Background: Problem, Objectives, and Key Assumptions
Addressing the needs of patients with Congestive Heart Failure (CHF) is a challenging task because of the numerous external factors that affect the changes in their health. The specified task becomes especially complicated once patients are introduced to the environment of acute care (AC). Seeing that the patients that are placed in the specified setting are especially vulnerable to external threats, it is crucial to reduce the exposure to imminent threats to their health. Changes in pulmonary pressure (PP) reduce the patients’ chances to recover fast and open a plethora of possibilities for the further deterioration of their health due to the effect that a change in PP rates, particularly, its increase, has on blood vessels and capillaries.
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Preventing the instances of rapid changes in PP rates in AC patients is, therefore, a crucial task that healthcare practitioners must address respectively. Innovative technological solutions are bound to help improve the monitoring process significantly due to their high precision and the chances for detecting the problem at the earliest stages of its development. CardioMEMS has recently been designed to measure and monitor patients’ PP rates, which is crucial in the AC environment. The objective of the paper is, therefore, to study the advantages and disadvantages of the specified technology in the AC setting for managing the needs of CHF patients when it comes to handling rapid changes in PP rates.
CardioMEMS is expected to become the device for enhancing the efficacy of AC services for CHF patients in AC. Seeing that it allows for very high precision in PP measurement, the instances of PP changes will not only be prevented successfully but can be modeled so that a comprehensive care plan could be improved. Thus, CardioMEMS and similar technology must be viewed as a crucial tool in addressing the needs of CHF patients in AC.
Literature Review: CHF, Its Treatment, and Role of Technology
CHF is a condition in which the ventricles of the heart do not function properly and, therefore, do not pump blood efficiently due to congestions in the vessels. Because of the issues with the transportation of blood, oxygen- and nutrient-rich blood does not reach the organs that need it, hence the problems in their functioning. The blood that returns to the veins due to the specified issue causes even greater congestions, thus, aggravating the problem (see Figure 1).
It should be noted that several types of CHF are typically distinguished. The nomenclature depends on the aspect of the problem. For example, CHF cases are classified based on the location of the problem (i.e., right- and left-sided CHF), the direction in which the flow is constricted (i.e., backward and forward CHF), the frequency and nature of the problem (i.e., acute and chronic CHF), phases of the cardiac cycle (systolic and diastolic), and type of cardiac output (high and low) (“Congestive heart failure,” n.d.). The choice of the appropriate treatment approach is defined by the type of CHF.
According to the official statistical data, CHF currently affects at least 26,000,000 people globally (Savarese & Lund, 2017). There is a disturbing propensity toward a gradual increase in the number of CHF patients globally; particularly, it is expected that the number of CF patients will rise to a total of 8,000,000 patients in 2030 (Savarese & Lund, 2017). At present, there is a direct correlation between the age of patients and the propensity toward the development of the disorder. To be more specific, a prevalence of CHF development has been noticed among people of 70 and older (Centers for Disease Control and Prevention, 2017).
In the AC environment, CHF is typically referred to as acute decompensated heart failure (ADHF). The specified disease affects at least 1,000,000 people on an annual basis. At present, the mortality rates are 5% in the AC setting, yet, with the recent adoption of innovative technological tools for managing patients’ needs, opportunities allows reducing the specified rate by 40%, according to a rent study (Fermann & Collins, 2013).
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Among the factors that may lead to the development of CHF, one must mention underlying conditions that include possible coronary artery disease, past instances of heart attacks, heart muscle disease, pulmonary hypertension, etc. (Fermann & Collins, 2013). Therefore, maintaining consistent supervision of the environment of the AC and the factors to which a patient is exposed is essential to the outcomes of the treatment and the successful recovery.
Determining the essential signs and symptoms of the disease, one must mention the presence of dyspnea, also known as the shortness of breath, syncope, i.e., the feeling of dizziness, fatigue, possible swelling in the area of legs and abdomen, also known as edema, etc. (Park, Aldwin, Choun, Suresh, & Bliss, 2016). The change in the color of a patient’s skin and lips toward a bluish hue must also be recognized as a symptom of CHF (cyanosis) and the sign that the patient requires immediate assistance from healthcare experts. Finally, shortness of breath can also indicate that a patient may have developed CHF or is likely to experience a CHF attack unless proper actions are taken.
When considering the issues that affect CHF patients’ health outcomes in the AC environment, one must mention problems with monitoring, as well as the difficulties associated with the transition from AC to the environment of home care. In other words, it is essential to supervise the changes in the patients’ condition consistently so that the slightest threats could be identified and eliminated successfully. Furthermore, the possible instances of recidivism must be identified and prevented or managed successfully so that the patient’s health could not deteriorate. Therefore, opportunities for monitoring the changes in CHF patients’ health in the AC realm must be revisited.
