Medicine and Health Sciences Commons^™

Self-Care Among Older Adults With Heart Failure, Sumayya Attaallah, Kay Klymko, Faith Pratt Hopp

Social Work Faculty Publications

Background: It is estimated that 5.7 million Americans are living with heart failure (HF) today. Despite the fact that HF is one of the most common reasons people aged 65 years and older are admitted into the hospital, few studies describe the self-care in this older adult population. Purpose: The purpose of the study was to review the current literature on self-care in this population to better understand the influence of selected factors on self-care and health outcomes. Methods: A literature search was completed and resulted in including 28 studies. Results: Multiple factors have been reported as barriers to self-care …

Using Community Health Workers In Collaboration With Nurse Case Managers In Effecting Change In Quality Of Life For Heart Failure Patients, Patra Hull Reed

Doctor of Nursing Practice (DNP) Final Clinical Projects, 2016-2019

This project was designed to evaluate the effectiveness in improving the quality of life among heart failure patients with the addition of the role of Community Health Worker (CHW) to a current continuum case management model. The study also addressed the increased need for more appropriate and cost-effective chronic care management for heart failure patients. Hospitals and healthcare systems are being challenged to find innovative ways to decrease readmissions, decrease unnecessary emergency room visits, increase patient adherence, and manage chronic disease, all improving the patient’s overall quality of life. Studies show that approximately 76% of heart failure patients have a …

The Short-Term And Long-Term Effects Of Biofeedback-Assisted Relaxation Therapy In Patients With Heart Failure: A Randomized Control Study, Tsuey-Yuan Huang, Debra K. Moser, Shiow-Li Hwang

Nursing Faculty Publications

Background: Relaxation techniques can reduce sympathetic nervous system activation and stress, potentially improving heart failure patients’ physical and psychological outcomes.

Purpose: To examine the effects of biofeedback-assisted relaxation (BFAR) therapy in patients with heart failure.

Methods: A prospective randomized control study was conducted. Participants in the treatment group received BFAR therapy, while participants in the control group received standard of care. Short-term outcomes were physical symptoms and psychosocial variables measured at baseline and 3 months; long-term outcomes were cardiac events and mortality assessed at 12 months.

Results: Fifty-two heart failure patients participated in the study: 23 (mean age 60.0 ± …

Improving Veteran Access To Heart Failure Specialty Care: A Change Model Project, Mark Bird Whelchel

Dissertations

Background: Many Veterans Health Administration (VHA) facilities have cardiac services, but not all VHA centers offer heart failure care. Viable alternative models exist to traditional outpatient treatment by physicians, such as Tele-medicine consultations, the use of nurse practitioner run clinics, and the use of models such as Specialty Care Access Network-Extension for Community (SCAN-ECHO) and site specific contracted physician services models. These have the potential to improve Veteran access to care. Objective: The purpose of this change project was to conduct a needs assessment survey, in joint effort with the Hershey Medical Center Heart and Vascular Institute, to identify barriers …

Influences On Self-Care In Women With Heart Failure: A Pilot Study, Joy Corcione

Dissertations & Theses (Open Access)

Background: Heart Failure self-care becomes exceedingly difficult to perform as the disease progresses; therefore social support becomes important in facilitating heart failure self-care. Woman with heart failure represent a significant and growing vulnerable population. Women tend to have lower self-confidence in providing self-care, experience greater negative emotions, decreased social support, experience more adverse psychosocial factors affecting self-care and experience greater psychosocial adversity than do men. Self-care is vital in managing heart failure and social support greatly facilitates self-care behaviors.

Purpose: The purpose of this pilot study was to gain a deeper understanding about the sources of perceived social support and …

Takotsubo Cardiomyopathy: The Pathophysiology Of Broken Heart Syndrome, Mason Murrey

Nursing Student Class Projects (Formerly MSN)

First identified in 1992 in Japan, Takotsubu Cardiomyopathy is a stress-induced cardiomyopathy that presents identically to ST-segment elevated myocardial infarction (STEMI). Termed Broken Heart Syndrome for its correlation to stressful events such as the loss of a spouse or family member, Takotsubo is a complex phenomenon in the world of cardiac care. Over-saturation of endogenous catecholamines is the most popular explanation for this clinical condition, but other explanations such as parasympathetic nervous system dysfunction and coronary artery vasospasm are also revealing themselves as causative factors.

