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A Sociomaterial Analysis Of Team-Based Care For Patients With Advanced Heart Failure, Allan Glen Mcdougall

Electronic Thesis and Dissertation Repository

This dissertation explores team-based care for patients with advanced heart failure (HF), especially care practices associated with integrating palliative care. Its three integrated articles explore advanced HF care as a team-based health care phenomena, focusing on both objects and people as integral for team activity. The dissertation utilizes the theoretical framework of sociomaterialism to explore the overarching research question: how do materials mediate and influence the integration of palliative and cardiac care for patients with HF? Study data take the form of 15 team sampling units (TSU), each of which consists of a patient interview and an interview with at …

Exploring Personal Growth In Individuals Living With Heart Failure, Kristen Jayne Overbaugh

Nursing ETDs

This exploratory study described levels of personal growth and examined relationships among personal growth, demographic, clinical, and cognitive factors in a convenience sample (N = 103) of community-residing adults with New York Heart Association (NYHA) functional class II-IV heart failure (HF). The study was guided by Mishels reconceptualized uncertainty in illness theory and Tedeschi and Calhoun's post-traumatic growth model. The following research questions were addressed: (1) Do adults living with NYHA class II-IV HF report personal growth following their diagnosis of HF? (2) To what extent are age, sex, ethnicity, disease severity, time since diagnosis, symptom status, and uncertainty levels …

The Impact Of Self-Care Education On Heart Failure Patients With A High Risk For Readmission, Neil Williams Ii

Nursing Theses and Capstone Projects

The purpose of this Capstone Project study was to answer the question: Does self-care education improve knowledge and decrease 30 day readmission rates in a class of heart failure patients that are at high risk for exacerbation? The study used a randomized control design with a pre-test/post-test. A convenience sample of 50 African Americans diagnosed with heart failure were entered; control group (n=25) and experimental group (n=25). Both groups received the Heart failure Pre/Post Test developed by the researcher during the initial interview and four weeks post discharge. The experimental group received a phone call weekly over the four weeks …

Perceived Social Support And Self-Care In Patients Hospitalized With Heart Failure, Lyne Chamberlain

Electronic Theses and Dissertations

Problem: Heart failure is the most frequent cause for hospital readmissions in Medicare recipients, with an estimated annual cost of $12 billion. Heart failure hospitalizations are also an independent risk factor for increased mortality. Self-care, thought to be enhanced by perceived social support, is key to managing this syndrome, and up to 50% of readmissions are considered the result of inadequate self-care. Purpose: To evaluate perceived social support and self-care characteristics of patients hospitalized with an exacerbation of heart failure, and to compare these characteristics with a study of ambulatory patients with heart failure. In addition, to assess the relationship …

Evaluating The Effectiveness Of A Heart Improvement Toolkit Program: A Pilot Project, Cheryl L. Mitchell

Doctor of Nursing Practice Projects

Heart failure (HF) is a chronic, debilitating disease resulting in over one million hospitalizations with an estimated 30.7 million dollars in total health care cost per year (Go et al., 2014). Evidence shows that HF education programs that promote adherence to pharmacological and non-pharmacological provider recommendations are effective in reducing 30-day HF recidivism rates, increasing self-care behavior, and decreasing adverse clinical events. The purpose of this evidence-based project was to implement the Heart Improvement Toolkit (HIT) Program which is a one-on-one, comprehensive HF-specific education program, for patients with a HF diagnosis who have been admitted to non-cardiac specialty units. Program …

Home Telehealth In Heat Failure Patients, Tanna R. Thomason

Dissertations

Aim: Technology holds a great potential to improve the quality of health care delivery. The use of remote patient monitoring, or telehealth (TH), has been widely adopted by many home care agencies to facilitate early identification of disease exacerbation, particularly for patients with chronic diseases such as heart failure.

Rationale: TH has been successfully utilized by agencies to improve symptom detection and potentially reduce rehospitalization rates. Quantifying program effectiveness through data analysis is a critical step for program improvement, resource allocation, and future strategic planning.

Methods: Utilizing the OASIS-C database, a retrospective analysis was conducted examining 22-months of heart failure …

Thirty-Day Readmission Rates For Total Joint Arthroplasty In Florida Hospitals: Are Most Due To Surgical Complications Or Comorbid Conditions?, Shirley Simpson Harkey

MUSC Theses and Dissertations

Hospital readmission reduction is the focus of many policy makers and healthcare providers to reduce the health care costs and improve quality. CMS initiated the Hospital Readmissions Reduction Program (HRRP) in October 2012. Financial penalties have been exercised for excessive readmission rates after heart failure, acute myocardial infarction, and pneumonia hospitalizations. The HRRP was expanded in federal fiscal year 2015 to include total joint arthroplasty. Total joint arthroplasty is the first procedure targeted for the readmission reduction program. The reasons for readmission after an elective surgical procedure may be different than the reasons for readmission after a medical condition such …