The Use Of An Education Protocol For Hf Patients And Its Impact On Multidisciplinary Team Members ' Perceptions Of Structured Patient

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

In the UK, reports show that heart failure has been affecting up to 2% of the population, over 900,000 people are living with heart failure, with 63,000 new cases being diagnosed each year (BHF, 2015). It costs the NHS £625 million per year, as a result of the high portion of emergency admissions, readmission and long length of inpatient stay (NHS Improvement, 2010). DH (2000) confirmed that Heart failure accounts for all cardiac admissions and the readmission rate can be as high as 50% within 3 months; also, it further estimated 50% readmission might be preventable. Unfortunately, Heart Failure can’t be cured, but early

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

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) core measures in relation to Heart Failure (HF) was examined using empirical-based nursing research. Findings suggest that lack of understanding by nurses contributes significantly to the privation of core measure implementation. A significant number of Americans suffer from HF, so patient quality of care assessment was necessitated. Identifying factors were: nurse-patient education resulting in follow-up appointments, left ventricular performance or left ventricular systolic (LVS) function, treatment medications, and smoking cessation programs. Nurses provide an important role in the education of patients with HF. The Nurse is integral in providing documentation in relation to LVS. Nurses play an important role in the administration of HF medication. Smoking, a major cause of HF, requires special nursing intervention. Nursing results in improved quality of care if HF core measures are implemented properly. Additionally, Orem’s universal requisites are fundamental in the nursing process.

Each year the number of readmissions of the heart failure patient within 30 days of discharge has grown. The Medicare division in relation with the Affordable Care Act is reducing the amount of money they are willing to pay for readmissions to the hospital. Hospitals are now more than ever looking for ways to reduce the number of readmissions to the hospital for the heart failure patient. The purpose of this paper is take a look at a program designed with to reduce the readmission rates of one hospital to reduce the number of readmission through improved education and follow up of the heart failure patient.

PICOT question: In elderly patient with congestive heart failure, how adequate multidisciplinary education compare with lack of education could reduce hospital readmission rates over a 6-month period? The research questions are: Does multidisciplinary education help elderly patient with CHF to adequately manage the disease at home? Does improve knowledge in the disease could decrease hospital readmissions in CHF patient? The hypothesis states that multidisciplinary approach and proper patient education will decrease readmission rate in elderly patients with CHF. The purpose of the study seeks to articulate the problem of lack of education for older patients with congestive heart failure regarding how to manage

Patient education is a must in this population, since many have limitations when it comes to lifestyle choices. An area I feel the heart team does an excellent job in addressing. As for their health literacy levels, since these clients have lived with their complex cardiac condition most of their lives, I believe their, or family’s, health literacy is relatively high. Most understand the severity of their disease and how it affects most other aspects of their lives. When it comes to an exercise regimen or planning a family, their cardiac health plays a key factor. Although, there are those minority with secondary mental disabilities that are at higher risk of errors in self-care, but what

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,

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.

With heart failure, increasing in incidence in the United States, hospital readmission rates are being scrutinized to save money, especially for Medicare beneficiaries. Over 5 million people in the United States are living with heart failure, defined as “a condition in which the heart cannot pump enough blood and oxygen to support other organs in the body” (CDC, 2013). Heart failure affects 2.4% of the United States population with nearly 12% of both women and men 80 years and older having heart failure (Heidenreich, P. A., Albert, N. M., Allen, L. C., Bluemke, D. A., Butler, J., Morrow, G. C., Ikonomidis, J. S., et al., 2013). Heidenreich et al (2013) project that by 2030, heart failure will affect over 8 million Americans, with 2 million of those being ages 80 years and older. Heart failure is one of three conditions to be included in the Centers for Medicare and Medicaid Services (CMS) reimbursements that hospitals are penalized for if the hospital experiences an excess amount of readmissions within 30 days of the initial hospitalization due to the disease.

Improving outcomes in heart failure and interdisciplinary approach concentrates on how to live with heart failure. The editors of the book have provided information to those who read the book to have a better quality of life, treatment and effective education for the patient and family. The book entails information for a patient suffering from heart disease to explore other avenues than pharmaceuticals. The main goal of the editors is to educate heart failure patients to be able to manage their disease (Moser and Riegel, 2001).

Koelling, Johnson, Cody, & Aaronson (2005) performed a study to discern if a discharge education program would improve clinical outcomes in patients with chronic heart failure. The study used a randomized, controlled trail of systolic heart failure patients. The effect of a 1-hour, one-on-one teaching session with a nurse educator was compared with the standard discharge process. The number of days hospitalized or dead in the 180-day follow up period was significantly lower for the education group (1554 days) than for the control group (2103 days). The combined end point of death or rehospitalization occurred in 64% of control and 47% of education patients, with the time of first hospitalization or death significantly lower for the education group. The combined end point of rehospitalization or death was reduced in the patients exposed to the education intervention by 35% compared to the controls. For this group there was also a 51% reduction in the need to be rehospitalized due to heart failure. The program was also effective in reducing costs per patient. The reduction in rehospitalizations in the education group led to saving $2823 per

“With shorter hospitalizations and high patient loads for both physicians and nurses, discharge planning is often hurried and incomplete” (Balaban, Weissman, Samuel, and Woolhandler, 2008). After reviewing national surveys regarding hospital discharge, they found that only 50% of patients with congestive heart failure received any sort of written instructions at the time of discharge. Other information revealed most patients were unaware of their discharge diagnosis, misunderstand the use of new medications, and receive insufficient discharge care, all of which are major contributors to hospital readmissions (Balaban et al., 2008). They proposed a similar model with the same goals and their findings supported the use of some sort of designated discharge coordination that connects the hospital and community, they were able to divert a significant number of revisits to the hospital for issues that had already been addressed and patients were simply uneducated regarding their condition or proposed treatment plan. Another study where the hospital set up an actual discharge clinic reported that in the first six months of operation they were able to “reduce emergency room visits and readmissions for targeted patients by 68%” (Beresford, 2011).

As the largest providers of health care in the United States, nurses are the drivers of that quality. For example, in my own role as director of a home health agency, I know there is huge drive to decrease the number of hospital readmissions in our patient population. This is due in part to the focus measures and data collection required and reported by CMS to include 30 and 60 days re-hospitalization rates (Centers for Medicare and Medicaid, 2017). Education programs have been implemented which focus on patients with diagnoses of heart failure, COPD, pneumonia, myocardial infarction and HTN. The education programs strive to instruct patients and caregivers on the

Heart failure (HF) is one of the leading public health concerns in America (USA), as well as, globally, with an occurrence of over 23 million worldwide, 5.8 million in the USA and increasing. HF causes extensive debility and deaths and poses a heavy burden on the healthcare system, costing USA, over $32 billion in treatment and management annually (Bui, Horwich, & Fonarow, 2011). The aim of this paper is to evaluate how Lenz & Colleagues’ Theory of Unpleasant Symptoms (TOUS) can be utilized in the nursing practice to enhance HF patients and home care-givers’ knowledge on early symptom identification and management. The goal is to reduce hospital re-admission, morbidity and death rates in the HF population. Literatures have illustrated how improvement of HF self-management through receipt of adequate education may have a positive effect on morbidity, reduce hospital re-admission rates and increase better health outcomes (Vincent, Mutsch, 2015). Therefore, the nurses’ responsibility is to provide current, and evidence based (EB) HF self-management teachings or educational materials for home use to patients and families. An overview of the state science was conducted using four pertinent and current articles. Lenz’s TOUS is the theoretical underpinning applied in this project.