Background
Congestive heart failure is one of the main health concerns in the United States today. According to Hodges (2009), heart failure is the only disease with an increasing prevalence in this country. More people are being diagnosed with this disease each year. Scholars have pointed out the importance of putting this disease under control as a way of achieving the Healthy People 2020 vision of this country. The process of treating heart diseases is not only expensive but also time-consuming. It is, therefore, of concern to see a large percentage of those who are hospitalized with heart failure are coming for readmissions. Cases of readmissions of patients with heart failure have been common in this country, and it is important to find a way of eliminating the vice.
The project focuses on how readmission of heart failure patients can be eliminated in hospitals within the United States through the teach-back method. The strategy seeks to offer heart failure patients knowledge on how they can lead healthy lives after leaving hospitals to avoid a possible need for readmission. This makes the project very important within the realm of cardiac nursing. The ability to make patients understand how to take care of themselves reduces the congestion in the healthcare facilities. This means cardiac nurses will have enough time to attend to new cases.
In this project, the focus will be on how the teach-back method for heart failure patients can be used to reduce cases of readmission of heart failure patients after discharge. The research will look at how the teach-back method can be used to enlighten patients on the kind of lifestyle they can lead to ensure they remain healthy.
Problem Statement
According to Evans (2010), over half a million new cases of cardiovascular diseases are diagnosed every year, with over five million existing cases, which need medical attention. This scholar gives an example of the Cleveland Clinic, which has seen the number of its inpatients increase to 1550 in 2009, from 1211 in 2005. This translates to about a 20% increase within three years. However, the facilities at this hospital have not increased, meaning the facilities of this hospital are forced to work at 120%. This case is replicated in various other hospitals across the country. the increased pressure on these facilities does not only reduce the efficiency and quality of healthcare provided but also causes stress to nurses who are forced to work for extra hours because of the high number of patients.
The above data clearly demonstrates the current state of affairs needs some immediate measures to revert the situation. Cardiovascular diseases have been considered as some of the leading causes of deaths in this country. If care is not taken to address this issue, more lives will be lost, and this country will lose a lot of money trying to budget for the increasing number of patients with heart diseases. To the nursing practitioners, this will be defeating the very essence of this profession. It is always the objective of nurses to help patients overcome their diseases and recover under a good environment before they can be discharged (Hatchett, 2011). However, they are already overwhelmed, and this is partly attributed to cases where some patients pass on while in hospitals. It is therefore, worth committing resources, including human resources, to ensure this project is made a success. It will cost the stakeholders to undertake this project, but the outcome will be of great benefit to the patients, the hospitals, the government, and the nursing fraternity.
Project Purpose
Holland (2009) says one of the main roles of nurses is to help a patient recover in an environment, which befits his or her condition, and upon discharge, the patient should lead a healthy life. However, this is not the case for cardiovascular patients. Readmissions have affected the ability of nurses to offer quality nursing because of the constant rise in the number of inpatients. This project therefore, seeks to help nurses achieve their nursing objectives by ensuring cases of readmission of heart failure patients are eliminated. This will help create an environment where nurses only deal with manageable number of patients. Upon completion of this project, the expectation is to eliminate cases of readmission of cardiovascular patients because the patients will have enough knowledge on how to lead healthy lifestyle (Steptoe & Freedland, 2010).
This project is in line with IOM aims. This is because it seeks to provide safety of the patients after leaving hospitals. When readmission of patients is reduced, nurses will be more effective and timely in their actions. This project is also patient-centered as stated in IOM aims. It is also strategically aligned to the system’s overall goals of offering quality healthcare to all patients. When readmission is reduced, congestion on healthcare facilities including the human resource will be eliminated. Performing this work will improve the researcher’s scholarly nursing practice in various ways. This awareness creation campaign will also enhance knowledge of the researcher on how an individual can keep cardiovascular diseases at bay. The patients will also share their experience with this disease, and this will enhance the knowledge of the researcher. This knowledge will be of benefit in the future practice.
Clinical Question
As Moser and Riegel (2008) note, it is important to understand how to ask good clinical question, which would yield the expected data. It is important to understand when to ask background questions or evidence-seeking questions. It is therefore, necessary to develop a well-structured and searchable clinical question with the help of four parts of PICO (Patient, Intervention, Comparison, and Outcome) structure. The following are some of the relevant questions to this project based on PICO format. The following are some of the questions, which will be subjected to the cardiovascular patients.
- How long have you experienced cardiovascular complication?
- How many times have you been admitted to a hospital due to heart related diseases?
- Do you believe enough education can make one lead healthy lifestyle free from cardiovascular diseases?
The following are some of the intervention questions relevant for this project.
- What are some of the measures you believe can be taken to reduce readmission of heart failure patients to hospitals?
- Do you believe awareness creation among patients through teach-back method is appropriate in fighting inpatient readmission for those suffering from cardiovascular diseases?
The following comparison question is relevant for this research project.
- What are some of the other alternative approaches, which can be used to reduce cases of readmission of patients suffering from heart failure diseases?
Finally, the research will need an outcome question as identified below.
- What are the expected objective objectives for this research?
Review of Literature
Researchers have conducted massive study into this field to try to explain some of the possible ways through which cases of readmissions of cardiovascular patients can be reduced or eliminated. According to Friedman and Quinn (2008), cases of readmission of inpatients, suffering from cardiovascular diseases has majorly been caused by limited patients’ knowledge on how they can lead healthy lives when they are discharged from hospitals. According to Woods (2010), when cardiovascular patients are discharged, they tend to go back to their previous lifestyle practices, which are detrimental to their health. Doctors and nurses do their best in treating the patients, but little has been done to make these patients lead lifestyles, which would protect them from health complications.
According to McQuillan (2009), the United States’ government has been forced to incur a lot of cost to offer healthcare services to the citizens suffering from heart failure diseases. If corrective measures are not taken to reverse the current trend, then the number of readmission of patients suffering from cardiovascular diseases is likely to be on the rise. As such, Levine (2013) says teach-back method for heart failure patients is a timely project, which will impart knowledge on these patients on how to start new lifestyles, which will make them healthy. However, Hatchett (2011) says research gaps exist on how this program can be enrolled to reach out all heart failure patients in this country. The research sets out to fill the research gaps identified by the existing literatures. Some of existing literatures in this field can be summarized as shown in the appendix below.
References
Evans, M. (2010). Cardiovascular nursing. Springhouse: Springhouse Corp.
Friedman, M. M., & Quinn, J.R. (2008). Heart failure patients’ time, symptoms, and actions before a hospital admission. Journal of Cardiovascular Nursing, 23(6), 506-512.
Hatchett, R. (2011). Cardiac nursing: A comprehensive guide. Edinburgh: Churchill Livingstone.
Hodges, P. (2009). Factors impacting readmissions of older patients with heart failure. Critical Care Nursing Quarterly, 32(1), 33-43.
Holland, J. M. (2009). Cardiovascular nursing: Prevention, intervention, and rehabilitation. Boston: Little, Brown.
Levine, A. (2013). The comprehensive textbook of healthcare simulation. New York: Springer.
McQuillan, K. (2009). Trauma nursing: From resuscitation through rehabilitation. St. Louis: Elsevier.
Moser, D. K., & Riegel, B. (2008). Cardiac nursing. Philadelphia, Pa: Elsevier Saunders.
Steptoe, A., & Freedland, K. E. (2010). Handbook of behavioral medicine: Methods and applications. New York: Springer.
Woods, S. L. (2010). Cardiac nursing. Philadelphia: Lippincott Williams & Wilkins.