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Full-Text Articles in Medicine and Health Sciences
Cardiomems Staff Education To Improve Use Of Pulmonary Artery Sensor Data In An Emergency Department, Betty Sue Reynolds
Cardiomems Staff Education To Improve Use Of Pulmonary Artery Sensor Data In An Emergency Department, Betty Sue Reynolds
Walden Dissertations and Doctoral Studies
Assessing volume status in patients with congestive heart failure (CHF) remains a difficult task. Newer technology, such as CardioMEMS, allows providers to download pulmonary artery pressure measurements from an implanted sensor. In a large rural emergency department (ED), lack of staff education on CardioMEMS made the device useless when a patient presented to the ED. The purpose of this project was to develop a staff education in-service to address the gap in practice. The theory used to guide development of an effective curricular program and instruction method was Knowles’ theory of andragogy. Application of the analysis, design, development, implementation, and …
Cardiomems Staff Education To Improve Use Of Pulmonary Artery Sensor Data In An Emergency Department, Betty Sue Reynolds
Cardiomems Staff Education To Improve Use Of Pulmonary Artery Sensor Data In An Emergency Department, Betty Sue Reynolds
Walden Dissertations and Doctoral Studies
Assessing volume status in patients with congestive heart failure (CHF) remains a difficult task. Newer technology, such as CardioMEMS, allows providers to download pulmonary artery pressure measurements from an implanted sensor. In a large rural emergency department (ED), lack of staff education on CardioMEMS made the device useless when a patient presented to the ED. The purpose of this project was to develop a staff education in-service to address the gap in practice. The theory used to guide development of an effective curricular program and instruction method was Knowles’ theory of andragogy. Application of the analysis, design, development, implementation, and …
Experiences Of Mechanical Circulatory Support Patients With Primary Implant Education, Dawn Michelle Christensen
Experiences Of Mechanical Circulatory Support Patients With Primary Implant Education, Dawn Michelle Christensen
Walden Dissertations and Doctoral Studies
Advancement in mechanical circulatory support (MCS) device therapy has led to increased use in heart failure therapy and relies on optimized patient education for successful support. The purpose of this 3-manuscript study, guided by the Husserlian transcendental phenomenological method, was to explore the lived experiences of (a) patients with primary mechanical circulatory support education (PMCSE), (b) patients who undergo unplanned MCS implantation with PMCSE, and (c) patients who undergo planned MCS implantation with PMCSE. Eleven participants were recruited (eight planned, three unplanned) from MCS targeted social media sites and interviewed using a semistructured open-ended question format. Data were analyzed using …
Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas
Evaluation Of A Telehealth Program For Heart Failure Patients, Virginia Elizabeth Lucas
Walden Dissertations and Doctoral Studies
AbstractHeart failure (HF) is a progressive and life -threatening disease that places a large burden on the health care systems worldwide with increased rates of re-hospitalization, readmissions, and outpatient visits. With the use of telehealth monitoring and support from nursing case managers, HF patients are able to manage this disease at home. The focus of this project was to evaluate a home health agency (HHA) telehealth program, exploring if there was an improvement in 30-day readmission rates, and patient satisfaction scores for the HHA telehealth program one year after revising the program incorporating nursing virtual case managers. This project used …
Program Evaluation Of A Home-Based Primary Care Practice And Patients With Heart Failure, Anne Rose Walsh
Program Evaluation Of A Home-Based Primary Care Practice And Patients With Heart Failure, Anne Rose Walsh
Walden Dissertations and Doctoral Studies
Heart failure (HF) affects over 5.5 million adults in the United States with a prevalence of 10%'20% in older adults and accounts for 3% of all hospital admissions with a readmission rate as high as 25% within 1 month of discharge. Patients with HF account for approximately 42% of the doctor of nursing practice project site's patient population, and the health system has a 30-day readmission rate of 35% for patients with HF in 2 large hospitals. Thus, the health system loses almost $13 million per year in Medicare penalties. This retrospective quality improvement project reviewed the effectiveness of care …
Staff Education On Heart Failure Guidelines And Self-Care Management Practices, Mary Mitcheltree
Staff Education On Heart Failure Guidelines And Self-Care Management Practices, Mary Mitcheltree
Walden Dissertations and Doctoral Studies
