PICOT
Population/Patient
Adults with congestive heart failure requiring hospitalization
Intervention
Heart Failure education (signs, symptoms, pathophysiology), self-care interventions (diet, fluid restrictions, sodium dietary restrictions, review of medications, exercise recommendations, weight monitoring), patient support (telephone support, increased clinic visits, home visits, social support, psychological support, multidisciplinary care).
Comparison
Usual care vs. intervention, one intervention vs. another intervention
Readmission rates (all causes), length of hospital stay, health care utilization, mortality rates (all causes), quality of life.
Timeframe
One Month follow up
Question
In congestive heart failure patients 50 years and older, what is the effectiveness of interventions to support post-discharge care compared with the usual care to prevent readmission?
How can we prevent readmissions for patients with congestive heart failure?
Introduction
Congestive Heart Failure (CHF) occurs when the heart is unable to pump enough blood flow to meet the needs of the body. It can cause a number of symptoms, including shortness of breath, exercise intolerance, swelling in the extremities, numbness, and even mimic the symptoms of gastric distress. Treatment is dependent upon severity of the affliction, whether chronic or first-incidence. Sometimes, treatment is environmental in nature (loss of weight, increased exercise, decrease in smoking, etc.), other times it is treated with implanted devices, blood thinners, or medication. Heart failure in the developed world is relatively common due to more sedentary lifestyles, with about 2% of the population suffering from the disease, but 10-12% of those over 65 (McMurray & Pfeffer, 2005; Hines, Yu, & Randall, 2010). Because HF is so common, we must also look upon it as an epidemic that may have...
Heart Failure Guidelines The 2009 revision of the ACC/AHA Guidelines for the Diagnosis and Management of Heart Failure in Adults contains a number of evidence-based updates, revised text, and a new section called "hospitalized patient" (Hunt et al. e395). These revisions are the result of a task force that convened in 2008 and represent new findings published between 2005 and 2008. Four stages along a continuum of heart failure are described, with
Heart failure has been described as a "complex clinical syndrome that results from either structural or functional impairment of ventricular filling or ejection," (Alspach, 2014, p. 1). Because of the multifaceted nature of heart failure, it is important to recognize its various symptoms and dimensions. Heart failure in general presents a major public health concern, with current prevalence at over five million adults in the United States and over 650,000
Heart Failure Literature Critique of Articles concerning Heart Failure The two articles in this literature review are concerned with different aspects of care for patients diagnosed with some stage of heart failure (HF). Heart failure is one of the most prevalent and debilitating diseases worldwide and is the leading cause for hospitalizations for people older than 65 years (Schwarz, Mion, Hudock & Litman, 2007). These two articles look at ways of
M.K., a 45-year-old female who has a history of Type II diabetes mellitus and primary hypertension. In addition to this, M.K. is overweight and persists with a poor diet. The patient has also been smoking for the past 22 years, and has recently been diagnosed with chronic bronchitis. Current symptoms include chronic cough, which tends to be more severe in the mornings and productive with sputum, light-headedness, distended neck
Treatment of Heart Failure in Nursing Home Residents Heart failure (HF) symptoms may occur because of systemic and pulmonary congestion, structural defects arising on account of HF, structural defects leading to HF, or from treatment complications. At first, studies addressing the issue of heart failure focused on HF patients and decreased left ventricular contraction. As a result, therapies were tested within this patient cluster. This patient cluster's agreed description is HF
Heart Failure Medication The purpose of the article by Gordin and Fonarow (2016) entitled “New Medications for Heart Failure” is to examine and discuss established guidelines for medical treatment for heart failure. Specifically, the article examines pharmacological interventions for heart failure with regard to ACE inhibitors, beta blockers, aldosterone antagonists and reduced ejection fraction. It looks at recent studies that have allowed new therapeutic methods to be developed using ivabradine and
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