role, so approvers know which parts are proven and which are adapted.