Cardiology Commons^™

"Reducing Heart Failure Readmission Rates Through Implementation Of Heart Failure Diuretic", Caley Tatrn, Yvonne Weideman, Venkatraman Srinivasan

Doctor of Nursing Practice (DNP) Manuscripts

Background and significance: heart disease was the number one cause of death in the United States in 2021, with 696, 962 deaths (Leading Causes of Death, 2022). There are about 6.2 million individuals in the U.S. total with heart failure (Kilgore et al., 2017). About one-quarter of patients with heart failure are readmitted within thirty days of discharge, while one-quarter of hospital readmissions are preventable. Between 2010-2017, over seven million patients were admitted for heart failure in the United States. Eighteen percent had a readmission within thirty days and thirty-one percent had a readmission within ninety days (Khan et …

Extubation Readiness Test In A Pediatric Cardiac Intensive Care Unit, Mary K. Holyoke

Dissertations

Extubation Readiness Test in a Pediatric Cardiac Intensive Care Unit

Abstract

Problem: The lack of standard extubation readiness tests (ERTs), that are practiced in pediatric ICUs to monitor extubation readiness, clinicians have the difficult task of weighing the risk versus benefit of extubation. ERTs can aid clinicians in deciphering patients ready to be successfully extubated and have shown to decrease length of mechanical ventilation and decrease extubation failures.

Methods: The quality improvement (QI) project utilized a descriptive observational design to assess the effects of the implementation of an ERT in a pediatric cardiac ICU. This project used a convenience sample …

Improving Door-To-Balloon Times In Adult Patients With St-Elevation Myocardial Infarction By Utilizing A Stemi-Rn, Amanda Hunter

Doctor of Nursing Practice Projects

Background: Heart disease is the leading cause of death in Alabama. The national estimated annual incidence of myocardial infarction (MI) is 605,000 new and 200,000 recurrent attacks, of which approximately 170,000 are silent (Tsao et al., 2022). Roughly every 40 seconds, an American will have an MI (Tsao et al., 2022). An ST-elevation myocardial infarction (STEMI) occurs when one or more of the coronary arteries supplying the heart with blood occlude, leading to myocardial injury (Akbar et al., 2021). Clinical practice guidelines for STEMI recommend Door to Balloon (D2B) intervention in 90 minutes or less (O'Gara et al., 2013), while …

Heart Failure Knowledge, Symptom Perception, And Symptom Management In Patients With Heart Failure, Jia-Rong Wu, Chin-Yen Lin, Muna Hassan Hammash, Debra K. Moser

UK CARES Faculty Publications

Background: Prevention of heart failure (HF) exacerbations requires that patients carefully self-manage their condition. Symptom perception is a key component in self-care for patients with HF that involves monitoring for HF symptoms and recognizing symptom changes. Heart failure knowledge is a prerequisite for better symptom perception and symptom management. However, the relationships among HF knowledge, symptom perception, and symptom management remain unclear.

Objective: The aim of this study was to explore the inter-relationships among HF knowledge, symptom monitoring, symptom recognition, and symptom response in patients with HF.

Method: We included 185 patients with HF in this study. Heart failure knowledge …

Implementation Of The Generalized Anxiety Disorder 2-Item Screening Tool For Adult Patients In An Underserved Outpatient Cardiology Clinic, Leila Joint

Doctor of Nursing Practice Final Manuscripts

Background: 11.7% of adults aged 18 and over have regular feelings of worry, nervousness, or anxiety. Anxiety can often present with somatic symptoms. The rates of misdiagnoses are high with symptoms often attributed to physical etiologies. Early recognition and treatment of anxiety can improve quality of life, prevent complications and reduce health care costs.

