Medicine and Health Sciences Commons^™

Promoting Self-Management Through Adherence Among Heart Failure Patients Discharged From Rural Hospitals: A Study Protocol., Lufei Young, Sue Barnason, Van Do

Journal Articles: College of Nursing

UNLABELLED: Background Heart failure is one of the most prevalent chronic conditions in adults, leading to prolonged morbidity, repeated hospitalizations, and placing tremendous economic burden on the healthcare system. Heart failure patients discharged from rural hospitals, or primarily critical access hospitals, have higher 30-day readmission and mortality rates compared to patients discharged from urban hospitals. Self-management improves heart failure patients' health outcomes and reduces re-hospitalizations, but adherence to self-management guidelines is low. We propose a home based post-acute care service managed by advanced practice nurses to enhance patient activation and lead to the improvement of self-management adherence in heart failure …

The Significance Of Timing Of Patient Daily Weights And The Barriers, Ann Pan

Master's Projects and Capstones

Background. Current unit practice is that patient daily weights are obtained in the afternoon or evenings. However, patient weights in the afternoon and evenings are not accurate dry weights. According to evidenced based research, to obtain an accurate patient daily weight, patients should be weighed every morning, after their first void and before they eat breakfast.

Purpose. The focus of the study was to compare the current practices of obtaining daily weights in the afternoon and evenings, compared to the evidenced based practice recommended in the literature.

Method. Through interviews and surveys with staff, the barriers to obtaining patient weights …

Multidisciplinary Group Clinic Appointments: The Self-Management And Care Of Heart Failure (Smac-Hf) Trial, Carol A. Smith, Ubolrat Piamjariyakul, Jo A. Wick, John A. Spertus, Christy Russell, Kathleen M. Dalton, Andrea Elyachar, James L. Vacek, Katherine M. Reeder, Niaman Nazir, Edward F. Ellerbeck

College of Nursing Faculty Publications

Background—This trial tested the effects of multidisciplinary group clinic appointments on the primary outcome of time to first heart failure (HF) rehospitalization or death.

Methods and Results—HF patients (n=198) were randomly assigned to standard care or standard care plus multidisciplinary group clinics. The group intervention consisted of 4 weekly clinic appointments and 1 booster clinic at month 6, where multidisciplinary professionals engaged patients in HF self-management skills. Data were collected prospectively for 12 months beginning after completion of the first 4 group clinic appointments (2 months post randomization). The intervention was associated with greater adherence to recommended vasodilators …

Limited Association Between Perceived Control And Health-Related Quality Of Life In Patients With Heart Failure, Teesta Banerjee, Kyoung Suk Lee, Steven R. Browning, Claudia Hopenhayn, Susan C. Westneat, Martha J. Biddle, Cynthia Arslanian-Angoren, Jo-Ann Eastwood, Gia Mudd, Debra K. Moser

Epidemiology and Environmental Health Faculty Publications

Background: Perceived control has been suggested as a modifiable factor associated with health-related quality of life (HRQOL). However, the relationship between perceived control and HRQOL has not been evaluated in patients with heart failure (HF). The purpose of this study was to determine whether perceived control independently predicts HRQOL in HF patients. Methods: A total of 423 HF patients were included. Hierarchical linear regression was performed to determine the independent association of perceived control to HRQOL after controlling for covariates. Results: Higher levels of perceived control were associated with better HRQOL in univariate analysis. However, this relationship was strongly attenuated …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

The Use Of 4g Android Tablets For Enhanced Patient Activation Of Chronic Disease Self-Management In People With Heart Failure, Judith Kutzleb, Nancy Elmann, Andrew Fruhschien, Stephen Angeli, Angel Mulkay, Jarrett Bauer, Dan Priece

Touro College of Osteopathic Medicine (New York) Publications and Research

Problem: The purpose of this research was to evaluate the impact of an advanced practice nurse-directed patient education approach to heart failure treatment integrating the use of an interactive 4G android tablet, will enable patients to experience enhanced patient activation and engagement in chronic disease self-management and fewer 30-day rereadmissions.

Data source: This was a prospective patient randomization, multi-center quasi-experimental design study of 50 patients comparing an advanced practice nurse-directed education of disease self-management and use of a 4G android tablet (TC) group (n = 25) and routine medical management (MC) group. The study length was 12 months.

Conclusions: Descriptive …

Improving The Transition Of Care From The Hospital To Primary Care Providers For Patients With Heart Failure, John Blake

Doctor of Nursing Practice (DNP) Projects

The goal of this quality improvement project was to enhance the transition of care from the hospital to primary care providers for patients with heart failure at one acute care hospital in Tampa, Florida. A literature review revealed that discharge summaries have a pivotal communication role in the transition of care. Consequently, the electronically recorded discharge summaries relating to a random sample of 60 patients discharged from this hospital were audited for a trial period of six months (three months before and three months after an intervention by the DNP candidate to encourage the attending physicians to improve the transition …

Relationships Among Heart Failure-Related Physical Symptoms, Social Support, Social Problem-Solving, Depressive Symptomatology, And Self-Care Behaviors In Individuals Living With Heart Failure, Lucinda Joy Graven

All ETDs from UAB

Introduction: Heart failure (HF) is a chronic condition that progressively worsens over time. The condition is more common in individuals over the age of 65 and commonly causes dyspnea, fatigue, orthopnea, nocturnal dyspnea, edema, and activity intolerance. Prior studies suggest a relationship between HF-related physical symptoms and depressive symptomatology in individuals living with HF. Depressive symptomatology in individuals with HF are linked with a higher mortality rate, decreased quality of life, decreased functional status, and disturbed sleep. Additionally, HF-related physical symptoms impact self-care in individuals living with HF. Previous studies have found that symptom severity and the associated decrease in …

Examination Of The Potential Association Of Stress With Morbidity And Mortality Outcomes In Patient With Heart Failure, Abdullah S. Alhurani, Rebecca Dekker, Elizabeth Tovar, Alison Bailey, Terry A. Lennie, David C. Randall, Debra K. Moser

Nursing Faculty Publications

OBJECTIVES: The high mortality and morbidity rates associated with heart failure are still not well explained. A few psychosocial factors have been studied and explain some of this risk, but other factors, like stress, remain largely unexplored in heart failure. This study aimed to (1) examine the association of stress with 6-month cardiac event-free survival, (2) examine the relationship of stress with salivary cortisol, and (3) examine the association of salivary cortisol level with 6-month cardiac event-free survival.

METHOD: A total of 81 heart failure patients participated. Stress was measured using the brief Perceived Stress Scale. Cortisol was …

Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus

DNP Projects

Abstract

Objectives:

1. Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
2. Determine which HF population characteristics are significantly associated with readmissions to the hospital.
3. Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.

Design: Retrospective chart review.

Setting: Regional acute care facility in Central Kentucky.

Participants: All patients (n = 175) with a diagnosis or history …