Abstract
One of the quality indicators presented in the National Database of Nursing Quality Indicators is focused on the issue of nursing hours per patient a day (Montalvo, 2007). This is the indicator selected for the clinical question development presented in this paper. The indicator is determined by such contributing factors as the number of registered nurses employed by an institution, the number of patients it assists, and also the number of LVNs (licensed vocational nurses), LPNs (licensed practical nurses), and UAPs (unlicensed assistive personnel) (Montalvo, 2007). It will be applied to the intervention for the clinical problem of CVD risk factors in the affected population and the individuals likely to develop it in the near future. In particular, the present paper seeks the CVD risk factors intervention that could be implemented without overloading the nurses.
Problem as Represented by the Quality Indicator
The specific problem analyzed in this paper is the control and prevention of the risk factors contributing to the prevalence of cardiovascular disease. In particular, many of the risk factors tend to occur in the outpatients and require an informed management strategy based on the patients’ literacy concerning the condition (Cicolini et al., 2013). The problem is that due to the insufficient nurse to patient ratio, many organizations do not have enough free nurses to deliver educational programs to the communities outside the hospitals and clinics; also, the percentage of CVD inpatients who can obtain the appropriate information is small. Moreover, a one-time educational session is ineffective against a chronic condition with ongoing symptoms and risks such as CVD.
Affected Population
The population affected by cardiovascular disease involves the people in their forties who already suffer from the condition or are at a high risk of developing it in the near future. Practically, it is known that CVD can occur due to a set of contributing factors that are manageable and can be addressed; they include passive lifestyle, obesity, hypertension, unhealthy diet, tobacco use, and high levels of blood glucose, cholesterol, and triglycerides (Cicolini et al., 2013). As a result, the affected population and the individuals at risk can engage in the successful self-management practices. What they require is the assistance of nurses providing the necessary information and advice concerning the practice.
Intervention
The problem of reaching out to the affected population and the individuals at risk of developing CVD can be solved with the help of a nurse-led tele-counseling program based on such means of communication as telephone and email. As found by Cicolini et al. (2013), a program of this type addressing the target population (adults in their forties with CVD or at a high risk of developing CVD) could improve a range of risk factors via a low-cost and non-time-consuming outreach plan. The implementation of the program took the participating nurses about 20 minutes a day (in addition to the usual tasks) to include a hundred of participants into a nurse-led reminder program (NRP).
Moreover, the study by Carrington and Stewart (2014) investigated the effects of nurse-led outreach programs produced on the CVD patients and detected significant positive outcomes visible in the long-term and a change in the patients’ lifestyles and choices in regard to the factors connected to the risk of CVD.
Desired Outcome
The desired outcome of this intervention is the minimization of the rates of cardiovascular disease in the target population achieved cost-effectively without overloading the nursing personnel. Namely, the targeted CVD risk factors involve unhealthy diets, the lack of physical activity, smoking cigarettes, excessive weight, high BP, and elevated levels of blood glucose, cholesterol, and triglycerides – all of them can be impacted by an NRP.
References
Carrington, M., & Stewart, S. (2014). Cardiovascular disease prevention via a nurse-facilitated intervention clinic in a regional setting: The Protecting Healthy Hearts Program. European Journal of Cardiovascular Nursing, 14(4), 352-361.
Cicolini, G., Simonetti, V., Comparcini, D., Celiberti, I., Di Nicola, M., & Capasso, L., … Manzoli, L. (2014). Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: A randomized controlled trial. International Journal of Nursing Studies, 51(6), 833-843.
Montalvo, I. (2007). The National Database of Nursing Quality Indicators (NDNQI). The Online Journal of Issues in Nursing, 12(3).