Heart disease is the leading cause of death in the United States with heart failure (HF) being one of the more prevalent diseases associated with heart disease. HF is reported to have a high mortality rate and presents an economic burden to the U.S. healthcare system. To improve patient outcomes and reduce the costs of treatment for HF-related symptoms, infusion nurses need adequate education and training. The purpose of this project was to train home infusion nurses on self-care management practices based on current HF guidelines. The Donabedian model, known for quality assurance, provided the framework to support the educational …
Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza
Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza
Walden Dissertations and Doctoral Studies
Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …
Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza
Improving Nursing Knowledge Of Heart Failure Discharge Self-Care Instructions, Maria Patricia Picar Deza
Walden Dissertations and Doctoral Studies
Patients with heart failure (HF) have recurrent symptoms that lead to frequent hospital readmissions. Moreover, HF is one of the leading causes of 30-day hospital readmissions. Evidence shows that patients with a high level of HF self-care have decreased readmissions. HF self-care education is commonly delivered by the nurse at hospital discharge, and the patient’s transition to self-care is a critical point in the continuum of care. However, nurses must be knowledgeable of patient self-care in HF to effectively convey this information to the patient upon discharge. Therefore, this staff education project question asked whether nursing knowledge of HF patient …
Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams
Exploring Education Needs For Heart Failure Patients' Transition Of Care To Home, Michelle D. Williams
Walden Dissertations and Doctoral Studies
Transitions of care is a model designed to ensure that patients have resources needed to assist them to care for themselves at home after hospital discharge, which helps to decrease preventable adverse events. For people with heart failure (HF) to transition home from the hospital successfully, specific education is needed that is individualized to the disease process, but most patients' educational needs after discharge are unmet. The purpose of this qualitative study, guided by the Meleis middle range theory of transition, was to explore the perspectives of people with HF about their educational needs in order to gather data that …
Improving Nursing Knowledge Of African American Heart Failure Self-Care Management, Sharnee Moore-Jervis
Improving Nursing Knowledge Of African American Heart Failure Self-Care Management, Sharnee Moore-Jervis
Walden Dissertations and Doctoral Studies
Heart failure is a complex chronic disease affecting 6.6 million people in the United States, with an annual cost of $39.2 billion per year. African Americans are at an especially high risk for poor outcomes and readmissions from heart failure complications, as they are 2.5 times more likely to develop heart failure than other ethnic groups. This disease requires a high level of patient self-care management, and evidence suggests that African Americans do not always receive culturally sensitive education, which can lead to suboptimal self-care practices. The practice-focused question for this educational program asked whether nurses of African American patients …
Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright
Teaching Heart Failure Patients A Low-Sodium Diet, Karen Faye Wright
Walden Dissertations and Doctoral Studies
Congestive heart failure (CHF) is a progressive medical condition affecting more than 7 million people in the United States (US) with 700,000 new cases reported annually. More than half of those treated for CHF are readmitted at least once a year. The problem addressed by this quality improvement initiative was lack of adherence to low sodium diet (LSD) among CHF patients, knowledge and skill deficit, and excessive 30-day CHF readmissions. The health belief model and the self-care deficit theory guide nurses in acquiring the skills needed to teach LSD. Twelve months of data were selected from 93 CHF readmissions from …
Incorporating Technology To Decrease Heart Failure Readmission Rates, Vernell Thames
Incorporating Technology To Decrease Heart Failure Readmission Rates, Vernell Thames
Walden Dissertations and Doctoral Studies
The rate of hospital readmissions within 30 days of discharge of heart failure (HF) patients affects patient outcomes, the financial stability of the health care facility, and the economy. Hospitals focus on strategies that will decrease the HF readmission rates by cultivating evidence-based interventions that improve patients' transition from the hospital to the community, including promoting self-management of their condition. The purpose of this quality improvement project was to develop, implement, and evaluate the use of health information technology along with written forms of plans of care to assist HF patients in managing their care, divert the HF patients to …