As the overview of CHF symptoms provided above shows, it is crucial to create the environment in which the slightest changes in the patient’s health are monitored and recorded accordingly; thus, the foundation for developing a coherent medical strategy and an approach for successful management of a CHF fit can be built.. the lack of certainty and the possibility of overlooking an essential factor that may trigger the further aggravation of the patient’s well-being, however, must be regarded as the primary impediment to providing proper care in the AC environment
The lack of opportunities for communicating with a CHF patient in the AC setting must also be deemed as a crucial obstacle on the way to preventing the instances of CHF attacks, as well as detailing the available strategies for managing the disease. At this point, the significance of technological innovations must be mentioned. With the adoption of the tools that allow for efficient monitoring of the changes in the patient’s health, as well as the identification of the factors that may lead to the aggravation of the patient’s health, the chances for reducing the death toll among CHF patients have appeared. Thus, extensive exploration of the available devices, including CardioMEMS as one of the essential contemporary devices for preventing the instances of CHF attacks in patients should be explored extensively. The opportunities for tracking down changes in PP, which is viewed as one of the primary factors triggering the development of CHF, must be considered the key advantages of CardioMEMS.
Case Description: Patient, Key Barriers, and Options
The patient (James) is a 75-year-old African American male, who has been suffering from CHF for 3 years. He was admitted to the AC unit after a CHF attack that he suffered at home. He has a significant abdominal enlargement and suffers from regular chest pains. James used to be a very heavy smoker, yet he stopped smoking around four years ago when he started experiencing respiratory problems.
James’s current state can be regarded as satisfactory, yet he is extremely vulnerable to the external factors that may possibly cause another instance of a CHF attack. The patient’s blood pressure is currently viewed as the primary issue of concern since it has been comparatively high. Seeing that a sharp increase in BP levels is defined as the primary cause of the CHF development in the identified case, it is crucial to maintain the consistent monitoring of John’s BP levels with high precision levels. The analysis thereof will allow defining not only the further changes in the therapy approach but also the possible forecast for James’s well-being and chances for recovery.
When considering the key barriers to care, one must mention the lack of communication opportunities in the AC environment between a patient and a healthcare provider. Thus, the needs of the patient may not be met fully. Furthermore, the lack of patient education and the exposure to external threats may complicate the process of transitioning from the realm of AC to the environment of James’s home. Thus, it is crucial to introduce the monitoring tools that will help shape the further approach toward meeting James’s needs, as well as forecast further instances of CHF so that the aggravation of the patients’ condition could be prevented successfully.
Technology Description: CardioMEMS and Pulmonary Pressure
As stressed above, the active use of the available monitoring tools for detecting changes in the patient’s condition and the further management thereof in the context of AC should be provided. CardioMEMS, in turn, can be viewed as a perfect device for carrying out closer supervision of the changes that occur in patients in the AC environment. The adoption of the identified device as the means of monitoring and registering changes in the patient’s health will compensate for the lack of communication between the patient and the staff in the AC environment.
The tool is referred to as the state-of-the-art device for addressing the issues of CHF in patients (Adamson, Henderson, Ginn, Neville, & Abraham, 2015). The device can be described as a miniature pressure measurement tool; therefore, when used by a CHF patient, it allows monitoring the PP levels closely. As a result, the information provided by CardioMEMS serves as the basis for defining the patient’s current state, identifying possible problems with PP levels that can occur within an observable amount of time, and designing a set of measures that will contribute to a gradual improvement of the patient’s state. What is especially useful about CardioMEMS is that it helps determine a particular CHF-related issue at the earliest stages of its development and, thus, provides the opportunities for its successful management.
In the case under analysis, the technology can be used to address two primary concerns, the first one being the lack of patient education and, therefore, awareness about the problem. As explained above, James seems to lack the knowledge necessary to locate an emerging problem and communicate it successfully to the healthcare practitioners. The situation is aggravated by the fact that the AC environment does not allow for close and long communication between a patient and a healthcare practitioner. Thus, it is essential to retrieve the necessary information about the changes experienced by the patient with the help of devices that allow registering the slightest alterations in the PP levels. As a result, the opportunities for meeting James’s needs can be built.
Furthermore, in James’s case, the creation of chances for a smooth transfer from the realm of the AC to home care will occur more naturally once the CardioMEMS devices utilized. The specified tool will provide healthcare practitioners with a chance to monitor the changes in the patient’s PP levels and, thus, registering the development of the premise for a possible aggravation of his condition, very carefully. The specified opportunity is crucial since, when experiencing the transfer from AC to his home, James is likely to face an array of external factors that will expose him to an imminent threat of PP levels increase.