Purpose of Project: Implementation of the Generalized Anxiety Disorder 2-item (GAD-2) screening tool in a fast-paced underserved outpatient cardiology clinic for adult patients presenting with chest pain and/or palpitations without documented history of anxiety. The purpose of this project is to improve the utilization …

Evaluating Nurse Use And Satisfaction With Video-Based Discharge Education For Adults With Heart Failure, Krystyna Simon Rn, Bsn, Molly Hendrickson Rn, Bsn, Windy Alonso Phd, Rn, Fhfsa

Doctor of Nursing Practice Projects: College of Nursing

Background

Heart failure (HF) readmission rates are high and influenced by self-care practices and self-efficacy for managing chronic disease. Using digital education via tablet can help improve the discharge education process and may increase self-care knowledge.

Objective

The purpose of the study is to assess the current discharge processes implemented for HF patients in cardiovascular units at a Midwestern academic medical center.

Methods

Participants for this two-phase study were recruited from two inpatient cardiovascular units within a 700-bed, Midwestern academic medical center. Phase one used a pre-post quasiexperimental design to evaluate a discharge educational intervention using the teach-back method in …

Center Based Cardiac Rehabilitation Outcomes Associated With Covid-19 Pandemic: A Retrospective Comparative Cohort Study, Haley Williams, Kayla Woodworth

Doctor of Nursing Practice Projects: College of Nursing

Background: Traditional cardiac rehabilitation (CR) is a multidisciplinary, multifaceted program for cardiac patients. Throughout the Covid-19 pandemic, health care, including center-based CR (CBCR) programs, were closed to in-person sessions. Even with the return to CBCR participation, patient outcomes may have been affected by this disruption in care. The goal of this study was to determine if CR participation outcomes differed before and after CBCR program closure due to Covid-19.

Methods: A retrospective comparative cohort design was used to examine CR participant outcome data before and after the Covid-19 pandemic. Convenience sampling of CR participants at a large, urban …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Decreasing Hospital Readmission Rates Of Heart Failure Patients: An Evidence-Based Quality Improvement Project, Elizabeth Rodriguez

DNP Projects

BACKGROUND: Teach back is an evidence-based health literacy intervention that encourages patient engagement in own treatment, adherence to treatment, medications, and quality of care. Implementation of teach back method could positively impact readmissions to the hospital in patients experiencing heart failure and any other chronic diseases and it could improve patient’s outcomes.

OBJECTIVE: The objective of this project was to implement teach back method in a home care agency in the Hartford area in patients with HF to prevent readmission to the hospital.

METHODS: The IOWA model was used and PSDA as tools to support EBP project.

RESULTS: Pre and …

Prevention Of Obesity-Related Morbidity & Mortality In Adults, Rachelle Virgin

Masters Theses/Capstone Projects

Poster presentation on the prevention of obesity related morbidity and mortality in adults.

Patient Experience In An Interprofessional Collaborative Practice For Underserved Patients With Heart Failure, Connie White-Williams, Maria R. Shirey, Reid Eagleson, Wei Su, Terri Poe, Brittany Fitts, Vera Bittner

Patient Experience Journal

Heart failure is a complex chronic condition that results in multiple patient visits throughout the care continuum. Patient experience has associations with clinical outcomes. The purpose of this study was to examine patient experience among the underserved in a specialized interprofessional collaborative practice heart failure clinic. This prospective study utilized both qualitative and quantitative data to describe the patient experience within an interprofessional collaborative practice. Data were collected from patient experience surveys in 1128 patients seen in the Heart Failure Transitional Care Services for Adults (HRTSA) clinic between January 1, 2018, and December 31, 2021. Interprofessional collaborative practice surveys were …

Implementation Of An Activity Protocol In The Acute Care Setting: A Quality Improvement Project, Crystal M. Ryan

DNP Projects

Background: Physical activity following cardiothoracic surgery can help decrease post-operative complications, expedite functional recovery, improve overall well-being, shorten hospital length of stay (LOS), and reduce morbidity and mortality (Miwa et al., 2017). Of these patients, 58% developed complications after cardiac surgery; of these complications, 31% were pulmonary, 16% were of cardiac in nature, and 14% were neurological (Yayla, 2018).

