Care on Patient Diagnosed with Heart Failure Order Instructions: Review of the Literature

Care on Patient Diagnosed with Heart Failure Details:
Write a paper (1,500-2,000 words) in which you analyze and appraise each of the (15) articles identified in Topic 1. Pay particular attention to evidence that supports the problem, issue, or deficit, and your proposed solution.

Hint: The Topic 2 readings provide appraisal questions that will assist you to efficiently and effectively analyze each article.

Refer to “Sample Format for Review of Literature,” “RefWorks,” and “Topic 2: Checklist.”

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

3 NRS 441v.11R.Module 2_Checklist.doc

Care on Patient Diagnosed with Heart Failure Sample Answers

REVIEW OF LITERATURE

Name

Institution

Adib-Hajbaghery, M., Maghaminejad, F., & Ali, A. (2013). The Role of Continuous Care in Reducing Readmission for Patients with Heart Failure. J Caring Sci., 2(4), 255-267. http://dx.doi.org/10.5681/jcs.2013.031

This article explores the importance of continuous care among patient diagnosed with Heart Failure. According to this article, approximately 20-50% of geriatric patients diagnosed with CHF undergo readmission in 2 weeks -90 days after they have been discharged. This paper explores the impact of post-discharge care in reducing the re-hospitalization rates and in improving patient’s quality of life. The research study is a systematic review, which was conducted to evaluate on studies that have been conducted on CHF follow up care post discharge or patients who had been readmitted. The studies from Gthe google search Engine, SID and Iranmedex databases were evaluated.

The studies evaluated were those conducted from 1995-2013. A total of 21 trials were generated, 16 of which evaluated the impact on home visits, telephone monitoring and patient education before the discharge of patients. A quarter of the studies did not report any reduction on post discharge re-admissions of patients diagnosed with CHF. This paper concluded that the post discharge interventions developed by nurses can considerably reduce the rates of readmissions. Considering the inadequacy of health care resources, using patient education combination method is an effective strategy that can be used to reduce the readmissions incidences among the geriatric population. This article will helps in building up my literature review by providing useful information on the effect of patient education using teach back method among the geriatric population diagnosed with CHF.

Black, J., Romano, P., Sadeghi, B., Auerbach, A., Ganiats, T., & Greenfield, S. et al. (2014). A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: study protocol for the Better Effectiveness After Transition – Heart Failure (BEAT-HF) randomized controlled trial. Trials, 15(1), 124. http://dx.doi.org/10.1186/1745-6215-15-124

CHF is a public health issue which is associated with costly hospitalization. According to evidence based research, transitional care programs do reduce readmission rates. However, the implementations of these transition care programs are faced by various barriers such as financial limitation and inadequate training. The aim of these randomized controlled studies is to evaluate on the impact of these transition care programs of the population which includes establishing interventions such as pre-education of a patient before and after their discharge, and telephone monitoring care as well as telephone nurse coaching. The study methodology is a randomized control study. A total of 1500 participants were used. The participants were above 50 years old and with a history of CHF. The study population was also from a diverse population background. The study reported a significant reduction on hospital readmission and increase in self management among the geriatric population diagnosed with CHF. This paper provides a rich source of information on the best strategies that can be used to improve patient transition care using remote technology as possible.

Chen J, Ross JS, Carlson MD, Lin Z, Normand SL, Bernheim SM. et al. (2012). Skilled nursing facility referral and hospital readmission rate after heart failure or myocardial infarction. Am J Med. 125(1):100. e1–9.

There has been a substantial increase on the number of hospital readmissions of patients diagnosed with CHF. There have been a considerable number of state-level variations in the discharge of skilled nursing facilities. However, there is limited information on hospital level variation of SNF rates and its association with increased re-admission rates. This quantitative research studies was conducted by evaluating the data obtained from fee charges of Medicare patients who had a principal diagnosis of CHF. The study indicated that a shortage of skilled nurses resulted to an increase in readmission rates. However, the article did not explain on the causes of readmission rates.

Dominque, FBI., Aliti, G., Dominguez, D., Rabelo, E., & Clausell, N. (2011). Education and telephone monitoring by nurses of patients with heart failure: a randomized clinical trial. Arq Bras Cardiol., 9(3), 233-239. http://dx.doi.org/Epub 2011 Feb 4.

Studies on nursing interventions in patients diagnosed with CHF reports reduced morbidity and mortality rates. However, there is limited information on intra-hospital education and telephone coaching. This comparative study compared two groups of patients hospitalized with CHF. The intervention group received patient education during hospitalization, which was followed by telephone monitoring and coaching after discharge. The control group only received training during hospitalizations. The patient evaluated the following outcomes including self care knowledge, the levels of CHF, re-admissions rates and the number of emergency visits. The study findings reported a 29% decrease in a number of readmission among the intervention group. This indicated that in-hospital educational nursing intervention benefited the CHF patients by making them understand their disease and effective self management care.

