Heart Failure : A Debilitating Syndrome That Has Driven Up Health Care Costs

A literature review of nurse – guided patient –centered heart failure education programs reveal that several studies have recommended strategies to promote improved outcomes for heart failure patients by placing emphasis on education focused on promoting patient self-care management in regards to diet, exercise, weight monitoring, and medication adherence (Baptiste, Mark, Groff-Paris, & Taylor, 2014, p. 53). Heart failure self-care refers to all of the practices in which patients engage to maintain their own health and the decisions that they make about managing signs and symptoms. Hospital initiatives working to improve heart failure readmission rates should implement a patient education program that focuses on self-care. To make it easier to manage the heart failure population at any given time, all patients presenting with heart failure should be admitted to a specific inpatient ward, and daily nursing huddles should be utilized in order to identify heart failure patients. All heart failure patients should be educated by the nursing staff throughout their stay by specialty nurse educators who are themselves educated on heart failure treatments and protocols. The research concluded that implementing standardized patient education programs that focus on self-care management

Providing patients diagnosed with Congestive Heart Failure effective teaching can eliminate reoccurring hospitalizations. Patients are discharged with CHF and readmitted within 30 days. The information provided will examine the process of enhancing patient knowledge and provide additional resources essential for effective health care management. Research evidence provides data that proves patients who are diagnosed with CHF needs a variety of health care needs during admission and after discharge. The proposal will display an evaluation plan, implementation plan and a dissemination of the

Evaluation is the final and often the most critical step in evidence based research and practice. Evaluation of evidence based practice follows a pathway beginning with the selection of the area for improvement, synthesizing the research into a process improvement activity and evaluating both the implementation of the process improvement as well and the outcomes of the intervention (Titler, 2008). To measure the results of process change in the management of heart failure patients a retrospective analysis will be conducted comparing the readmission rates of a pilot and control population over a 6-month period. The pilot population will be evaluated with the LACE index readmission risk assessment upon admission and subsequently receive the recommended interventions based on the risk stratification. In comparison, the control group will receive the current process of telephonic contact only. The pilot group will include patients over the age of 18 residing in zip-codes 45402 and 45403,

Heart failure (HF) is a debilitating condition that has become a public health problem. There are many debilitating effects of HF for many people that have to live with this disease. According to Hardin and Hussey (2003), recognize inadequate patient education, poor symptom control, and insufficient social support as factors that contribute to preventable HF related hospitalizations (p.p.74). Many people are frequently hospitalized because of HF exacerbation related to lack of knowledge, poor quality of life and medication non adherence. This research proposal determines the effect of Advance Practice Nurse led telephone intervention in the community and how their phone calls would improve the outcomes of patients with Heart Failure. This proposal identifies variables and measurement levels, research methodology and conclusion. The results of the research studies will support the idea that Advanced practice nurses has a positive impact on patients with HF, decreasing HF related hospital admissions and improving their quality of life.

Literature suggests that nurses may not be knowledgeable in self-management by patients with heart failure. Sterne and her colleagues (2014) conducted a study to assess nurse’s knowledge of heart failure by reviewing test scores and evaluating the 30-day readmission rate for patients with heart failure before and after the educational program. The conclusion of this study was that the nurses gained knowledge from the program and the 30-day readmission rate for patients with heart failure decreased (Sterne et al., 2014). Educating providers will have a positive impact of patient

During exacerbations of Congestive Heart Failure (CHF), older patients may receive care in multiple settings; often resulting in fragmented care and poorly-executed care transitions. The negative consequences of fragmented care lead to duplication of services; inappropriate or conflicting discharge instructions, medication errors, patient/caregiver anxiety, and increased costs of care. In light of changes in Medicare reimbursement penalizing hospitals with above set limits for heart failure (HF) readmissions, models of care are being evaluated for their effectiveness in satisfying this change as well as reducing fragmented care in this population. This paper reviews the Transitional Care Model created by Dr. Mary Naylor at the

Based on Goodman and Fuller (2015), it was estimated that the annual population in the United States with (CHF) congestive heart failure is about five hundred fifty thousand, and approximately five million male and female elderly individual (65 years old and above) is the leading cause of hospital admission. Moreover, heart failure has a significant twenty percent of an estimated death rate and fifteen percent survival rate of patients diagnosed with CHF (Bocchi, Vilas-Boas, Perrone, Caamaño, Clausell, Moreira et al., 2005; Hunt, Abraham, Chin, Feldman, Francis, Ganiats et al., 2005).

