Heart failure is the condition in which the heart pumps blood at a lower rate than the normal function rate. In this state, the blood moves through the heart and the body at lower rates. The most common and the leading form of heart failure is the Congestive Heart failure (CHF). The cases of family members and patients, admitted with congestive heart, represent a nursing case that requires immediate response. Effective self-management of CHF has become an ongoing problem. Psychosocial issues are one of the important variables that need to be addressed in patients with CHF. Congestive Heart Failure is a serious health issue which can lead to morbidity and disability if left untreated. A recent report by Ketner et al (2013) presents a case of a fatal CHF that resulted from inefficiency in treatment. These are cases which we can avoid through effective self-management behaviors and prompt treatments. This project therefore, seeks to develop a platform of interaction to enhance effective education on effective self-management behaviors.
Project Objective Questions
Does the daily patient and family teaching using teach-back method with patients who have congestive heart failure decrease re-admission rates when compared with patient teaching at discharge only?
Professional team and the PICO elements
This project intends to provide a diagnostic environment for these conditions and instill effective behavior among patients. In this project I intend to incorporate four nurses, three physiotherapists and a pharmacist. As nurses, we must advocate for our patients and ensure effective communication among the interdisciplinary team. Teaching must start on admission and continuously reassessed by the nurse in order to effectively evaluate the patient’s understanding. The scope of this paper is to emphasize the importance of effective teaching of heart failure, self-management for patients in the hospital setting and to prepare them to function in the community. Nurses should be in the front line if we want to make a difference in our society today. Evidence from the data gathered in one of the hospitals reports that a large number of family members and patients in the hospital have been diagnosed with congestive heart failure. It has also been reported that, among the patients, there has been a good number of cases of readmission within thirty days. Studies show that effective self-management educational instructions are only given to these patients on the day of discharge. These result in poor implementation. The outcome is the rising cases of readmissions and new cases. The level of knowledge among the family members and the patients admitted remains in doubt. However, such cases can be intervened through daily patient teaching on CHF using the teach-back method. Such techniques can help to improve self-management of disease and decrease readmission rates before 30 days. Each nurse is to help in the handling of the inpatients and case diagnosis process; each physiotherapist will help to educate the individuals on the effective self- behaviors while the pharmacist will enable emergency medical demands.
Evidence Appraisal
Using peer-reviewed articles as an appropriate literature resource, my team will be able to establish an effective database for the project. This kind of resource is integrative and has a high strength for such studies. Using such resources we can establish certain facts. Qualitative and quantitative research may also be applied randomly. The trend in the number of patients with CHF is a big problem in the clinics, education centers, public offices and other administrations since it can be fatal and as well consume valuable time in the treatment process. The problem also has an accumulated cost effect.
Evidence
According to the Center for Disease Control (CDC), heart failure cost the nation an estimated $32 billion each year, which includes the costs of health care services, medications to treat heart failure and missed days of work (CDC, 2013). Therefore, it is crucial for healthcare providers to provide effective teaching in order to reduce both cost and re-admission rates. “Readmission of patients who were recently discharged after hospitalization with HF represents an important, expensive and often preventable adverse outcome.” (AHRQ, 2012). When teaching is provided with teach- back method, the healthcare provider has an opportunity to evaluate patients’ understanding of their disease and provide reinforcement as needed. When teaching is effective, re-admission rate decrease and patients’ quality of life increase (Zimmerman et al 2013). It is also evident that cognitive behavior plays a very important role in effective self-management strategies (Barnason et al 2013)
Recommendations
When nurses are provided with the latest and most effective research based data, they will be able to perform at their highest level of practice. The practice model provided by the Johns Hopkins Nursing department, provide a very effective model that advocate for research, evaluation of the environmental factors. It provides an inter-link in the field of practice, education, and research (CDC). I therefore recommend an evidence-based education strategy in influencing the cognitive behaviors of the patients to reduce these cases.
Project Action plans
The nursing team members are entitled to act accordingly to avoid these reports. The project members are therefore, scheduled to meet every evening to discuss the project progress plan as immediately as the implementation begins. Develop focus group discussions. Review the available hospital records and identify the target population and sites for the project. Each member of the team must play a role.
Outcome indicators and steps
This project is desired to improve the effective self-management characters among the heart failure patients and the general public. The indicators used: reduced re-admission of CHF cases, reduction in mortality ratios, and improved self-performance among the hospital nurses. These findings can be reported through bar graphs, charts, pie charts, audio recordings among other methods. The key stakeholders are policy makers, health professions and the general populace.
Implementation and communication strategies
In brief, congestive heart failure case evidences provide a strong link to a nursing emergency that requires an effective response plan to change behavior in the hospital settings. Evidence-based education is the best strategy to achieve this. However, the action plan requires a proper monitoring and evaluation
References
Barnason S., Zimmerman, L., & Young, L. (2012). An integrative review of interventions promoting self-care of patients with heart failure. Journal Of Clinical Nursing,21 (3/4), 448-475.
Rahimi, K., Patel, A., & MacMahon, S.(2012). Two decades of research on innovative models of care delivery for patients with heart failure: the end or just the beginning? Archives Of Iranian Medicine, 15 (7), 439-445.
Daley, K., & Campbell, S. H. (2009). Framework for simulation learning in nursing education. Simulation scenarios for nurse educators: Making it real, 287-290.
Pan, A. (2014). The Significance of Timing of Patient Daily Weights and the Barriers.
