Wellness Programs: Disease Management Essay

Nearly 5.1 million people in the United States have been diagnosed with heart failure. Yet so many people don’t have a clue what it is until they have been diagnosed with it. Congestive Heart Failure, or CHF, is a disease that has many symptoms, can be tested and treated, has several causes, and can be avoided.

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,

Clinical coordinators would oversee the process to monitor for safety, quality, recruitment, and retention of patients in the program. The patients would receive detailed instructions and protocols on how to make calls daily, report vital signs, weight, and answer questions about their health and symptoms of heart failure. (Chaudrey et al., 2010). Results would then be transferred via a secure network connection. The providers could then evaluate the data to identify and manage early signs of decompensation, and to make recommendations on patient care. Providers could also provide patient education to help patients understand their discharge instructions and medications. (Inglis et al., 2011).

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.

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

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.

Congestive heart failure (CHF) is a type of cardiovascular diseases. CHF occurs when the efficiency of pumping the blood in the heart is decreased, which means it can no longer function properly. CHF is a prevalent disease, according to CDC, "About 5.7 million adults in the United States have heart failure" [1]. People with CHF may experience wheezing or persistent coughing, nausea, which is a lack of appetite, increased heart palpitations, and shortness of breath that is also named dyspnea. CHF has four stages, each one describes the risk factors, symptoms of CHF, and structural disorder. The stages of CHF disease sometimes can be treated. However, if CHF is not treated from the early signs, it will develop from one stage to another until

Heart failure is a chronic, debilitating disease affecting 5.1 million Americans. It is the most common cause of hospital admissions for Medicare beneficiaries, and is the diagnosis associated with most readmissions (Sterne, Grossman, Migliardi, & Swallow, 2014). Lower quality of life is experienced by patients with heart failure. Mortality rates remain high with about 30% of patients dying within the first year after diagnosis (Vellone et al., 2013). In the U.S. heart failure has become a major public health concern. The number of annual hospitalizations for individuals with heart failure increased from 2.4 million to 3.6 million from 1990 to 1999 (Veroff et al., 2012). Therefore, it is imperative to develop interventions to better

The author also uses images to help understand the topic how CHF happens more efficiently. Further more in the article the author discusses how the nurses should manage CHF representing what medications are important elements of CHF treatment, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptors blockers (ARBs), which the are key medication in managing CHF. Further more William & Wilkins (2012) indicate that diuretics are another class of medication that plays a major role in the treatment of CHF. The article also discusses other options that are available for patient whose condition is not under control, such as medical devices: pacemakers and other devices that can be implanted. For patient that in there last stage of CHF, the author suggested that palliative care and or hospice

CHF is the most frequent diagnosis at initial discharge that results in readmission. In 2009, Medicare began publicly reporting hospitals risk-standardized, all 30 day readmission rates among fee-for-service beneficiaries discharged after heart failure hospitalization from all United States acute care hospitals. That same year the average 30 day readmission rate for Medicare patients diagnosed with CHF was 21.2 %. Readmission rates six months post discharge are estimated around 44 %. Noncompliance with medication contributes to 65 % of patients admitted with exacerbation of CHF. It has been estimated that one quarter to one third of exacerbation of CHF admissions are preventable. A prior analysis of MedPac reported that 76 % of readmissions were preventable (Jencks, Williams, & Coleman, 2009). Variations in estimates of this proportion may reflect variances in the quality of care; it is also a result of subjective criteria used to demonstrate an avoidable readmission. The association between

Heart disease is the leading cause of death in the United States and the estimated cost of treatment is $32 billion yearly. Approximately 5 million people living in the United States suffer from congestive heart failure (CHF) and half of those diagnosed will die within 5 years. The quality and length of life for someone suffering from heart failure can be improved with early diagnosis, medication, physical activity, and diet modification (CDC, 2013). Congestive heart failure continues to account for more health care cost and readmissions than any other illness. The increase in the prevalence of CHF is contributed to the percentage of elderly population. Adherence to performance measures can increase patient outcomes (Mazimba, Grant, Parikh, Mwandia, Makola, Chilomo, Redko, & Hahn, 2012).

For patients with existing symptoms of heart disease, the nurses role may include helping to identify risk factors and lifestyle habits that have led to the disease, as well as obtaining and documenting vital signs and diagnostic tests used to determine the extent of the disease. Education on identification of significant symptoms and the proper subsequent actions will play a major role in the patient’s ability to advocate for themselves and help them determine when it is necessary to seek care. Nursing responsibilities in caring for a patient already experiencing chronic heart failure, like the one being discussed in this review, include specialized cardiac monitoring, monitoring of vital signs and major organ function, post-procedure care, assessment and care of surgical incisions, administration of medications, managing patient anxiety and compliance, and patient education. Discharge is perhaps the most critical educational opportunity for nurses dealing with HF patients. The level of patient self care and symptom recognition and management after discharge is a significant factor relating to the prevalence of readmittance to the hospital and death in HF patients (Barnason, Zimmerman, and Young, 2011). Barnason, Zimmerman and Young (2011) reveal that one of the factors affecting the compliance with self care actions by heart failure patients is the amount of nurse directed

Health promotion and disease prevention is a fairly new trend designed to preserve the health of Americans based on a public-private partnership (Williams & Torrens, 2008). Preventative care must be contemplated ahead of time, even when no symptoms are present (WFR, n.d.). Being educated and actively practicing preventive care is the best way to prevent diseases in the first place.

In year 2000 and 2010, an estimated 1 million hospitalizations for Congestive Heart Failure (CHF), of which most of these hospitalizations were for those aged 65 and over, the share of CHF hospitalizations for those under age 65 increased from 23% to 29% over this time period (Hall, Levant, & DeFrances, 2012). According to Held (2009), acute decompensated heart failure (ADHF) ensues when cardiac output fails to meet the demand of the body’s metabolic needs. The fluid volume overload makes the unstable condition necessitates instant treatment for the reason that it impairs perfusion to systemic organs, endangering their function.