Research Proposal Draft
KLeyva
ReviewofLiteratureheartfailureweek4.docxRunning head: LITERATURE REVIEW ON HEART FAILURE AND READMISSION 1
LITERATURE REVIEW ON HEART FAILURE AND READMISSION 9
Review of Literature
Student’s Name Kenya Leyva
Institution of affiliation South University
Course Name-Course Code Nursing Research
Professor Yvonne Johnson
Date 09-11-2020
Review of Literature: Identification of Research Studies
Hoffman and Cronin conducted in-depth research to develop the most suitable method for understanding financial impacts felt within the hospital vicinity (2015). Furthermore, the two researchers wanted to identify ways to mitigate and reduce the high readmission fees paid by CHF patients. Their researcher study scope was centered on prominent hospitals that are known to host and treat the heart-related patient. According to their findings, CMS, as well as the hospital readmission reduction, centers substantially increase the number of penalties beyond the expected levels it readmission cases. From Hoffman and Cronin conclusion, hospitals need to improve their financial performance while at the same time, reduce the amount paid by CHF patients for readmission.
On the other hand, Kripalani, Jackson, Schnipper & Coleman’s research concluded that the move from hospital to home is a sensitive time of discontinuity and may lead to adverse effects. Instead of seeing discharge as an end to their responsibility for the patient, hospital workers, or other providers in service should try to foster an efficient and safe transfer of care. The two researchers study emphasized on the role played by hospitalists in closing the difference between hospital and ambulatory services through careful discharge preparation and successful patient, family and outpatient contact.
Another way of reducing the readmission cases witnesses in most hospitals is to create a platform where the patients or their family relatives are educated on efficient ways to deal with the sick. According to research conducted by Anderson, Deepak, Amoateng-Adjepong, & Zarich (2015), most healthcare discharge CHF patients without proper instructions to their relatives on better to care for the sick. Findings suggest that education and discharge planning need to be well-coordinated in amidst to ensure that the transition for the patient does not warrant readmission probabilities. The discharge of home healthcare is available to people over 50 years old who are predominantly diagnosed with CHF. The research indicates that the readmission rate in CHF is lowered independently of medical care through patient education and mobilization.
In the research performed by Gunadi, Opfield, Pham, Yea and Schmiedeberg & Stahmer (2015), a prescription transition-free protocol was created and introduced to minimize readmission risk and improve comfort for patients who are suffering from cardiac failure (HF). Results demonstrate that, by prioritizing people in need of medical recovery, the initiative strengthened patient safety (for 205 ED patients with 40 severe prescription errors), resulted in an-HF conformity, a variety of patient satisfaction ratings and increased and decreased the target of PICO — hospital readmission. This was the outcome of the plan.
The research was conducted by Hernandez et al. (2015) to examine associations between ambulatory follow-up within seven days after HF discharge and readmission within 30 days. According to the findings, the rates of hospital-level early ambulatory follow-up after release are substantially variable, and the study found that the risk of thirty days of readmission is lower in patients aged 65 or older who are discharged from hospitals at higher early monitoring rates.
Hess et al. (2015) characterized early follow-up hospital variance in admittance to non-ST-segment elevation myocardial infarction (NSTEMI). They studied the connection between early follow-up and patient success for patients 65 years or older. Data have been collected from CA / AHA registry Early Introduction of ACC / AHR (CRUSADE) Registry Risk Stratification for Dysfunctional Inguinal, Patients Reduce Adverse effects related to clinical Medicare results. Research showed that higher early follow-up hospitals might not have better re-entry rates for 30 days and interventions other than early follow-up could be required to minimize readmissions in this demographic. This findings and conclusion are vital for both the reduction of readmission cases and for multidisciplinary teams.
In Huntington, Guzman, Roemen, Fieldsend, and Saloum's (2014) research, CHF-admitted patients were examined from 2010 to 2011 using a pilot programme. The study aimed at minimizing the thirty-day readmission rate for CHF patients after hospital stays by introducing a comprehensive patient adjustment program consisting of patient self-management and effective clinical follow-up and monitoring. The analysis showed that the readmission rate for patients reflecting a net economic gain in the community for thirty-days has declined by 42 per cent and also accounts for the additional costs for the treatment.
The Koelling, Johnson, Cody, and Aaronson research (2015) contrasted a normal discharge protocol in CHF patients with the results of a one-hour, single-on-one training session to the nursery instructor. The study showed that improved health results and conformity with self-management behaviours lowered the costs of treatment for patients with CHF. The nurse instructor who taught at the time of release supervised the patients for one year.
Present successful HF inpatient and ambulatory treatment techniques have been reviewed by McClintock & Smith (2014). The researchers indicated that self-management preparation, structured follow-up intervention methods used to overcome challenges to treatment, and the development of realistic targets in patients and caregivers could be part of HF revision prevention. The study showed that HF readmission avoidance begins on the first day of hospital stay, discharge and monitoring; both of these measures are intended to save hospital resources and encourage patients to get out of hospitals.
Schell (2014) explored the possible advantages of the discharge navigator, patient safety and discharge management. Improved medication transfer by comprehensive routine education decreases HF patients' hospital readmission through and patient engagement through efficient contact and education, ensuring correct continuity of prescriptions by follow-up appointments by providing strong, hands-on coordination with other healthcare providers and improving patient safety through providing. Once again, we will help achieve our PICO result by-readmission rates in hospitals within 30 days of initial discharge by the significance of a multidisciplinary team and successful treatment transfer.
