The Failure Of Congestive Heart Failure

"Reducing 30-Day Readmissions for African Americans with Congestive Heart Failure by improving health literacy through a Comprehensive Context Oriented Discharge Plan”

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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

Congestive Heart Failure (CHF) patients and their consistent trending of hospital re-admissions continue to threaten quality care and patient quality of life. Considered a chronic condition, CHF is diagnosed in approximately 13% of patients 85 or older (Clarke, Shah & Sharma, 2011). Re-admissions have become so prevalent among the CHF populations, that Centers for Medicare has initiated a quality campaign and offers incentives when hospitals implement telemedicine programs and show reduction in CHF hospital admissions. In relation to CHF, Conway, Inglis, and Clark (2014) states that, “Telemedicine involves transmission of physiological data, such as weight, … from the measuring device to a central server via telephonic, satellite,

A resident at the time saw that although there is a hearty amount of evidence that illustrates that adhering to heart failure guidelines decreases the rate of mortality and morbidity, nationally there is modest adherence to heart failure practice guidelines. Doctors have voiced a multitude of reasons to this poor participation including but not limited to time constraints in a visit, inertia of patterns in practice, lack of awareness and lack of acceptance are a few. This new web-based tool, the “Smart” Heart failure sheet is designed to help connect previously compartmentalized information. It seeks to link guidelines to their patients’ clinical and laboratory characteristics and systematize adherence to heart failure guidelines. It accomplishes this by uploading pertinent patient-specific data, including laboratory and imaging results, procedure reports and relevant medications. Additionally it also provides tools, such as a flow chart for diuretic dosage and weights. Overall this tool is useful to help physicians identify patients who may benefit from a treatment. From there it provides support tools that alert the physician to a personalized medical treatment. The “Smart” Heart Failure Sheet acts as a registry for scholarly research and also provides educational resources to expand providers’ knowledge, thereby improving patient care (Battaglia,

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

• What is the role of specialist heart failure nurses in the interdisciplinary team in managing improving outcomes of heart failure patients?

One of the most important aspects of treating a patient with heart failure is providing an ample amount of education and counseling to both the patient and their family. It is essential that the patient understands the importance of participating in their treatment regimen and that it is a lifelong commitment that they must actively be involved with in managing their care (Hinkle & Cheever, 2014, p.800).

Approximately 2-3 million Americans, more than one percent of the population, are currently affected by this medical problem with numbers increasing frequently (Drug Store News, 1997). Congestive heart failure tends to be more common in the elderly, men, and also African Americans. Congestive heart failure has become the most common cause for current hospital admissions. Among causing prolonged hospital stays congestive heart failure has a very high mortality rate, which has declined since recent medical advancements.

When an immediate intervention is required, Tele-health Access Centre nurses can conduct live 2-way video consultations directly with patients in their homes using PHD Medical's Tele-visit system. With an Internet connection and a Tele-visit terminal installed in the patient's home, the nurses can communicate with the patient over live video and use integrated medical devices to evaluate his or her condition quickly and effectively.

A 72-year-old male patient is being seen for a hospital follow-up visit. He was discharged 1 week ago after a 3-day stay for an exacerbation of congestive heart failure. He has a history of CAD and dilated cardiomyopathy, with a left ventricular ejection fraction (LVEF) of 0.30 (30%). You note he has been hospitalized for the same problem 3 times in the last 8 weeks. While performing his history and physical, you learn he has not been taking his diuretic as directed because it makes him go to the bathroom all the time and it disrupts his sleep. He also is not taking the prescribed beta-blocker because it makes him sleepy.

Many factors can have a robust effect on how healthcare is standardized, such as heart failure (HF). HF, a chronic illness, results when the heart is unable to pump the required amount of blood to meet the body demands (Centers for disease and control and prevention [CDC], 2016). HF is prevalent in 5.7 million adults in the United States (US) and financially impact the nation in cost estimating at 30.7 billion dollars a year (CDC, 2016). HF is the most expensive diagnosis and common source of hospitalization among individuals 65 and older (McClintock et al., 2014). In addition, if adequate discharge planning is not provided, it may result in hospital readmissions which will economically affect the reimbursement rate from healthcare payors.

Many times you’ll be told that the patient is in congestive heart failure (CHF) which is a poor diagnoses, in my experience many times, no one person has actually evaluated the patient. And the feeding tube is still running.

The Centers for Medical Services’ financial reimbursement penalties on hospitals for readmissions that are higher than set targets called for immediate measures for quality improvement and reduction of hospitalizations for heart failure patients. Sixty-minute patient education was provided two times a week for inpatients incorporating updated written material and teach-back method. After one-year, 30-day readmission dropped significantly as the 60 minutes patient education improved. This article is helpful as it explains a direct relationship between 30-day readmissions and education provided to patients, but causality cannot be assumed.