Identification of the Issue
The paradigm of nursing interventions has always been closely associated with the development of long-term prevention care plans in order to anticipate negative patient outcomes. Patients with chronic cardiac conditions are at risk of struggling with disease complications triggered by the slightest change in their environment. For this reason, the issue identified for the present intervention is the travel implications for patients with congestive heart failure (CHF). The notion of traveling explicitly relates to the process of air travel as a major trigger for change in the patient’s heart rhythms and blood pressure. Thus, educational intervention for the CHF patients prior to air travel will decrease the probability of cardiac complications during or after the flight.
Setting and Context
Over the past years, commercial air travel has become one of the most widespread means of transportation for travelers. In the context of air travel, cardiac patients are regarded as passengers who “have a medical condition that may be adversely affected by a flight environment” (Houm, 2020). Considering the fact that both populations of air travelers and cardiac patients have been steadily increasing for the last decades, it would be reasonable to assume that there is a demand for medical intervention in terms of patient education and preventive care (Mather, 2017). Thus, the immediate context of the existing intervention is the increased demand for consulting and examining cardiac patients on the matter of their fitness for flights and travel.
Issue Description
The process of travel, along with a variety of routine tasks, may serve as a trigger for health condition deterioration for patients with heart failure. The difficulty is primarily caused by one’s predisposition and increased sensitivity to high altitudes, as such a rapid change may naturally elevate the patient’s PA pressure and exacerbate heart failure (Letourneau et al., 2020). Other issues detrimental to the patient’s cardiac condition include “decreased humidity, gas expansion, prolonged immobility, and increased physical and emotional stress” (Hammadah et al., 2017, p. 660). Such a variety of risk factors presents a demand for systematic medical intervention and quality preventive care.
Effect of the Intervention
The process of preventive education for cardiac patients prior to the travel will have a beneficial effect on the patient outcomes, as the vast majority of patients are currently unaware of the complications their disease might trigger in a flight environment (Kamata et al., 2017). The issue is especially relevant for older patients who are frequently unable to share relevant information concerning their state (Morey et al., 2017). Thus, when securing pre-travel communication and examination, patients would be able to draw appropriate conclusions concerning their fitness to travel and the medical assistance required to handle the trip safely.
Significance and Implications for Nursing Practice
Nurses play the most significant role in terms of the present intervention, as they facilitate the process of education and communication with cardiac patients. In fact, nurses serve as primary prevention of the emergency medical cases during the flight, as the current patterns of air travel do not secure a systematic framework for an emergency landing in case of medical complications (Stefanacci & Gambs, 2017). A major implication for the nursing practice concerns the promotion of collaborative dialogue with patients instead of providing them with a brief and incomprehensive list of recommendations.
Solution
The primary solution in terms of the present intervention concerns the conduction of pre-flight examination and therapy for CHF patients willing to travel. Despite the existing model of examining patients at the airport prior to the departure, there are patients who avoid medical intervention before the flight and, consequently, remain unaware of the potential risks (Sutherland & O’Connor, 2018). Hence, according to Mather (2017), a pre-flight educational session conducted by a nurse should include but not be limited to the following recommendations:
- Maintaining hydration during travel;
- Creating proper patterns of medication administration regarding the possible changes in PA pressure and overall well-being;
- Securing enough medical supplies to maintain adequate cardiac indicators during the travel.
References
Hammadah, M., Kindya, B. R., Allard‐Ratick, M. P., Jazbeh, S., Eapen, D., Wilson Tang, W. H., & Sperling, L. (2017). Navigating air travel and cardiovascular concerns: Is the sky the limit? Clinical Cardiology, 40(9), 660-666.
Houm, K. C. (2020). Commercial air travel for passengers with cardiovascular disease: Recommendations for common conditions. Current Problems in Cardiology, 46(3).
Kamata, K., Birrer, R. B., & Tokuda, Y. (2017). Travel medicine: Part 1–The basics. Journal of General and Family Medicine, 18(2), 52-55.
Letourneau, M. M., Brancheau, D., Estes, J., & Zughaib, M. (2020). Take me higher: A case of heart failure at high altitude detected using the CardioMEMS™ HF system. The American Journal of Case Reports, 21.
Mather, J. (2017). Flying high for heart failure: Considerations for air travel. British Journal of Cardiac Nursing, 12(1), 34-39.
Morey, S. A., Barg-Walkow, L. H., & Rogers, W. A. (2017). Managing heart failure on the Go: Usability issues with mHealth apps for older adults. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 61, No. 1, pp. 1-5). SAGE Publications.
Stefanacci, R. G., & Gambs, S. (2017). Prepping for take off: Readying older adults for air travel. Annals of Long-Term Care, 25(5), 39-45.
Sutherland, S. F., & O’Connor, R. E. (2018). Preflight therapies to minimize medical risk associated with commercial air travel. In In-Flight Medical Emergencies (pp. 141-149). Springer.