Hospital Congestive Heart Failure

The prevalence of congestive heart failure is on the increase both in the United States and all over the world, and it is the leading cause of hospitalization in the elderly population. Congestive heart failure is a progressive disease generally seen in the elderly, which if not properly managed, can lead to repeated hospital admissions or death. Heart failure means that the heart muscle is weakened. A weakened heart muscle may not be strong enough to pump an adequate amount of blood out of its chambers. To compensate for its diminished pumping capacity, the heart may enlarge. Commonly, the heart's pumping inefficiency causes a buildup of blood in the

Heart failure is a chronic, progressive condition in which the heart muscle is unable to pump enough blood through to meet the body 's needs for blood and oxygen. Basically, the heart can 't keep up with its workload. American Heart Association Statistics (2016) reveals that heart failure accounts for 36% of cardiovascular disease deaths. Projections report a 46% increase in the prevalence of Heart Failure (HF) by 2030 by affecting over 8 million people above 18 years with the disease. Healthy People 2020 goals are focused on attaining high quality longer lives free of preventable diseases, promotion of quality of life, healthy development and healthy behaviors across all stages of life (Healthy People 2020, 2015).

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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,

Mr. Javier Escobar, U.S Army Veteran, 50-year-old Latino male and divorced claiming to “not having anyone in his life due to Combat Post Traumatic Stress Disorder”. Mr. Escobar is a newly patient diagnosed with Congestive Heart Failure (CHF). Patient claims to smoke 1 pack of cigarettes a day, also the consumption of 1 bottle (750mls) per night of alcohol. Congestive Heart Failure is due to Chronic high blood pressure that puts great stress on the heart muscle. The muscle of the heart weakens and fails to push the normal amount of blood around the body leading to Congestive Heart Failure. There are multiple symptoms that could by identified before heart failure such as anxiety, restlessness, cyanotic (blue

Congestive heart failure is a chronic condition that is responsible for the highest number of hospitalizations among adults. Readmission rates after hospitalization also remain high, with 50% of patients being readmitted within 6 months of discharge. (Desai & Stevenson, 2012). The Affordable Care Act penalizes hospitals with readmissions within 30 days after discharge, making readmissions a focus of hospitals nationwide. Several factors including discharge planning, patient education, diet restrictions, and early follow up appointments can help to reduce readmissions, but continuous monitoring is necessary to catch early signs of decompensation. (Desai & Stevenson, 2012).

Rising health care cost and stricter regulations for insurance reimbursement plans have pushed health care leaders to re-evaluate health care services. One focus is reducing hospital readmission rates for chronic disease process (Bos-Touwen et al, 2015). Congestive heart failure is one of the leading causes of hospital readmission (Cubbon et al, 2014). Fifteen million people worldwide have a diagnosis of CHF. In addition, 15-20% of those with the diagnosis of CHF are hospitalized yearly (Sahebi et al, 2015). In 2010, 40 billion dollars was spent on health care needs for CHF patients. Seventy percent of the resources were for hospital services (Siabani, Driscoll, Davidson, and Leeder, 2014). The need for streamline healthcare for CHF patients is imperative to improve overall patient outcomes and reduce the amount of hospital readmission rates.

Congestive Heart Failure is when the heart's pumping power is weaker than normal. It does not mean the heart has stopped working. The blood moves through the heart and body at a slower rate, and pressure in the heart increases. This means; the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body or by becoming more stiff and thickened. This only keeps the blood moving for a short while. The heart muscle walls weaken and are unable to pump as strongly. This makes the kidneys respond by causing the body to retain fluid and sodium. When the body builds up with fluids, it becomes congested. Many conditions can cause heart

Heart failure (HF) is defined as a multifaceted clinical syndrome that can result from any structural or functional cardiac disorder that impairs the ability of the ventricle to fill with or eject blood. In HF, the heart may not provide tissues with adequate blood for metabolic needs, and cardiac-related elevation of pulmonary or systemic venous pressures may result in organ congestion1. In the United States, HF is increasing in incidence with about 5.1 million people suffering from HF and half of people who develop HF die within 5years 2. Over 75% of existing and new cases occurred in individuals over 65 years of age, < 1% in individuals below 60 years, nearly 10% in those over 80 years of age. HF costs the

