Introduction
Heart failure (HF) is a clinical symptom that occurs when impairment of ventricular filling prevents the heart from properly maintaining blood flow (ACCF/AHA, 2013). A recent report issued by the Center for Disease Control and Prevention (2016) reveals that almost 5.7 million American adults suffer from the disease. Moreover, approximately 50 percent of all diagnosed with HF die within five years (CDC, 2016). Even though substantial progress has been achieved in decreasing mortality rates in patients suffering from HF, rehospitalization rates are still as high as 30 percent within 60 to 90 days after discharge (Gheorghiade, Vaduganathan, Fonarow, & Bonow, 2013). The aim of this paper is to outline an evidence-based project (EBP) proposal for the reduction of HF rehospitalization rates.
EBP vs. A Research Project
The EBP aims to reduce rehospitalization rates for patients hospitalized with HF. To this end, it is necessary to concentrate on post-discharge outcomes instead of focusing on short-term therapies. Unlike a research project the sole aim of which is to obtain new evidence, EBP uses existing research and all forms of evaluation data to determine the best strategies for improvement. It is important to understand that best practices are in constant flux; therefore, health care professionals have to rely on the most current evidence to support their clinical expertise (Conner, 2014).
Description of the Problem
The post-discharged rates for patients hospitalized with HF are still as high as 30 percent (Bowers, 2013). Taking into consideration the fact that almost 1 million patients are being hospitalized with HF each year in the United States, the rate of rehospitalization is excessively high. The necessity to reduce HF readmissions is also pressing because of hospitalizations for HF “account for over 6.5 million hospital days and a substantial portion of the estimated $37.2 billion that is spent each year on HF in the United States” (Gheorghiade et al., 2013, p. 105). It has been recognized that by preventing clinical and subclinical congestion it is possible to substantially reduce rehospitalization rates (Gheorghiade et al., 2013). The most popular therapies for congestion management include, but are not limited to vasopressin, adenosine-blocking agents, and loop diuretic therapy (Katz & Konstam, 2012).
In terms of measurable outcomes of the project, it is necessary to make sure that it decreases rehospitalization rates within 60 to 90 days after discharge by 10 percent and reduces post-discharge mortality rates by 3 percent. Currently, post-discharge mortality rates for patients with HF vary from 5 percent to 15 percent (Gheorghiade et al., 2013).
The relevance of the Project
No single diagnostic test can be used to diagnose HF; however, patients that have the pathology are usually associated with its cardinal manifestations that include but are not limited to “dyspnea and fatigue, which may limit exercise tolerance, and fluid retention, which may lead to pulmonary and/or splanchnic congestion and/or peripheral edema” (ACCF/AHA, 2013, p. 246). It is extremely important to properly manage HF symptoms in order to improve the patients’ quality of life and reduce comorbidities associated with the condition.
Conclusion
The EBP project dresses the issue of excessively high rehospitalization rates for HF. The interventions that can be used for decreasing the rates of readmissions include, but are not limited to vasopressin, adenosine-blocking agents, and loop diuretic therapy.
References
ACCF/AHA. (2013). Guideline for the management of heart failure. Web.
Bowers, M. T. (2013). Managing patients with heart failure. Journal for Nurse Practitioners, 9(10), 634-639.
CDC. (2016). Heart Failure Fact Sheet. Web.
Conner, B. (2014). Differentiating research, evidence-based practice, and quality improvement. American Nurse Today, 9(6), 14-21.
Gheorghiade, M., Vaduganathan, M., Fonarow, G., & Bonow, R. (2013). Rehospitalization for heart failure: Problems and perspectives. Journal of the American College of Cardiology, 16(4), 104-122.
Katz, M., & Konstam, A. (2012). Heart failure: Pathophysiology, molecular biology, and clinical management. New York, NY: Lippincott Williams & Wilkins.