Purpose: This quality improvement project aims to implement an evidence-based protocol for evaluating the correlation between physical activity in uncomplicated post-operative coronary artery bypass and length of stay.

Methods: The Plan-Do-Study-Act (PDSA) tool from the Institute for Healthcare Improvement (IHI) guided …

A Metabolic, Mechanical, Multi-Organ Masterpiece: Dural Device Support Bridge To En-Bloc Heart-Liver Transplantation In Propionic Acidemia, Rebecca Juhl, Brian Birnbaum, Aliessa P. Barnes, William Gibson, Bhargava Mullapudi, Beth Lang, Megan Faseler, Daniel E. Heble, Victoria Urban, Ryan T. Fischer, Jennifer L. Gannon, David Sutcliffe

Posters

Introduction: Propionic Acidemia (PA) is a disorder related to abnormal protein and lipid metabolism resulting in progressive neurological injury and dilated cardiomyopathy (DCM). Interventions for PA and secondary disease manifestations can require multi-organ transplantation. Herein we report the case of a child with PA and end-stage DCM requiring left ventricular assist device (LVAD) support with eventual heart-liver transplant. Case Report: A 17 year old male diagnosed in childhood with PA developed chronically progressive DCM culminating in end stage heart failure with acute decompensations. In a recurrent admission, he progressed to require dual inotropic support and systemic anticoagulation for new LV …

Preserving The Patients’ Lifeline: Reducing Complications By Adopting A Vascular Access Assessment Improvement Process, Ana Lopez Franco

Providence Nursing Research Conference 2023 – Present

No abstract provided.

Promotion Of National Certification In Telemetry, Janelle Maciej

Nursing Posters

Situation:

Goal to bring awareness to telemetry nurses, the specialty certifications they are eligible for, and criteria for eligibility. Currently, six telemetry nurses hold a nationally recognized certification.

Action Plan:

• March 19, 2023 was Certified Nurses Day and was the kickoff for the start of encouragement for telemetry nurses to be certified.
• Each telemetry nurse was delivered a card and lifesaver candy inviting them to consider a nationally recognized certification.
• A certification informational packet promoting CV-BC and PCCN certification was placed at each desk and referenced during huddle for one week.
• Certification preparation books are available upon request.

Impact Of A Parent Education Program On Parents Of Children With Complex Congenital Heart Disease Prior To Discharge Home, Laura Elkhoury

DNP Projects

Abstract

Background and Purpose: Children with complex medical needs, such as children with complex congenital heart disease, are at risk for hospital readmission, morbidity, and mortality related to disease complications. Parents must be adequately prepared to care for their children following hospital discharge to prevent hospital readmission and complications. This study seeks to evaluate the impact of an education intervention on parental knowledge and stress related to caring for their child with complex medical needs.

Methods: The study design is a quasi-experimental, nonequivalent control pre-test/post-test design. The pre-test was administered prior to the educational intervention, with the post-test …

Effects Of A Residential Lifestyle Intervention Program On Selected Lipid Measures And Nutritional Choices, Delores M. Rugless

DNP Research Projects

Abstract

Objective: Cardiovascular disease has been the leading cause of death since the early 1920s. As with other chronic diseases, cardiovascular disease is primarily influenced by behaviors and the environment, with poor nutrition being a major contributing factor. Despite knowing the importance of lifestyle modification to manage cardiovascular disease effectively, many individuals have difficulty adhering to lifestyle modification principles. Residential lifestyle modification centers provide the education and support necessary to assist individuals with implementing behavioral changes. This DNP project aimed to demonstrate the value of diet modification implemented at a residential lifestyle center to decrease specific cardiovascular risk factors. Method: …

The Impact Of A Blood Pressure Reduction Program In Optimizing Control Of Hypertension Amongst Adult Females In An Outpatient Ambulatory Clinic, Brooke Englert

DNP Projects

Background: Hypertension (HTN) is a public health problem that, when well-controlled, can significantly reduce the risk of stroke, coronary heart disease, heart failure and death. Effective patient-provider communication strongly incentivizes an improvement in medical outcomes. Communication with patients can often be effectively delegated to other clinical staff, such as registered nurses (RNs) or clinical service technicians (CSTs) (Tavakoly Sany, Behzhad, Ferns & Peyman, 2020).