In a small study, symptom data was collected through a web application regarding symptoms of CHF that identified improvement of symptoms through self-management (Dorsch, Farris, Bleske, & Koelling, 2015). Utilizing the data collected in the telehealth program would provide clinicians with data on weight, blood pressure, medication use and oxygenation (Appendix A). In the CHF telehealth intervention, patients provide self-care based on the provider instructions at discharge and through office visits. Studies have shown that self-management is a major element of CHF management (Lee, Lennie, Warden, Jacobs-Lawson, & Moser, 2013). Patient-perceived low QOL is a major predictor of mortality and evaluating the CHF telehealth interventions utilizing qualitative survey data will help guide any revisions in the plan of care (Hoekstra et al., 2013). The Minnesota living with heart failure questionnaire (MLHFQ) is a widely used tool in healthcare that assesses the patient’s perception of the effects CHF has on their life (Munyombwe et al., 2014). Monitoring telehealth data and QOL survey components would provide data on improvement of CHF care both from a clinical perspective as well as from a patient perspective.

management have been shown to help reduce the number of readmissions with the key topic being the education of the patient (Hobbs et al., 2016). In designing this program to reduce the readmission for the heart failure patient a review of the literature was completed and follows.

A great amount of time, money and resource is devoted to improving the transition to home from hospital in the heart failure patient (Qaddoura, Ashoori, Kabali, Thabane, Haynes, Connolly & Spall, 2015). With extensive research available on heart failure and readmission, this study will focus on four main categories. This four category approach allows the clinician to best formulate and prepare for practice in the outpatient setting. The four categories will include various articles based upon evidenced based practice approaches with ultimate goal of reducing admission by implementing successful outpatient care. The four categories are as follows: Frequent monitoring or reporting to the PCP; Medication and Diet compliance; Predictors of

Heart failure is a condition that weakens the heart muscles and makes it very hard for the body to circulate blood. It affects over five million Americans and is one of the leading causes of death. Out of the five million, five-hundred thousand die each year. Only 5,000 out of the millions of cases actually receive a heart transplant, which is the best way to treat the disease. This means that most people with heart failure never receive the treatment they truly need. Now, doctors in Texas have found a treatment that doesn’t rely on a transplant, which are few and far between.

“About 5.8 million people in the United States have heart failure. The number of people who have this condition is growing. Heart failure is a leading cause of hospital stays among people on Medicare” (National Heart, Lung, and Blood Institute, 2012). It is very common in individuals who are 65 years old or older, overweight people, and children with congenital heart defects. Heart failure is a chronic condition characterized by the heart’s inability to pump enough amounts of blood rich in oxygen and nutrients throughout the body in order to meet its needs.

1a. Study Problem-The cost of heart failure in the united states was 37.2 million in 2009 and expected to rise to 69.7 million by 2030, mainly due to readmissions. Heart Failure readmissions are preventable if patients have better self-management skills. Programs using multidisciplinary teams and in-person communication have shown to lead to fewer HF readmissions. Patients can learn about medication adherence, sodium intake, and self-care skills. (Smith et al., 2015, p. S25)

I agree with your statement that “self-care and outpatient treatment will reduce hospitalization for patients” with heart failure. When I worked as a manager at Sub-acute rehab, I encountered many patients with a diagnosis of heart failure that were lacking self-care and outpatient treatment. In that circumstance, they were re-admitted to the hospital multiple times when they went into heart failure exacerbation. At home they had difficulty breathing, their lower extremities were so swollen that they couldn’t put their shoes on and they were scared. After acute care they were referred to my unit for a rehab and in that case, I placed a referral to a Palliative Care team for a chronic disease management and comfort care. According to “Palliative

Heart disease affects the lives of many individuals throughout the world. The therapeutic education for patients with heart failure trial targeted to decide whether a pragmatic education intervention in general practice could advance the quality of life of patients with chronic heart failure compared with routine continuation (Vaillant-Roussel et. al, 2016). The setting of this randomized study took place in fifty-four different general practices in France. The participants of the study included 241 male patients, with an average age of 74