Feltner, C., Jones, C., Cené, C., Zheng, Z., Sueta, C., & Coker-Schwimmer, E. et al. (2014). Transitional Care Interventions to Prevent Readmissions for Persons With Heart Failure. Annals Of Internal Medicine, 160(11), 774. http://dx.doi.org/10.7326/m14-0083

Approximately 25% of the geriatric populations hospitalized with CHF are hospitalized within the first days after discharge. The aim of this study is to assess the comparative effectiveness and challenges of transitional care in the reduction of readmission rates as well as the mortality rates. The paper conducted a systematic review from the CINAHL, MEDLINE, Cochrane library and WHO registry. A total of 47 studies were identified. Most of the studies focused on the geriatric population. Some of the studies reported a 30 day readmission rates. About 65% of all the studies indicated that integration of multidisciplinary programs such as home visiting programs reduced the re-admission rated considerably. The paper recommended that the use of structured telephone support (SOE) and home visiting programs should be integrated in all clinics and by all providers who are seeking to implement the transitional care. This article is important for this capstone project as it will facilitate in the identification of programs that aid in the reduction of the readmission rates.

Gruneir A, Dhalla IA, van Walraven C, Fischer HD, Camacho X, Rochon PA. et al. (2011). Unplanned readmissions after hospital discharge among patients identified as being at high risk for readmission using a validated predictive algorithm. Open Med.;5(2):e104–11

The unplanned hospital readmissions are common among the geriatric population and are very expensive. These readmission rates are preventable if the appropriate strategies of patient education and improvement of self management programs are integrated in the clinics. The aim of this study is to identify geriatric patients at risk of readmission using an alogarithm (LACE index). This aims at evaluating of the index is effective in identifying patients who are at high risk of getting readmissions and to identify the factors that puts the patient at risk, and ways to address these challenges. The study concluded that the use of the LACE index score of 10 is effective in identifying patients who are at high risk, and those who can benefit to maximum after post discharge. Therefore, this is a useful tool that can be used by the healthcare providers to identify patients who would need the integration of the post-discharge interventions.

Hasan O, Meltzer DO, Shaykevich SA, Bell CM, Kaboli PJ, Auerbach AD. et al. (2010). Hospital readmission in general medicine patients: a prediction model. J Gen Intern Med. ;25(3):211–9.

The study conducted to evaluate the effectiveness of training the CHF patient’s family members so that they can support and provide patient home care in order to improve patient’s quality of life and to reduce the readmission rates of patients diagnosed with CHF. This single blinded randomized control study enrolled participants through random sampling. The participants were divided into two groups, the control group and the intervention group. The intervention group had training during and after hospitalization. The study findings indicate that the mean score of the patient’s quality of life reduced in the control group as compared with the intervention at a period of six months. The study concluded that nursing follow up care of CHF geriatric patients improved their quality of life.

Hasanpour-Dehkordi, A., Khaledi-Far, A., Khaledi-Far, B., & Salehi-Tali, S. (2016). The effect of family training and support on the quality of life and cost of hospital readmissions in congestive heart failure patients in Iran. Applied Nursing Research, 31, 165-169. http://dx.doi.org/10.1016/j.apnr.2016.03.005

This paper explores the early indicators patient readmission by using a complex prediction model. The study design is a prospective observation of the population, which involved 10, 496 participants. The study evaluated the number of readmission after 30 days, and grouped the factors into four categories including the health condition, social support, health utilization and socio-demographic factors. After performing a regression study, seven main factors were identified including the patient insurance status, regular physicians and the patient’s marital status. The study indicated that the nurses can utilize the prediction model effectively to identify risk factors for readmission, and use the findings to develop an education plan that targets the patient’s individual needs and challenges. This will help establish the efficient interventions that will help reduce the readmission rates.

Inglis, S., Clark, R., Dierckx, R., Prieto-Merino, D., & Cleland, J. (2015). Structured telephone support or non-invasive telemonitoring for patients with heart failure. Cochrane Database Of Systematic Reviews. http://dx.doi.org/10.1002/14651858.cd007228.pub3

Specialized management of CHF involves the improvement of care and clinical outcomes as well as healthcare utilization. This paper reviews the effect of structured telephone support in a combination of non invasive home telemonitoring on CHF patients care and in comparison of the usual standard of care. The study reported a 55. 1% of the patients under the specialized management improved their medication adherence. This reduced the patient’s risk of all because of mortality as well as the heart related disorders. The interventions indicated significant improvements on the patient’s quality of life as well as the heart failure knowledge as well as self care behavior.

Inglis, S., Clark, R., McAlister, F., Stewart, S., & Cleland, J. (2011). Which components of heart failure programmes are effective? A systematic review and meta-analysis of the outcomes of structured telephone support or telemonitoring as the primary component of chronic heart failure management in 8323 patients: Abridged Coc. European Journal Of Heart Failure, 13(9), 1028-1040. http://dx.doi.org/10.1093/eurjhf/hfr039

Several clinical studies indicates that use of structured telephone support (STS) and telemonitoring have a high potential of helping the nursed to deliver specialized management to patients diagnosed with CHF. However, the efficacy of telemonitoring and STS has not been established. This meta-analysis paper evaluated the existing the randomized control trails (RCTs) by comparing the TM and STS interventions to usual care interventions. The study findings found that the interventions improved the patient’s quality of life, and reduced their costs significantly. The study concluded that key strategies in the reduction of patient readmission rates are by making improvements on patient self care, patient knowledge and improve the patient, functional class.