Purpose: Given the increased risk of all-cause and cardiovascular disease mortality of uncontrolled HTN, the purpose of this study was to implement and evaluate a standardized, evidence-based practice intervention via communication between APRN providers and patients …

Dietary Antioxidant Insufficiency Is Associated With Increased Inflammatory Markers And Poorer Health-Related Quality Of Life In Patients With Heart Failure, Jia-Rong Wu, Eun Kyeung Song, Debra K. Moser, Terry A. Lennie

UK CARES Faculty Publications

Background: Antioxidant insufficiency, elevated inflammatory markers, and poor health-related quality of life (HRQOL) are prevalent in patients with heart failure (HF). Objective: The objective of this study was to examine the associations among dietary antioxidant intake, inflammatory markers, and HRQOL in patients with HF. Methods: This was a secondary analysis of 265 patients with HF who completed a 4-day food diary. We assessed intake of 10 antioxidants: alpha carotene, beta carotene, beta cryptoxanthin, lutein, zeaxanthin, lycopene, vitamins C and E, zinc, and selenium. Antioxidant insufficiency was reflected by a measured level for each antioxidant that was below the estimate average …

Frailty Determination And Responsiveness In Left Ventricular Assist Devices, Sarah Schroeder

Theses & Dissertations

Frailty, the state of being vulnerable with susceptibility to decreased age-related physical reserve, is found in 56-79% of adults with end-stage HF receiving durable left ventricular assist device (dLVAD) therapy. Frailty increases risk of adverse events, including increased mortality in the dLVAD population, but less is known about depression, quality of life (QOL), cognition and frailty responsiveness. Therefore, we aimed to describe and compare frailty (5-Meter Walk Test, 5MWT), depression (Patient Health Questionnaire-9, PHQ-9), quality of life (EQ5D Visual Analog Scale, EQ-5D VAS) and cognition (Trailmaking B) from pre- to 12-months post-dLVAD We also compared demographics, clinical characteristics, and post-dLVAD …

The Role Of Telehealth In Reducing Hospital Readmissions For Heart Failure Patients, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Heart failure affects over six million people annually, and is expected to increase to over eight million by 2030. Over 60 million people live in the rural United States. Telehealth is a tool to improve access to care, provide early intervention, and follow up with patients within 48 hours of a hospital discharge. Utilizing Telehealth to conduct a medication reconciliation within 48 hours of discharge to address any medication errors or admission, and reinforce adherence is a way to improve access to care to those living in rural areas.

Telehealth And Hospital Readmissions For Heart Failure Patients: A Literature Review, Tommy Lee Bratcher

Graduate Theses, Dissertations, and Capstones

Currently heart failure affects over six million people and is expected to increase to over eight million people by 20230. The US Census Bureau estimates over 60 million people live in a rural setting. This literature review seeks to determine the state of the science regarding the utilization of Telehealth to reduce heart failure readmissions in rural areas.

Prevent Vascular Access Complications By Adopting A Vascular Access Assessment Improvement Process In The Adultdialysis Unit, Ana Lopez Franco

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

Patient Outcomes: Stemi Diagnosis In The Emergency Care Center (Ecc) Resulting In Subsequent Pci Procedures, Laura Derr

St. Joseph Hospital, Orange, CA. Evidence Based Practice Conference

No abstract provided.

