Heart Failure Nursing

This article sought to find an appropriate model to predict the risk of unplanned heart failure readmissions. The primary outcome from chart reviews also included death of heart failure patients within 30 days of discharge. The study looked at Centers for Medicaid and Medicare Services (CMS) models and the LACE+ index, to mention two of many

A resident at the time saw that although there is a hearty amount of evidence that illustrates that adhering to heart failure guidelines decreases the rate of mortality and morbidity, nationally there is modest adherence to heart failure practice guidelines. Doctors have voiced a multitude of reasons to this poor participation including but not limited to time constraints in a visit, inertia of patterns in practice, lack of awareness and lack of acceptance are a few. This new web-based tool, the “Smart” Heart failure sheet is designed to help connect previously compartmentalized information. It seeks to link guidelines to their patients’ clinical and laboratory characteristics and systematize adherence to heart failure guidelines. It accomplishes this by uploading pertinent patient-specific data, including laboratory and imaging results, procedure reports and relevant medications. Additionally it also provides tools, such as a flow chart for diuretic dosage and weights. Overall this tool is useful to help physicians identify patients who may benefit from a treatment. From there it provides support tools that alert the physician to a personalized medical treatment. The “Smart” Heart Failure Sheet acts as a registry for scholarly research and also provides educational resources to expand providers’ knowledge, thereby improving patient care (Battaglia,

Hospitals nationwide have been striving to reduce the rate of patient readmissions. Both the federal government and private insurers are tired of picking up the tab. In a 2009 study in the New England Journal of Medicine, researchers estimated that a year's worth of unplanned re-hospitalizations cost Medicare alone $17.4 billion. Congestive heart failure is a particularly big target, as one in four patients end up back in the hospital within 30 days of discharge. Starting in the fall of 2012, the government will cut Medicare reimbursements for hospitals with higher-than-expected 30-day readmission rates for heart failure and two other conditions: heart attack and pneumonia (Avril, 2011).

To contain the cost experienced by hospitals with HF readmissions, evidence based practice must be applied to avoid reduction penalties by CMS. Evidence base practice shows implementing effective outpatient measures have reduced HF readmissions by 14% to 87% (McClintock et al., 2014). These outpatient measures include case management, early follow-up care, heart failure clinics, cardiac rehabilitation, medication reconciliation regimen, mailing & telecommunications home health and targeting caregiver burden (McClintock et al., 2014). Subsequently, prior to discharge it is the responsibility of the nurse to advocate for the patient. Effective teaching and patient reinforcement of information is important to avoid readmissions of any time

My phenomenon of interest is: The effect of health promotion on the outcome of African- American heart failure patients. Heart failure is fast becoming prevalent among African -Americans due to high incidence of CAD and hypertension. African Americans have the highest mortality rates from chronic diseases. Evidence depicts health promotion as vital to the outcome of heart failure patients. The role of nursing in health promotion has been shown to promote positive outcomes such as adherence, knowledge of illness and improved quality of life. There is a need to decrease readmission and mortality rates in African American heart failure

Each year the number of readmissions of the heart failure patient within 30 days of discharge has grown. The Medicare division in relation with the Affordable Care Act is reducing the amount of money they are willing to pay for readmissions to the hospital. Hospitals are now more than ever looking for ways to reduce the number of readmissions to the hospital for the heart failure patient. The purpose of this paper is take a look at a program designed with to reduce the readmission rates of one hospital to reduce the number of readmission through improved education and follow up of the heart failure patient.

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) core measures in relation to Heart Failure (HF) was examined using empirical-based nursing research. Findings suggest that lack of understanding by nurses contributes significantly to the privation of core measure implementation. A significant number of Americans suffer from HF, so patient quality of care assessment was necessitated. Identifying factors were: nurse-patient education resulting in follow-up appointments, left ventricular performance or left ventricular systolic (LVS) function, treatment medications, and smoking cessation programs. Nurses provide an important role in the education of patients with HF. The Nurse is integral in providing documentation in relation to LVS. Nurses play an important role in the administration of HF medication. Smoking, a major cause of HF, requires special nursing intervention. Nursing results in improved quality of care if HF core measures are implemented properly. Additionally, Orem’s universal requisites are fundamental in the nursing process.

Heart failure (HF) is a debilitating condition that has become a public health problem. There are many debilitating effects of HF for many people that have to live with this disease. According to Hardin and Hussey (2003), recognize inadequate patient education, poor symptom control, and insufficient social support as factors that contribute to preventable HF related hospitalizations (p.p.74). Many people are frequently hospitalized because of HF exacerbation related to lack of knowledge, poor quality of life and medication non adherence. This research proposal determines the effect of Advance Practice Nurse led telephone intervention in the community and how their phone calls would improve the outcomes of patients with Heart Failure. This proposal identifies variables and measurement levels, research methodology and conclusion. The results of the research studies will support the idea that Advanced practice nurses has a positive impact on patients with HF, decreasing HF related hospital admissions and improving their quality of life.

