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Preventing Re-Hospitalization - - Research Paper Example

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Instructor: Contents Contents 2 Introduction 3 Studied Outcomes 4 Study Limitations 4 Performance Measures related to Discharge Education to Patients with Heart Failure 5 Factors Influencing Outcomes 5 Summary of Findings 6 Table of Evidence: Research Grid 7 Conclusion 9 References 10 Testing the Effect of and Intervention in Preventing Re-hospitalization Introduction As the expenditure in the United States leads with $2.3 trillion in 2008, attention has been focused on the rise of chronic disease among Americans as the major source of costs…
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Download file to see previous pages The only solution is improving chronic disease management which yields savings on a predictable basis. Though there has been much advancement in the curing of chronic diseases and in this case heart failure (HF), it still remains the core cause of hospitalizations in many nations and is linked with high mortality and morbidity, high medical care costs, and particularly in impaired quality of life. The different new approaches to heart failure care that have been investigated in clinical trials have raised the complexity of the treatment (Stromberg, 2002). The latest meta analyses indicates that, in addition to optimal pharmacological treatment or curing, the care of heart failure patients by a multidisciplinary team lowers rehospitalization and mortality rates and improves the quality of life of patients.(Van der Wal & Van Veldhuisen, 2005). A North-American survey of an intervention that involved telephoned contact and home visits by an HF specialized nurse after hospital discharge revealed that the intervention effectively reduced mortality and morbidity rates (The Lewin Group, 2008). During all visits, care givers of the patients were invited to listen to the instructions. After being discharged, patients were randomized to receive, systematic telephone contact for a three month investigational time or to receive the common care that comprised of the follow-up of the patient at the return appointment at the outpatient clinic without any telephone contact (GESICA, 2005). A single telephone contact per week was done in the first month, accompanied by one every 15 days in the second month and a single every 15 days in third month summing up to eight calls per patient. Telephone calls had to begin seven days after the release from the hospital, aiming and reinforcing and emphasizing instructions that were received during hospitalization and monitoring symptoms and signs of de-compensation and investigating probable visits to rehospitilizations and the emergency unit. Studied Outcomes The scores for the levels of heart failure knowledge and awareness of self-care were considered as primary results. The frequency of visits to the emergency care unit, deaths at the end of the three month duration and re-hospitalizations were considered as secondary results (Whellan, & Hasselblad, 2005). Study Limitations Some of the study limitations were: some of the patients could not be located at the start of the intervention and after the three month duration due to blocked telephone numbers or wrong telephone numbers. Another limitation of the study was the patient's economic and social statuses and cultural norms. On the other hand, the three-month duration of the study was perhaps too short for the patients to change the health behaviors and habits to the extent that could lower the rate of visits to the emergency care unit, death and re-hospitalizations (Folz, Friedenzohn , DeFrancesco et al., 2003). Performance Measures related to Discharge Education to Patients with Heart Failure Performance measures are used to determine whether a firm or an organization is meeting its patient focused goals and ...Download file to see next pagesRead More
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