Congestive Heart Failure - Assignment Example

? Literature Review Project Reminder: Five Matrices (Evidence Based Practice) Introduction Even though Congestive Heart Failure (CHF) patients are more vulnerable to non-pharmacological management, research evidence points out that many of them may survive longer by using pharmacologic management. Despite being a lifestyle disease, CHF prognosis posts a great danger in older and terminally ill people regardless of gender. Out of the approximated $20-40 billion, hospitalization uses about $15 billion (Anderson et al., 2010). Notably, medical conditions, including hypertension, idiopathic reasons, thyroid disease, alcohol abuse and myocarditis also cause Nonischemic CHF (Kalisch & Lee, 2010). Case management for the CHF patients is the selected disease process. In containing the disease, evidence-based guidelines recommend for education and counseling the patients on issues such as diet, physical activity, treatment intervention, social support, meeting spiritual needs, coping skills, self-monitoring, coping skills, and prognosis. Upholding clinical recommended practices reduces hospitalization among the patients. Being a chronic illness, congestive heart failure (CHF) is likely to be diagnosed among the elderly since the affected patients suffer for a long time. In many hospitals, in the US, it accounts for the highest admission cases, thus challenging the provision of ample medical care. This is coupled with the high cost of medication, beyond the capability of many patients, approximately $20.2 billion (Cheah, 2008). Discussion Among other cardiovascular diseases, CHF patients’ prevalence is much higher, causing anxiety among the health experts and caregivers. The available data indicate that the people suffering from CHF exceed four million (Anderson et al., 2010). Older people above seventy years account for approximately ten percent. In the United States, many hospitalized patients over 65 years suffer high cases of heart failure (Anderson et al., 2010). Therefore, the diagnosis is common among them, perhaps due to the advancing age and reduced immunity in their body system. CHF is also the main cause of death among the older patients, with male patients accounting for the highest percentage (Susan et al., 2000). Therefore, this research gives a comparison between non-pharmacological management and pharmacologic management of the disease. Matrix Table Citation Variables/ Key Concepts Sampling Design/ Method Instruments/ Data Collection Results Strengths & Limitations Critique Anderson, R. et al. (2010). “Development of a Congestive Heart Failure Protocol in a Rehabilitation Setting.” Rehabilitation Nursing, 35 (1), 3-30. The aim of this study was to determine if CHF patients suffer from a cumulative result of heart infections, pericadium, endocardium, myocardium, and other diseases, which affect the coronary artery system (CAD). Key concepts revolved around this most important research question: The sample included three hospitals in California, United States. The hospital capacities were from 150 to 450 bed spaces. 33 units from the three hospitals made up the entire sample. Design: Quantitative description was used to collect information about 500 participants. Method: Surveys were served for each hospital for the nurses to fill. The instrument used for data collection was observation and surveys. Notably, This was a quantitative survey containing fifteen questions. Data Collection was carried out for two weeks. ANOVA was used for data analysis. Eighty percent of the hospitalized CHF patients results from systolic dysfunctions of left ventricular system (22). The disease has bad effects on the human neurological system, sometimes necessitating surgical intervention to guarantee the patient’s life. Strength: Qualitative sampling is an objective way of doing research and normally leads to dependable outcome. Weakness: Since the nurses had to fill the forms on behalf of the patients, there could be some level of biasness. The number of hospitals under this study was only three, making the research not objective. However, there could be remarkable improvement and a sense of reliability if the study sample was done in more than 10 hospitals. Cheah, T. S. (2008). The Affect of Clinical Assessments and Clinical Pathways on Medical Practice. Annals Academy of Medicine, 27(4), 534-539. The main purpose of this research was to determine whether information relating to the management of CHF patients is usually channeled through proper guidelines. Key concept revolved this research questions: Are medical experts postulate that such guidelines would even help in future healthcare delivery? In this study, The sample included six hospitals in New York, United States. The hospitals studied had capacities of about from 350 to 700 bed spaces. 20 units from the six hospitals made up the sample population. Design: Qualitative description was used to collect data from 1500 participants. Method: The researcher used questionnaire in collecting data. The instrument used for data collection was surveys. This was a quantitative survey containing 30 questions. Data Collection was carried out for three weeks. T-test was used for data analysis. The research established that since the disease affects mostly the older people, there are possible financial burdens during this age, making the CHF disease not within the reach of many patients. Strength: It covered six hospitals, thus the outcome was reliable. Weakness: Biasness was a major weakness in the study (Nancy, 2004). The T-test that was used was likely to pose a challenge to the researcher if he/she did not collect adequate and representative data were not collected. Kalisch, B. J., & Lee, K. H. (2010). Nurse staffing levels and teamwork: A cross-sectional study of patient care units in acute care hospitals. Journal of Nursing Scholarship, 43 (1), 82-88. The purpose of the study was to determine if a relationship between staffing levels and nursing teamwork existed. Key concepts revolved this research questions: “Controlling for hospital size and CMI, does the level of staffing predict nursing teamwork?” (p. 83) The sample included four hospitals in the Midwestern United States. The hospital ranged from 300 to 900 bed facilities. A total of 52 units from the four hospitals made up the sample. Design: A cross-sectional, descriptive design was used for this study. The sample size was 2545 participants on 52 patient care units. Method: The Nursing Teamwork Survey (NTS) was the method used to collect data. Data collection occurred over 4 weeks and included two phases. Teamwork was measured by the Nursing Teamwork Survey (NTS). This was a qualitative survey containing ten questions. The NTS measured trust, team orientation, back up, shared mental models, and team leadership. The survey was voluntary and confidential. A Statistical Package for the Social Science (SPSS), version 16.0, was used for data analyses. Overall internal consistency of the survey was 0.94. When there is a large number of NAs there are more problems associated with teamwork than when there are more RNs. Study results show a