Telephone Follow-Up For Heart Failure Patients Discharged To Skilled Nursing Facilities, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Reducing hospital readmissions has become a national priority for health care institutions. Telephone follow-up, a cost-effective intervention, has been used with varying degrees of success in reducing 30-day readmissions for heart failure (HF) patients. However, little is known about interventions directed toward HF patients discharged to skilled nursing facilities (SNFs). The purpose of this project was to test the effect of telephone follow-up with SNF staff by an advanced practice nurse (APN) on 30-day readmission rates. A one-time call to SNF staff was made by the APN to review key components of HF management. Readmission rates for the intervention …

Impact Of Nurse-Led Telephone Follow-Up On Heart Failure Readmissions, Anna Laura Trimbur

Graduate Theses, Dissertations, and Capstones

Abstract

Heart failure readmissions are a common and costly issue. Poor transitions of care as patients move from one setting to another are thought to be a major contributor to this growing problem. For those patients discharged to skilled nursing facilities (SNFs), poor transitions can be especially problematic. Telephone follow-up by nurses is a cost effective intervention commonly used to improve communication and coordination of care, thought little is known about interventions directed at patients discharged to SNFs. The purpose of this review is to evaluate the evidence regarding nurse led telephone follow-up in the transition of care process and …

The Effect Of Heart Failure Education On Knowledge And Readmission, Sara A. Golden

Evidence-Based Practice Project Reports

Heart Failure (HF) is a chronic progressive disease affecting over 5 million individuals with an expected increase in incidence as the population ages (Yehle & Plake, 2010). The costs associated with managing HF continue to increase and the Centers for Medicare and Medicaid Services (CMS) have attempted to identify ways to improve patient management of HF to reduce the revolving door of hospital readmissions and decrease expenditures. According to 2006 data, as many as one fourth of the Medicare beneficiaries discharged from acute care to skilled nursing facilities (SNF) were readmitted to the hospital within 30 days and the majority …

Effect Of An Emergency Nurse Heart Failure Educational Intervention, Lori Hudgens

Doctoral Projects

Background: Research indicates many nurses lack the appropriate heart failure (HF) education necessary to assist with readmission reduction efforts. Employer approved nurse HF education has resulted in improved nurse HF knowledge, and, reduced readmissions.

Problem: ED nurses require a competent knowledge of heart failure to effectively educate heart failure patients upon admission to the ED. No research has been conducted with ED nurse specific populations to assess ED nurse knowledge of heart failure, and, to determine if heart failure educational interventions increase ED nurse' HF knowledge.

Aims: To evaluate the effectiveness of an ED nurse b.eart failure educational intervention in …

A Standardized Palliative Care Referral Workflow And Educational In-Service At An Outpatient Congestive Heart Failure Clinic, Rachel E. Cardosa

Doctoral Projects

Cardiovascular disease is a significant health issue in the US as it is the leading cause of death and most cited reason of hospitalizations in Medicare enrollees (Centers for Disease Control, 2014; Unroe et al., 2011). The American Colleges of Cardiology and the American Heart Association Guidelines recommend palliative care for all patients with heart failure (Yancy et al., 2013). The purpose of the scholarly project was to address the gaps in current practice by creating a standardized palliative care referral process and education for clinicians in an outpatient Advanced Congestive Heart Failure (ACHF) Clinic. A referral tracking process was …

Systematic Review Of Symptom Clusters In Cardiovascular Disease, Holli A. Devon, Karen Vuckovic, Catherine J. Ryan, Susan Barnason, Julie J. Zerwic, Bunny J. Pozehl, Paula Schulz, Yaewon Seo, Lani Zimmerman

College of Nursing: Faculty Publications

Background: Although individual symptoms and symptom trajectories for various cardiovascular conditions have been reported, there is limited research identifying the symptom clusters that may provide a better understanding of patients’ experiences with heart disease. Aims: To summarize the state of the science in symptom cluster research for patients with acute coronary syndrome, myocardial infarction, coronary artery bypass surgery, and heart failure through systematic review and to provide direction for the translation of symptom cluster research into the clinical setting. Methods: Databases were searched for articles from January 2000 through to May 2015 using MESH terms “symptoms, symptom clusters, acute coronary …