CardioMEMS will also serve as the means of reducing the process of fluid accumulation, which is crucial for James at present because of the issues that he is having with edema. As James’s record shows, his legs have been swollen since the admission to the hospital, which has been affecting his state negatively. The accumulation of liquid in the patient’s body ultimately leads to a gradual rise in pressure levels; consequently, the problems associated with the CHF issue remain in their place. The introduction of the tool that will trigger a slow reduction in the levels of liquid retention will not cause the patient to experience the stress associated with a rapid loss of fluid; instead, it will carefully lad to a series of changes in the treatment process that will ultimately lead to the removal of the edema and the further recovery.
Therefore, being the representation of the technology that allows monitoring the alterations in a CHF patient’s body for a faster recovery, CardioMEMS must be applied to manage James’s needs successfully. The suggested device allows addressing the lack of communication that can be observed among the patient and the AC staff. Furthermore, the lack of awareness that the patient demonstrates as a threat to a successful conversation between James and the healthcare staff in the AC environment can be compensated with the introduction of CardioMEMS as the tool for providing the required information to the staff and preventing the instances of the aggravation of James’s condition.
Summary: Key Facts and Arguments
CHF remains one of the key factors leading to an increase in the death toll worldwide. The disease affects primarily people of senior age and creates significant health complications that must be addressed with intensive treatments and therapies. The necessity to embrace a large variety of factors that may contribute to the deterioration of a CHF patient’s well-being implies that a tool allowing for close monitoring of the patient’s progress must be introduced into the realm of AC.
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James is a 70-year-old African American who has developed CHF and has been placed in the AC environment. At present, it is crucial to supervise the changes that the patient is experiencing after the provision of therapy and the suggested medications. Furthermore, it is essential to make sure that the healthcare staff is provided with the information necessary to define the further course of the treatment process and meet James’s needs in a manner as efficient and expeditious as possible. The importance of developing the strategy for the further prevention of CHF issues must also be incorporated into the range of concerns that have to be handled within a relatively short amount of time. The lack of communication with the patient and the absence of proper patient education should be viewed as the primary impediments to the successful provision of care. The situation is aggravated by the presence of edema in James’s legs.
The use of CardioMEMS as the means of detecting possible changes in James’s state and the identification of patterns that will serve as the foundation for the further forecast must be viewed as a necessity.
Moreover, the device can be utilized as the basis for carrying out the transfer of the patient from the AC environment to the realm of his home. Because of the rapid exposure to an array of external factors that the specified transfer will entail, it will be imperative to monitor the changes in the patient’s health closely. With the ample opportunities for monitoring alterations in PP levels, which CardioMEMS provides, one must deem it as an essential addition to the range of tools for managing James’ needs.
Conclusion: Improving Management of CHF in Acute Care
The issue of CHF remains a concern for global healthcare. Therefore, it is crucial to create an environment in which a faster recovery and more efficient management of CHF-related issues could become a possibility. A closer look at the nature of CHF reveals that the levels of PP affect the patient’s chances for a successful recovery, as well as define the threat of recidivism in the future. Therefore, introducing the tools for monitoring the patient’s health and PP levels, in particular, is an essential step toward the enhancement of CHF patients’ well-being. The specified change is especially important in the AC environment, where the opportunities for efficient communication with a patient are reduced due to health issues.
The adoption of CardioMEMS must be deemed as a necessity since it allows measuring the PP levels accurately. Thus, successful prevention of CHF-related issues will become a possibility. Furthermore, further prognoses can be made based on the measurement results. Therefore, the inclusion of CardioMEMS into the range of devices used in the AC environment will contribute significantly to the enhancement of the recovery process and the successful management of patients’ needs. The device will compensate for the lack of communication in the AC environment and allow for a careful transfer of patients from the AC setting to their home.
Adamson, P. B., Henderson, J., Ginn, G., Neville, S., & Abraham, W. T. (2015). Pulmonary artery pressure guided heart failure management during a ‘real-world’clinical setting follow-up period demonstrated even greater improvement in clinical outcomes than that achieved in the CHAMPION randomized controlled trial. Journal of Cardiac Failure, 21(8), 118-119. Web.
Centers for Disease Control and Prevention. (2017). Heart failure fact sheet. Web.
Congestive heart failure [Image]. (n.d.). Web.
Fermann, G. J., & Collins, S. P. (2013). Initial management of patients with acute heart failure. Heart Failure Clinics, 9(3), 291-301. Web.
Park, C. L., Aldwin, C. M., Choun, S., Suresh, D. P., & Bliss, D. (2016). Spiritual peace predicts 5-year mortality in congestive heart failure patients. Health Psychology, 35(3), 203-210. Web.
Savarese, G., & Lund, L. H. (2017). Global public health burden of heart failure. Cardiac Failure Review, 3(1), 7-11. Web.