MAR-MT

Student Name: Martha Ramos

MSN Project Manuscript Section I-III

Heart Failure Management

Chamberlain University

Advanced Nursing Role Synthesis

Date: May 15, 2024

Heart Failure Management

Executive Summary

The main goal of this project was to investigate the implementation of a thorough disease management program for heart failure patients in the elderly population in Miami, Florida. The project was designed to determine if this intervention, as opposed to standard care, would result in better clinical outcomes, fewer hospital readmissions, and a better quality of life within the 8 weeks. The amalgamation of literature and evidence helped to understand the current practices and interventions in managing heart failure. The suggested intervention, implementation strategies, and dissemination plans were designed to deal with the identified problem properly.

Section 1: Introduction and Problem Identification

Problem Statement

Heart failure is a significant healthcare problem, especially among the older adults in Miami, Florida. The high rate of heart failure in this age group leads to more hospitalizations and poor quality of life. Although heart failure management has advanced, there is still a need for more focused interventions to improve the outcomes and cut healthcare costs. Hence, this project is designed to investigate the efficiency of a complete disease management program in meeting the needs of elderly heart failure patients in Miami.

Problem Background

Heart failure management is a multidisciplinary task, considering the complicated nature of the disease and its effect on the patients' lives. Present practices mainly focus on symptom management and acute care interventions. Thus, hospital readmissions and suboptimal outcomes are frequent. By introducing a comprehensive disease management program for the elderly population in Miami, it is possible to improve patient care, decrease healthcare usage, and increase the overall quality of life.

Stakeholders

This project affects elderly patients with heart failure, their families, healthcare providers, hospitals, insurance providers, and community organizations that are part of the healthcare delivery system. Every stakeholder group is crucial in making the proposed intervention successful and sustainable.

PICOT Question

“In heart failure patients (elderly population), does the implementation of a comprehensive disease management program (intervention) compared to standard care (comparison) lead to improved clinical outcomes, reduced hospital readmissions, and enhanced quality of life (outcome) in the U.S within an 8-week timeframe (timing)?”

Section 2: Literature Support

Review of Literature

The literature gives strong proof for introducing comprehensive disease management programs for heart failure patients, especially among older adults. Many studies have shown that these programs effectively improve patient outcomes, especially in reducing the morbidity and mortality rates associated with heart failure (Jackevicius et al., 2018). Moreover, these interventions have been repeatedly found to be connected with reducing hospital readmissions, which means that they can be used to ease the pressure on the healthcare systems and make resource use more efficient. Gingele et al. (2019) and Bozkurt et al. (2021) assert that comprehensive disease management programs are very effective in improving the quality of life for heart failure patients. These programs usually have a comprehensive approach that includes not only medical management but also dietary counseling, exercise regimes, and psychosocial support, all of which are factors in the well-being of a person. The literature, in general, stresses the importance of implementing these programs to improve care delivery, promote positive health outcomes, and enhance the quality of life of elderly heart failure patients.

Section 3: Intervention Description

Proposed Intervention

The proposed solution is establishing a comprehensive disease management program tailored to the specific needs of the elderly heart failure patients in Miami. This program includes medication management, dietary counseling, exercise regimens, symptom monitoring, and patient education, enabling individuals to manage their conditions effectively.

Setting

The project will be conducted in health facilities that serve the elderly population in Miami. The goal is to create an organizational culture that supports the change to evidence-based practice. The readiness to change in these environments will be checked to ensure the intervention is implemented successfully.

Barriers

The project's obstacles include healthcare providers' resistance to change, the scarcity of resources, and difficulties in patient adherence to the program. Staff education, stakeholder engagement, and the use of community resources to help patients' needs are ways of coping with these problems.

Outcomes

The expected results of the intervention are a reduction of hospital readmissions, enhancement of symptom management, increased patient satisfaction, and better adherence to treatment regimens. The results will be measured by observing clinical indicators, patient-reported outcomes, and healthcare utilization metrics.

Action Plan

The action plan outlines the steps, tasks, and deadlines for the project. It includes the Johns Hopkins Action Planning tool and a financial table that lists the resources necessary to implement the intervention successfully.

References

Heart Failure and Transplant Section and Leadership Council of the American Heart Association (ACC) & Bozkurt, B., Fonarow, G. C., Goldberg, L. R., Guglin, M., Josephson, R. A., Forman, D. E.,... 2021). JACC expert panel on cardiac rehabilitation for individuals with heart failure. 77(11), 1454–1469 in Journal of the American College of Cardiology.

Gingele, A. J., Kragten, J., Van Empel, V.,... & Knackstedt, C.; Ramaekers, B.; Brunner-La Rocca, H. P. (2019). Impact of customized telemonitoring on heart failure patients' functional status and health-related quality of life. Dutch Heart Journal 27, 565–574.

C. A. Jackevicius, R. L. Page, L. F. Buckley, D. L. Jennings, J. M. Nappi, & A. J. Smith (2019). Essential publications and protocols for the treatment of heart failure: an update for 2018. 32(1) Journal of Pharmacy Practice, 77–92.