Effectiveness Of Cognitive Screening For Heart Failure Patients, Comfort Nkengla

Walden Dissertations and Doctoral Studies

Cognitive impairment is commonly seen in the elderly population. It is unclear if cognitive deficit in heart failure (HF) patients is a primary factor for higher hospital readmission rates in this population. The Centers for Medicare and Medicaid Services have established strict guidelines for reimbursement on readmissions that occur within 30 days. It is imperative that organizations identify and rectify issues that impact readmissions. The aim of this project was to determine if there is a reduction in HF readmission after patients are screened for cognitive impairment. Orem's self-care model guided the project by providing a framework of inquiry regarding …

Prediction Screening To Identify Heart Failure Patients At High Risk For Readmission, Kelly L. Taylor

DNP Projects

Background: There is an increased need to identify factors associated with higher risk for excessive HF re-hospitalizations due to hospitals receiving financial penalties related to these re-hospitalizations and poorer patient outcomes. Identifying HF patients at highest risk for re-hospitalization with a screening instrument upon admission to the hospital would allow for early implementation of interventions tailored around reducing risk factors for re-hospitalization.

Objectives: The specific aims of this study were to 1) identify characteristics that were predictive of HF re-hospitalization; and 2) use those characteristics to create a screening instrument.

Methods: A total of 158 patients (age=63±13; 50.6% female; 73.4% …

The Importance Of Screening For Sleep Apnea In The Heart Failure Population, Loreen Williams, Pamela Aselton

Elaine Marieb College of Nursing Faculty Publication Series

Background: Sleep disordered breathing occurs in over half of the estimated 5.1 million people in the United States diagnosed with heart failure.

Aim and Methods: The purpose of this integrative review is to find evidence for the routine use of a sleep apnea screening protocol in patients with heart failure.

Results: Several useful tools are described including the Epworth Sleepiness Scale, the STOP BANG questionnaire and the Berlin questionnaire. Using one of these tools along with an overnight pulse oximetry is a cost effective way to screen patients before the more costly sleep studies.

Conclusions: Evidence shows that treatment of …

Development Of A Teach-Back Educational Module For Heart Failure Discharge Teaching, Marissa Blair Jamarik

Walden Dissertations and Doctoral Studies

Heart failure (HF) readmissions create a financial burden for healthcare nationwide and speak to the lack of effective discharge preparation for patients to be successful with self-care at home. The 183-bed hospital where this DNP quality initiative will take place currently reports an observed-over-expected (O/E) readmission rate for HF patients (Centers for Medicare and Medicaid [CMS]). Core measures on HF developed by the Joint Commission and the Centers for Medicare and Medicaid Services do not appear to be enough to ensure successful transitions of care from hospital to home. Guided by the LOGIC model, the purpose of this quality improvement …

Effect Of Home Telehealth On Vterans With Chronic Heart Failure, Yolanda Major

Walden Dissertations and Doctoral Studies

More than 5 million Americans have heart failure, with approximately 5% of those affected being veterans. As the number of patients with CHF continues to rise, new treatment options are needed to improve the quality of care. Current studies show Telehealth is one treatment option. The purpose of this scholarly project was to determine if veterans diagnosed with CHF were able to maintain optimal weight and blood pressure following participation in Care Coordination Home Telehealth (CCHT) program. The CCHT program provides care to veterans, through the use of monitoring devices placed in their home. Bandura's self-efficacy theory was used as …

Co-Morbid Symptoms Of Depression And Anxiety And Bio-Behavioral Response To Stress In Patients With Heart Failure, Abdullah S. Alhurani

Theses and Dissertations--Nursing

Heart failure (HF) is a major public health problem throughout the world. It accounts for one death certificate among nine in the United States. Heart failure and sudden death combined are responsible for the largest number of deaths in America. The total costs of HF in the United States are estimated to be $37 billion each year. Despite substantial medical and surgical advances related to treatment of HF, it remains a very costly condition with high mortality and morbidity rates. Although biological factors contribute to high morbidity and mortality in HF, there are many unexplored psychosocial factors that also likely …

Biobehavioral Influences Of Anxiety, Depression, And Hostility Symptoms On Health-Related Outcomes In Patients With Heart Failure, Lynn P. Roser

Theses and Dissertations--Nursing

The incidence of heart failure (HF) has increased each year as more people are living longer with heart disease and other chronic conditions. Recently, there has been much interest in the psychological dimensions of HF and the influence psychological symptoms have on the health outcomes (e.g., self-care, rehospitalization, mortality and quality of life) of patients living with HF. Patients with HF frequently experience symptoms of anxiety, depression, and hostility that may be associated with poor health outcomes. The purpose of this dissertation was to examine how psychological variables influence health outcomes of patients with HF, how psychological variables change over …