Individuals with end stage decompensated congestive heart failure (CHF) will often be admitted to the hospital when complications arise. This is often the case because treatments (such as intravenous medications) needed to deal with the various complications of CHF require interventions that need to be administered by a team of medical staff with close monitoring of the patient. According to the CDC website report Hospitalizations for Congestive Heart Failure: United States 2000 -2010, 5.8 million people suffer from CHF in the United States, and hospitalization rates for individuals under the age of 65 with CHF increased significantly from 23% to 29% with rates for men higher compared to women. Fluid retention that is unresponsive to oral diuretic treatments is one of the most common situations that lead to a hospital admission (Austin, Hockey, Williams, & Hutchison, 2013). Detecting early signs of decompensated heart failure could help reduce the need for a hospital admission and improve the quality of life for those with end stage CHF by allowing treatment to occur in the home setting that might normally be provided in the hospital

Congestive heart failure (CHF) is a syndrome that occurs when the heart cannot pump sufficient blood to meet the tissues metabolic and oxygen needs. As a result, intravascular/ interstitial volume overload and poor tissue perfusion occurs. An individual with heart failure experiences reduced exercise tolerance, a reduced quality of life and shortened life span. The most common cause of heart failure is coronary artery disease (CAD). The incidence of heart failure increases with age. Approximately 1% of people over the age of 50 and 10% of people over the age of 80 experience heart failure. The prognosis depends on underlying cause and response to treatment. Heart failure may be classified according to the side of the heart affected.

Nonsurgical treatment usually involves medications such as diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs), nitrates, digitalis, potassium, aspirin, calcium channel blockers, blood thinners, and beta blockers. Some surgical treatments include pacemakers, implantable cardioverter defibrillators (ICDs), intra-aortic balloon pump, ventricular assist devices (VADs), an implantable artificial heart, angioplasty and coronary bypass surgery, heart-valve surgery, heart transplantation, and myocardial replacement therapy. Some alternative medicines include antioxidants, homocysteine metabolism, magnesium, taurine, carnitine, essential fatty acids, diet, herbs, acupuncture, massage, biofeedback, and

As I reflect on the information system that we utilized in the Congestive Heart Failure telemonitoring program, this system was specifically designed to transmit the patient's biometric data from wireless scales and blood pressure monitors via a wireless hub to the nurse's dashboard for monitoring set parameter to alert. If a specific alert was triggered, the nursing staff reached out to the patient via telephone to determine first if the alert was correct and then second to follow up on how the patient was feeling. Thereby, nursing care wisdom was demonstrated. According to the American Nurses Association ( 2015), "nurses' decision making can be described as an array of choices that include specific behaviors, as well as cognitive processing

According to the Heart Foundation (2010), “Best-practice management of chronic heart failure (CHF) involves multidisciplinary care” (p. 3). A care coordinated with his different physicians including cardiologist, pulmonologist, and referring physicians, as well as clinical nurses, and dieticians will be an important step in Mr. P’s CHF care. As they are concerned about the mobility outside of their home, a telephonic follow-up after discharge from the hospital, and door delivery of medicines could be beneficial. It is also very important to help him to overcome his polypharmacy. Since Mrs. & Mr. P seem emotionally weak, they need emotional support to cope up with the situation. They are worried about the heaping medical bills. Provide information about the possibility of getting qualified for Medicaid/Medicare as well as grants from organizations like Patient Access Network

Congestive heart failure is a chronic disease that requires daily monitoring and life style management. Affecting the elderly, and their family the adjustment is a challenge. Daily life skills include the monitoring of daily weights, intake and output, and a low sodium diet. The person with congestive heart failure is generally admitted to the hospital for medication adjustments when their symptoms increase. The patient is often times short of breath, with a decrease in energy and an increase in their weight. The patients are generally elderly 60-65 years of age or older, and when comparing African Americans to Caucasians the African Americans have a 1.5 greater chance of developing heart failure ("Heart Failure," 2017). The