Kitsiou, S., Paré, G., & Jaana, M. (2015). Effects of Home Telemonitoring Interventions on Patients With Chronic Heart Failure: An Overview of Systematic Reviews. J Med Internet Res, 17(3), e63. http://dx.doi.org/10.2196/jmir.4174

The article explores the impact of post discharge patient education care using telemonitoring and coaching of patients diagnosed with CHF. This systematic review conducted a comprehensive literature search where a total of 15 reviews were published. The studies indicated a 1.4-6.5% risk reduction of all causing mortality and readmission rates. The study concluded that future studies should explore the home monitoring to identify more optimal strategies that it confers effective self management strategies.

Navidian, A., Yaghoubinia, F., Ganjali, A., & Khoshsimaee, S. (2015). The Effect of Self-Care Education on the Awareness, Attitude, and Adherence to Self-Care Behaviors in Hospitalized Patients Due to Heart Failure with and without Depression. PLOS ONE, 10(6), e0130973. http://dx.doi.org/10.1371/journal.pone.0130973

The exacerbation of CHF is influenced by factors such as the psychological factors and other health disorders associated with old age. This paper evaluates the impact of self care education on patient’s adherence, attitude and awareness of CHF patients who are hospitalized. The study findings found those intervention groups have improved scores on patient attitude, awareness and adherence as compared to control groups.

Pandor, A., Thokala, P., Gomersall, T., Baalbaki, H., Stevens, J., & Wang, J. et al. (2013). Home telemonitoring or structured telephone support programmes after recent discharge in patients with heart failure: a systematic review and economic evaluation. Health Technol Assess, 17(32). http://dx.doi.org/10.3310/hta17320

The readmission rates for CHF patients are common among the geriatric population. Research indicates that the integration of remote monitoring and patient education have a potential to deliver effective and specialized care, one that will meet the growing demands for the CHF needs for the geriatric population. Some of the challenges identifies by this study is that there is no a care package such as protocols on communication, staff visits or other resources. This indicated that there are still uncertainties about the effectives of Home monitoring in terms of management of CHF patients. However, the study generalized that where standard care is less good, then, home monitoring strategy should be used.

White, M., Garbez, R., Carroll, M., Brinker, E., & Howie-Esquivel, J. (2013). Is “Teach-Back” Associated With Knowledge Retention and Hospital Readmission in Hospitalized Heart Failure Patients?. The Journal Of Cardiovascular Nursing, 28(2), 137-146. http://dx.doi.org/10.1097/jcn.0b013e31824987bd

CHF is a chronic disease that affects approximately 5.8 million people in the USA. In addition, a further 670,000 are diagnosed with CHF annually, The large fraction of the people diagnosed with CHF are geriatric population. The average readmission days are within 30 days after hospital discharge. Despite the guidelines established on the importance of patient education to avoid readmissions, the most effective strategy of education is still unknown. The aim of the paper is to explore if the teach back method of patient education aids in the reduction of readmission rates. This prospective cohort study found that teach back method of education reduced readmission rates by 8.4 %. The study concluded that the teach back method is an effective teaching method as it helps the patients retain the information for a significantly longer time than patients who had been taught using briefer teaching.

Vedel, I. & Khanassov, V. (2015). Transitional Care for Patients With Congestive Heart Failure: A Systematic Review and Meta-Analysis. The Annals Of Family Medicine, 13(6), 562-571. http://dx.doi.org/10.1370/afm.1844

The paper is a meta-analysis paper conducted to determine the effect of transitional care interventions on the patients diagnosed with CHF. A systematic review was conducted on the following databases including the Medline, EMBASE, Psychinfo and Cochrane. A total of 41 randomized control studies were identified, The study indicated that the integration of Transitional care reduced the readmission rayed by 8-29%. The paper concludes that high intensive training which involves the combination of telephone coaching, telephone follow up and clinical visits reduced readmission risk effectively. Therefore, it is highly recommended that that the healthcare providers should integrate these interventions in their healthcare facility.

Care on Patient Diagnosed with Heart Failure References

Adib-Hajbaghery, M., Maghaminejad, F., & Ali, A. (2013). The Role of Continuous Care in Reducing Readmission for Patients with Heart Failure. J Caring Sci., 2(4), 255-267. Retrieved from http://dx.doi.org/10.5681/jcs.2013.031

Hasan O, Meltzer DO, Shaykevich SA, Bell CM, Kaboli PJ, Auerbach AD. et al. (2010). Hospital readmission in general medicine patients: a prediction model. J Gen Intern Med. 25(3):211–9.

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