decrease in teamwork as nursing staff becomes stressed and overwhelmed from lack of staffing. Strengths: The teamwork study is a cross-sectional design and used an appropriate method for keeping anonymity of respondents, which increases the number of respondents. There were 52 units used from four hospitals, which is a large sample size. Lastly, the authors used many (32) references in the study. Weaknesses: Disproportionate numbers of the titles of staff were surveyed. The study could be improved upon by adding more hospitals and by evaluating the differences in teamwork between shifts. Quality of research. The study was conducted in an unbiased way as participation in phase 1 was voluntary and confidential. Nancy, D. (2004). Global Health Issues and Issues. New York: John Wiley & Sons. The purpose of this study was to determine what happens Once the disease attack the cardiac system? Key concepts revolved around this fundamental research questions: Does it spread on a high note to block the vital arteries, making the rate of heart beat quite rapid and with growing fatigue? In this research, the sample included two hospitals in Ohio, United States. The capacity of each hospital was ranging between 500 to 720 bed spaces. A total of 30 units from the two hospitals made up the entire sample population. Design: Qualitative description was used to collect data from 2200 participants. Method: The researcher used Survey in collecting data. The instrument used for data collection was questionnaire. The questionnaire contained 10 questions. Data Collection was carried out for three weeks. Chi-Square was used for data analysis. The research established that monitoring the patient as he/she recovers from the chronic condition is vital in ensuring a milestone in the program and minimizing social interruption. Strength: Qualitative description provided reliable information. Weakness: Survey questions could be answered wrongly, thus giving a poor impression of the situation. Only two hospitals were studied, making it un-representational of the population. In this regard, the researcher had to increase the number of hospitals under study to make this research reliable. Susan, E. et al. (2000). Management of the Patients with CHE Using Outpatient, Home and Palliative Care. Progress in Cardiovascular Diseases, 43(3), 259-274. The main purpose of this research was to determine the effective ways of managing patients with CHF conditions. Key concepts revolved around this fundamental research questions: What are the benefits of systematic management of CHF patients? In this study, The sample included four hospitals in Indiana, United States. The hospital capacities were from 480 to 600 bed spaces. 25 units from the four hospitals made up the study sample. Design: Both quantitative and qualitative description was used to collect data from 1000 participants. Method: The researcher used Questionnaire to collect data. The instrument used for data collection was interview. 10 patients were interviewed from each facility. Data Collection was carried out for one week. SPSS was used for data analysis. The result showed that in controlling, monitoring and managing CHF patients, applying systematic management is very helpful (Cheah, 2008). Strength: The research was objective because a total of four hospitals were studied. Weakness: The participants were biased in giving information. Even though the researchers tried to be objective in the study, participant education was lacking, thus making the information they gave to be partially reliable. Conclusion In summary, achieving high quality is a central issue that satisfies public expectations in healthcare matters. The patients and medical experts started demanding for standardization and transparency during the medical operation. Therefore, the regulatory bodies to protect the professionals and consumers emerged and introduced the clinical pathways. Notably, academic and non-academic institutions have enhanced the clinical pathways, which have been used in managing chronic diseases. Therefore, in the case management development plan, the pathways to be used include the suggestions bellow. Scholars have suggested several pathways and some adopted in the medical practice. Indeed, the pathways are comprehensive care plans, which are professionally developed to document, coordinate, review, monitor, and deliver appropriate care due to their tangible and immediate affect. For effective case management of CHF patients, some of the clinical pathways include diet modification, activity change and proper medication among other. Observing such pathways strictly is central to the success. Diet modification is another approach in the management plan. Mostly, the patients suffering from CHF would be diagnosed with excessive fat in their blood vessels, especially those originating from the heart. Since this interferes with the circulation of blood, the patients should be given or advised to consume non-fatty food stuff. This is a simple approach that is applicable at home, thus creating the need for such programs. Indeed, the healthcare professionals have an important role in making sure that the patients get the required food that would free them from the effects associated with accumulated fats in the body. Activity change is another approach that the program should take into an account. In most cases, older people suffer heart failure because of inadequate body activity. Basically, age is a factor that reduces the level of activity of the body. This condition is responsible for body fatigue, which the old person normally experience. Notably, research shows that fatigue account for some levels of heart failures, meaning that the old people should do minimal exercise on daily basis to improve their body activity. Through consistent body activity, the patients even under chronic condition might reduce cases of congestive heart failure, thus contribute to the management of the disease. Patients should be encouraged to stick to medication however complex it may be. Usually, medication is very complicated and some patients might be forced to abandon them. Sometimes, the patient’s body may exhibit side effects of the medicine, forcing him/her to use alternative means or different drug that the physician would consider appropriate. Therefore, the patients are encouraged to cooperate during the management period to get a better outcome. References Anderson, R. et al. (2010). “Development of a congestive heart failure protocol in a rehabilitation setting.” Rehabilitation Nursing, 35 (1), 3-30. Cheah, T. S. (2008). The affect of clinical assessments and clinical pathways on medical practice. Annals Academy of Medicine, 27 (4), 534-539. Kalisch, B. J., & Lee, K. H. (2010). Nurse staffing levels and teamwork: A cross-sectional study of patient care units in acute care hospitals. Journal of Nursing Scholarship, 43 (1), 82- 88. Nancy, D. (2004). Global health issues and issues. New York: John Wiley & Sons. Susan, E. et al. (2000). Management of the Patients with CHE Using Outpatient, Home and Palliative Care. Progress in Cardiovascular Diseases, 43 (3), 259-274. Read More