An integrative literature review was performed by Shan, Finder, Dichoso, and Lewis (2014), which examined the effectiveness of strategies to minimize HF readmission rates, with an emphasis on the role of nursing care in carrying out these strategies. Structured HF systems achieved positive outcomes through unique protocols such as optimum care treatment, patient education and guidelines for self-catering and sufficient follow-up following discharge. The caregiver is a valuable part of the healthcare team; it is also necessary for the patient released from the hospital to follow the care plan and understand.
In the Simpson study of HF, patients age 65, or older were found to be at high risk of complications employing risk stratification techniques for heart failure awareness and post-discharge telephone communication. As a result of HF education and post-discharge telephone communication, the targets to reduce the readmission rate by a factor of 5% over the five months by 30 days were accomplished.
In Snyderman, Salzman, Mills, Hersh, & Parks’ (2014) study, the goal was to identify primary methods that family doctors should use by successful ambulatory treatment and increased quality of treatment in CHF patients aged 65 or older to cope with "evitable" hospitalizations. The conclusion of the study proposes minimizing hospital readmission by using risk stratification methods to classify high-risk patients via electronic medical reports, direct handoff contact, patients with prompt outpatient follow-up, reconciliation of medications, scheduling, a one-on-one planning session with plans of action.
The feasibility of the specialized transitory treatment nursing practice(TCPs) program(s) for recently-hospitalized patients over age 65 years with HF and its consequences for the 31-day all-cause readmission, lifetime and 60% of the overall cost of the hospital. This was the bases of Stauffer, Fullerton, Fleming, ogola, Herrin, Stafford, and Ballard (2014) study. Preliminary studies show that TCPs decrease readmission rates for 30-day HF patients. A policy impact analysis leveraging expenses and operation payment experience indicated that each HF Medicare patient received a $227 drop-in hospital funding contributions.
The results of the pharmaceuticals controlled scheme, which included guidance and disclosure guidelines for adult patients with HF, were analysed by Warden, Freels, Furuno, & Mackay (2014). The study found that the pharmacist's role in drug restitution and HF patient discharge therapy was linked to a significant increase in conformity with JCAHO’s core steps, a dramatic drop in all-cause readmissions for 30 days, and a positive impact on patient satisfaction.
References
Anderson, C., Deepak, B.V., Amoateng-Adjepong, Y., & Zarich, S. (2015). Benefits of comprehensive inpatient education and discharge planning combined with outpatient support in elderly patients with congestive heart failure. Congestive Heart Failure, November/December, 315-321.
Gunadi, S., Upfield, S., Pham, N.D., Yea, J., Schmiedeberg, M., & Stahmer, G.D. (2015). Development of a collaborative transitions-of-care program for heart failure patients. American Journal Health-System Pharmacists, 72, 1147-1152
Hernandez, A., Greiner, M., Fonarow, G., Hammill, B., Heidenreich, P., Yancy, C., Peterson, E., & Curtis, L. (2015). Relationship between early physician follow-up and 30-day readmission among medicare beneficiaries hospitalized for heart failure. The Journal of the American Medical Association, 303(17), 1716-1722.
Hess, C. N., Shah, B. R., Peng, S. A., Thomas, L., Roe, M. T., & Peterson, E. D. (2015). Association of early physician follow-up and 30-day readmission after non-ST-segment-elevation myocardial infarction among older patients. Circulation, 128(11), 1206-1213 8p. doi:10.1161/CIRCULATIONAHA.113.004569
Hoffman, J., & Cronin, M. (2015). The true financial impact of hospital readmissions. Healthcare Financial Management, 69(1), 68-75.
McClintock, S., Mose, R., & Smith, L. F. (2014). Strategies for reducing the hospital readmission rates of heart failure patients. Journal for Nurse Practitioners, 10(6), 430-433 4p. doi:10.1016/j.nurpra.2014.04.005
Schell, W. (2014). A review: Discharge navigation and its effect on heart failure readmissions. Professional Case Management, 19(5), 224-234.
Shan, D., Finder, J., Dichoso, D., & Lewis, P. (2014). Interventions to prevent heart failure readmissions: the rationale for nurse-led heart failure programs. Journal of Nursing Education and Practice, 4(11), 23-32.
Simpson, M. (2014). A quality improvement plan to reduce 30-day readmissions of heart failure patients. Journal of Nursing Care Quality, 29(3), 280-286.
Snyderman, D., Salzman, B., Mills, G., Hersh, L., & Parks, S. (2014). Strategies to help reduce hospital readmissions. Journal of Family Practice, 63(8), 430-438a 1p.
Stauffer, B., Fullerton, C., Fleming, N., Ogola, G., Herrin, J., Stafford, P., & Ballard, D. (2015). Effectiveness and cost of a transitional care program for heart failure. The Journal of the American Medical Association, 11(14), 1238-1243.
Warden, B. A., Freels, J. P., Furuno, J. P., & Mackay, J. (2014). Pharmacy-managed program for providing education and discharge instructions for patients with heart failure. American Journal of Health-System Pharmacy, 71(2), 134-139 6p. Doi: 10.2146/ajhp130103