With heart failure, increasing in incidence in the United States, hospital readmission rates are being scrutinized to save money, especially for Medicare beneficiaries. Over 5 million people in the United States are living with heart failure, defined as “a condition in which the heart cannot pump enough blood and oxygen to support other organs in the body” (CDC, 2013). Heart failure affects 2.4% of the United States population with nearly 12% of both women and men 80 years and older having heart failure (Heidenreich, P. A., Albert, N. M., Allen, L. C., Bluemke, D. A., Butler, J., Morrow, G. C., Ikonomidis, J. S., et al., 2013). Heidenreich et al (2013) project that by 2030, heart failure will affect over 8 million Americans, with 2 million of those being ages 80 years and older. Heart failure is one of three conditions to be included in the Centers for Medicare and Medicaid Services (CMS) reimbursements that hospitals are penalized for if the hospital experiences an excess amount of readmissions within 30 days of the initial hospitalization due to the disease.

Rising health care cost and stricter regulations for insurance reimbursement plans have pushed health care leaders to re-evaluate health care services. One focus is reducing hospital readmission rates for chronic disease process (Bos-Touwen et al, 2015). Congestive heart failure is one of the leading causes of hospital readmission (Cubbon et al, 2014). Fifteen million people worldwide have a diagnosis of CHF. In addition, 15-20% of those with the diagnosis of CHF are hospitalized yearly (Sahebi et al, 2015). In 2010, 40 billion dollars was spent on health care needs for CHF patients. Seventy percent of the resources were for hospital services (Siabani, Driscoll, Davidson, and Leeder, 2014). The need for streamline healthcare for CHF patients is imperative to improve overall patient outcomes and reduce the amount of hospital readmission rates.

Congestive Heart Failure (CHF) and Heart Failure (HF) are serious problems in regards to hospital re-admissions especially regarding the sixty-five year old population. Data demonstrates approximately over 670,000 individuals each year are diagnosed with CHF, along with that there are 6 (six) million Americans affected with CHF. Hersh, Masoudi, and Allen (2013) described readmissions of patients with CHF is increasing by 25% within thirty days of discharge from the hospital. This creates a huge impact on the taxpayers and patients due to the increasing percentages being re-admitted into the hospitals (Post discharge Environment Following Heart Failure Hospitalization: Expanding the View of Hospital Re-admission, 2013). The problem is to identify a plan to decrease the CHF/HF hospital re-admissions into the especially regarding the 65 (sixty-five) year olds and older, in spite of efforts from the hospital staff providing guidelines and nursing education regarding CHF/HF signs and symptoms.

According to the Centers for Disease Control and Prevention (CDC) there are an estimated 5.1 million adults suffering from heart failure (2013). As the prevalence of heart failure continues to rise, one out of every nine deaths occur as a result of this chronic condition. Studies conducted at Yale found in Medicare age patients with heart failure, there is a median 30-day mortality rate of 11.1% and 5-year rate of approximately 50% (Alspach, 2014). According to Desai & Stevenson (2012), rising costs of care are in direct correlation to the number of hospital admissions related to a primary diagnosis of heart failure especially among adults age 65 years or older. The national rate for readmissions within 30 days is approximately 24.7%, consequently having

The authors of this article explore the importance of and latest advances in transitions of care programs for patients with Heart Failure (HF). The authors paint a clear picture about the scope of the problem and go on to discuss some of the most well-known and researched transitions of care interventions in current practice. Although many of these interventions have been successful, the authors report fact that programs vary in organizational framework, team composition, and program focus. Programs are also noted to differ based on population size and care

"Reducing 30-Day Readmissions for African Americans with Congestive Heart Failure by improving health literacy through a Comprehensive Context Oriented Discharge Plan”

A great amount of time, money and resource is devoted to improving the transition to home from hospital in the heart failure patient (Qaddoura, Ashoori, Kabali, Thabane, Haynes, Connolly & Spall, 2015). With extensive research available on heart failure and readmission, this study will focus on four main categories. This four category approach allows the clinician to best formulate and prepare for practice in the outpatient setting. The four categories will include various articles based upon evidenced based practice approaches with ultimate goal of reducing admission by implementing successful outpatient care. The four categories are as follows: Frequent monitoring or reporting to the PCP; Medication and Diet compliance; Predictors of