Nurses-Led Telephone Intervention and Readmission

In a reviewed article, Theodosios Stabrianopoulos focuses attention on a scientific experiment on two groups of people with a key goal to establish a correlation between a nurses-led telephone intervention and the frequencies of readmissions of HF patients. During his research, the author discovers that “telephone intervention programs appear to reduce the risk factors and have a positive effect on self-care” (Stavrianopoulos, 2016, p. 4).

The purpose of this particular study is to assess the value of the researcher’s report and evaluate the degree of evidence credibility. All the used methods and approaches will be closely analyzed to provide a verdict on whether scholars across the world can rely on the author’s statement that an intervention program gives positive results to HF patients’ treatment efficiency or not.

The researcher is known to claim that the rehospitalization of patients with heart failure issues can be put to a minimum through a nurse-led telephone intervention. To prove this fact, he had divided 50 test participants into the two groups of 25 people each, with a nearly equal number of men and women in both. The vast majority of examinees were of senior age, and all of them had been suffering from heart failure problems of various complexity levels.

The test lasted for 16 weeks. Group A received a 20-minute weekly consultation from nurses via telephone, while group B was relieved of regular control. According to the data that the author acquired after the experiment’s completion, the group, which was subjected to nurses-led intervention showed fewer signs of disease reoccurrence and demonstrated a reduced rate of readmissions. Naturally, one cannot argue that the scores (readmission rates) provided by Stabrianopoulos appear to be rather convincing: 31.52 in group A and 53.80 in group B. However, one cannot judge objectively without considering an overall research design.

Regarding the study design, the researcher relied on both qualitative and quantitative methods of data retrieving. The qualitative approach is tracked through the use of questionnaires that include research of “a wide range of demographic and socioeconomic characteristics” (Black et al., 2014, p. 124).

Also, the focus on a particular group of people serves as proof of the presence of qualitative analysis. The quantitative method is clearly traced through the use of statistics and numeric tables that served as the means of data recording. The fact the author refers to a mixed method of study leads one to the hypothesis that Stabrianopoulos attempted to receive a versatile view of the matter as opposed to narrow-focused observations. In its turn, it allowed him to provide more evidence for the thesis statement and leave less background for a theory refutation. Eventually, one may call it a strong point of a research course. However, testing a larger group would require more staff members to be engaged and would lead to additional costs, which unveils its weak sides as well.

The author stresses in his research that “the sample selection was made irrespective of origin and marital or socioeconomic status” (Stavrianopoulos, 2016, p. 2). The experiment took place in the prefecture of Ilia in Greece. Both male and female participants were people of senior age (above 60 years old); the changes in their behavior were studied using the same approaches. As was mentioned above, there were 50 people in total engaged in the experiment.

Naturally, for a large-scale data collection, this number is not sufficient. Therefore, the sample cannot be viewed as an entirely objective and adequate form of research. Should one operate with two or three times higher figures there could be an inverse tendency established. However, regarding the new behavioral trends occurrence, one can still make predictions as to which effect the nurses-led intervention into HF patients care may have. Thus, the number of examinees appears to be acceptable.

The information was collected by four nurses, whose clinical experience ranged from four to eight years of work in cardiology units. “Minnesota Living with Heart Failure Questionnaire” (MLHFQ) turned out to be the main tool for data retrieval. The questionnaire was assessing the quality of patients’ lives on both pre- and post-intervention stages. The research data prove that “the intervention was associated with improvements in HF self-care knowledge and home care behavior skills” (Smith et al., 2015, p. S25).

However, one should stress that the results could show other figures if ethical norms were strictly observed. It is known that the researcher did not consider the sex-related differences influencing the final scores. Men and women responded to a nurse intervention differently: male participants were more inclined to hide their concerns, while female representatives openly expressed their fears. Planning a nurse-led intervention by gender peculiarities would probably be a more reasonable approach to choose from.

As to the study limitations, the major challenge was caused by a relatively small size of the sample. Generalizing the results is difficult without operating a sufficient volume of data. Also, “personnel cost is the major component of the total intervention cost” (Smith et al., 2015, p. S28). For a larger sample, one would require a higher budget and more nurses. Moreover, one cannot exclude the opportunity of deliberate changing of answers by the participants. Regarding this fact, it is of great importance to consider all the available limitations in the subsequent studies and take measures accordingly. Thus, naming challenges is a relevant part of any study, since the audience needs to know what external conditions may lead to a change of variables.

The study findings show that in group A rehospitalization rates decreased from 50.88 pre-intervention to 31.52 post-intervention, whereas in group B the score increased from 52.40 to 53.80 respectively (Stavrianopoulos, 2016). When looking at the numbers, one realizes that the purposes of the researcher’s study were fully achieved: the group with a regular telephone-based intervention did show a lower rate of readmissions compared to an opposing one. This fact provides the answer to a key question of this particular research: the work of Stavrianopoulos can be used as a credible source for other scholars in their studies of HF issues treatment. The methods and tools used for data collection leave no room for doubts regarding the results credibility.

Summarizing the facts, the study of Stavrianopoulos gives plenty of evidence to the statement that a nurse intervention in the process of HF patients’ care creates premises for lower readmission rates. The work focuses much attention on the experiment arrangement, research design, and data collection tools. Also, the occurring limitations were mentioned to emphasise the need of expanding the variables in subsequent studies.

The findings show that the concept can be referred to in a day-to-day healthcare practice and can significantly improve the situation with HF patients’ rehospitalization. All the figures provide strong evidence to the fact that readmission occurrences become reduced through a nurse-led intervention experience. In its turn, it proves the statement that the research of Stavrianopoulos can be relied on in further studies of care delivery to the HF patients.

References

Black, J. T., Romano, P. S., Sadeghi, B., Auerbach, A. D., Ganiats, T. G., Greenfield, S., & Ong, M. K. (2014). A remote monitoring and telephone nurse coaching intervention to reduce readmissions among patients with heart failure: Study protocol for the Better Effectiveness After Transition-Heart Failure (BEAT-HF) randomized controlled trial. Trials, 15(1), 124-132.

Smith, C. E., Piamjariyakul, U., Dalton, K. M., Russell, C., Wick, J., & Ellerbeck, E. F. (2015). Nurse-led multidisciplinary heart failure group clinic appointments: Methods, materials and outcomes used in the clinical trial. The Journal of Cardiovascular Nursing, 30(401), S25-S34.

Stavrianopoulos, T. (2016). Impact of a nurses-led telephone Intervention program on the quality of life in patients with heart failure in a district hospital of Greece. Health Science Journal, 10(4), 1-8.

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