The Development And Implementation Of Evidence-Based Preanesthesia Assessment Tools For Lvad Patients Undergoing Non-Cardiac Procedures, Tracey Rooney, Casey Weimer, Eileen Giardino, Kerry Shanklin, Pete Pelletier, Audrey Rosenblatt

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Abstract

A university-affiliated tertiary medical center with a newly developed Advanced Heart Failure and Mechanical Circulatory Support program identified the need to implement a more systematic approach to the preanesthesia assessment process for patients with a Left Ventricular Assist Device (LVAD) undergoing noncardiac procedures and standardized guidelines to determine the best blood pressure monitoring system for patients with an LVAD during these noncardiac procedures. A multidisciplinary panel of clinical experts developed an LVAD Preanesthesia Toolkit using standard recommendations identified via evidence-based literature and expert opinion. The Toolkit included an LVAD Preanesthesia Assessment (VaPA) tool and an LVAD Blood Pressure Monitoring …

An Ebp Approach To Managing Post Cardiac Arrest Interdisciplinary Care, Mary Kay Bader, Teresa Wavra, Tauseef Qureshi, Jon Cline, Marne Andersen

2022 Southern California Nursing Research Conference

The Joint Commission (TJC) published new performance standards on Post Cardiac Arrest (PCA) care that went into effect on Jan 1, 2022. The new standards encourage hospitals to review and synthesize current scientific literature on Post Cardiac Arrest Syndrome (PCAS) and analyze current hospital practice. Following a review of the evidence, hospitals are guided to create a multidisciplinary protocol and education that facilitates training of personnel, implementation of the evidence into clinical practice, data collection, and case review processes. The intent of the standard is to bring hospital based clinical practice in line with the established standards to improve patient …

Adults With Preexisting Diagnosis Of Heart Failure In The Environment Of Coronavirus Disease 2019, Ronald Phillips

Dissertations

Background: Heart disease continues to be the leading cause of death among adults in the United States and other industrialized countries. Heart failure (HF) is a form of heart disease and has become an epidemic with complications and medical care costs increasing at an alarming rate. HF affects more than 5.7 million adults in the United States with an incidence between 550,000 to 670,000 annually, primarily affecting females, African Americans, and adults aged 55 years and older. HF is also associated with a high rate of mortality, estimated to increase, with a risk rate of 13%, 32%, and 64% among …

A Qualitative Inquiry On Smokers’ Perceptions Of Smoking Cessation During Covid-19, Sajid Iqbal, Rubina Barolia, Kiran Iftikhar, Pammla Petrucka, Jeniefer Anastasi, Faris Farooq Saeed Khan, Naheed Feroz Ali

School of Nursing & Midwifery

Background: This qualitative exploratory study explores smokers’ perspectives regarding smoking cessation processes amid the COVID-19 pandemic.
Methods: Purposive sampling was employed to conduct semi-structured interviews with cigarette smokers visiting cardiac and pulmonary clinics at a tertiary care hospital in Karachi, Pakistan. Thematic analysis was performed to identify themes from the participants’ responses.
Results: Three themes emerged from the thematic analysis. These were smoking cessation facilitators, smoking cessation barriers, and COVID-19 impacts on smoking cessation. Awareness and education, threat of acquiring health problems, religious beliefs and family or support system behave as smoking cessation facilitators. While, role modeling, associating smoking to …

Podium Presentation: Using An Existing Clinical Practice Guideline To Develop And Implement An Adult Ecmo Program During A Global Pandemic, Brandy Pitts, Midge Vaughan, Jamie Roney

2022 Providence Nurse Research Conference

No abstract provided.

Cardiology Implications Of Ed Covid-19 Patients In An Underserved Rural Health Care Environment, Pedro Colio

Dissertations

Background/Purpose: Positive COVID-19 patients with chronic comorbidities have been associated with severe cardiac complications (e.g., STEMI, NSTEMI, myocarditis, pericarditis, AF) specifically among underserved communities. Acute STEMI and NSTEMI are cardiac conditions associated with ruptured atherosclerotic plaque leading to significant myocardial injury. AF, the most common arrhythmia leading to cerebrovascular accidents, is also common in hospitalized patients with severe illnesses. Myocarditis and pericarditis are inflammatory heart conditions associated with acute viral infections. According to the literature, these cardiac issues have been linked as complications of COVID-19. COVID 19 is an emerging, complex, and costly public health challenge globally with potential lifelong …