Transition Of Care Guideline For Reducing Heart Failure Hospital Readmission, Geeti Farrahi
Transition Of Care Guideline For Reducing Heart Failure Hospital Readmission, Geeti Farrahi
Walden Dissertations and Doctoral Studies
Heart failure (HF) patients are among the populations with the highest rates of hospital readmission within 30 days of discharge. Because of the 2010 Health Care Reform legislation, healthcare organizations are subject to financial penalty when a patient population exhibits excess readmissions. A significant reason for readmission of HF patients is a gap in the transition of care from hospital to home. The purpose of this doctoral project was to develop a practice guideline of best practices for transitioning HF patients from hospital to home. The transitional care model and care transitions intervention provided the theoretical underpinnings for developing this …
Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li
Using An Apn-Led Transitional Care Program To Reduce 30-Day Hospital Readmissions, Miaozhen Li
Walden Dissertations and Doctoral Studies
Heart failure (HF) is a serious public health problem associated with high mortality rates, hospital readmissions, and health care costs. Transitional care has emerged as a disease management model used to reduce readmissions for hospital-discharged patients with HF. However, the efficacy of an advanced practice nurse (APN)-led transitional care program (TCP) in readmission reduction is under debate. The practice question for this project examined the extent to which an APN-led TCP was effective in reducing 30-day all-cause readmissions for hospital-discharged HF patients. The logic model was the framework guiding this program evaluation. An analysis of quality improvement HF data from …
Steps To Reducing Heart Failure Hospital Readmissions Through Improvement In Outpatient Care, Paticia Laubach Dunn
Steps To Reducing Heart Failure Hospital Readmissions Through Improvement In Outpatient Care, Paticia Laubach Dunn
Walden Dissertations and Doctoral Studies
The outpatient care of the heart failure (HF) patient is fragmented due to the lack of evidence-based practice guidelines use. The primary goal of this project was to improve the care of the HF patient in the outpatient arena through use of clinical pathways using the logic model as the project framework. The intervention was carried out over a 4-week period on a convenience, random sample of patients (n = 80) attending a cardiology practice. The patients were recruited from 2 physicians' patient populations and were selected based on an adult diagnosis of HF, reduced ejection fraction of <40% at some point in time, and the New York Heart Association (NYHA) functional class II-V. Comparisons were made in the documentation of care between patients on or off the pathway. The intervention included documentation of patient education, care follow-up, medications, NYHA functional class, and symptom exacerbation, documented in the electronic medical record. The quality of care data were evaluated based on 3 of the Joint Commission core measures for outpatient care of the HF patient. Additional data were collected regarding use of the clinical pathway based on provider and week of implementation. Data were analyzed via a Chi-square test of independence comparing pathway use by provider and use of pathway as study progressed. The comparative results show statistically significant differences in use of the pathway by provider and a statistically significant increase in use during the project . The quality of care results varied in statistical significance. The pathway utilization increased over time and provided a method for standardizing documentation of care for the HF patient in this outpatient clinic, a benefit for HF patients and providers in this cardiology practice and beyond.
Care Transition Gaps: Risk Identification And Intervention, Michael Howard Jongsma
Care Transition Gaps: Risk Identification And Intervention, Michael Howard Jongsma
Walden Dissertations and Doctoral Studies
Hospital readmissions related to chronic heart failure (CHF) are costly, widespread, and often avoidable. Patient education that includes diagnosis, causes, medications, diet, exercise, and exacerbation warning signs has been shown to reduce the number of CHF readmissions. The purpose of this study was to use risk stratification to identify CHF patients at high risk for 30-day readmission. Once a high-risk CHF patient was identified, nursing interventions would be triggered to reduce readmissions and close the gaps in the continuum of care following acute care admission. Transitions of care theory was used as the framework for this project. The methodology had …