Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change
Evidence-Based Project, Part 3B: Critical Appraisal of Research
Heart failure (HF), especially among the elderly patients who are 65 years and above, is a complex chronic condition that contributes to increasing cost of healthcare. Patients with the condition have a high incidence of hospital readmission within 30 days after discharge than any other condition. The disease is a leading cause of hospital admissions among the elderly patients (Al-Tamimi et al., 2018). The purpose of this critical appraisal paper, part B, is to identify a best practice that emerges from the researched and reviewed literature comprising of four articles on the kind of interventions that nurses can have to reduce the prevalence of readmissions within 30 days after discharge these patients.
The reviewed literature comprises of four articles on the selected topic of heart failure among patients aged 65 years and above and the use of nurse-led educational interventions to reduce the surging prevalence. Studies consistently show that the main cause of these readmissions within 30 days after discharge is non-compliance to treatment protocols and self-management care. The provision of nurse-led multidisciplinary education can help reduce the prevalence and this emerges as the best practice based on the reviewed four articles. The first article by Awoke et al. (2019) is a quasi-experimental study that evaluates the impact of nurse-led education program to improve knowledge, and self-care management with the aim of reducing the rate of readmissions for individuals with heart failure.
The second article by Breathitt et al. (2018) is a randomized controlled trial that leverages use of tablets and nurse practitioner education to reduce the rate of readmission for patients with heart failure condition. These two articles provide level one and two evidence, implying that the best practice they recommend works in different settings and have proof of efficacy. The two articles are categorical that using nurse-led interventions alongside others can help patients with heart failure improve their self-care and compliance to treatment interventions, especially at home once discharged from hospitals.
Nurses play a critical role in management of diseases and patient care. These providers are tasked with the responsibility of ensuring
that patients are free from the risk of getting readmissions upon discharge through effective compliance with treatment interventions (Melnyk & Fineout-Overholt, 2018). Nurse-led self-care management education and practices enhance information distribution to patients and their families, ensuring that patients follow the suggested or recommended treatment interventions.
The article by Clarkson et al. (2017) focuses on the impact of an inter-professional heart failure education program to mitigate heart failure readmissions. This article supports the need for a nurse-led education program through the inter-professional team to enhance adherence to treatment protocols and self-care management. The implication is that effective self-care management happens when nurses are involved since they are patient advocates, interact more with the patients than any other health professional, and are based placed to understand their needs.
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The study by Rice et al. (2018) also emphasizes the role of nurse-led education to reduce hospital readmission and quality of life and lower the cost among adults with heart failure. The systematic review presents the best evidence to demonstrate the significant role that nurses play in mitigating readmissions and enhancing the quality of life for patients with heart failure condition. These articles identify a hands-on nurse-led education program through increased interactions with patients and provision of materials that allow patients to adhere to the treatment protocols and recommendations as offered by their providers.
Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change Conclusion
Conclusively, better nurse-led interventions are a core aspect of managing heart failure and reducing readmissions. The reviewed articles show that nurse have a critical role to enhance patient education and better outcomes in heart failure condition. Their efforts improve self-care and reduce susceptibility to readmissions thus lowering the overall cost of care burden on patients, their families and the healthcare system.
Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change References
Al-Tamimi, M. A. A., Gillani, S. W., Abd Alhakam, M. E., & Sam, K. G. (2021). Factors
Associated With Hospital Readmission of Heart Failure Patients. Frontiers in pharmacology, 2726. https://doi.org/10.3389/fphar.2021.732760
Awoke, M., Baptiste, D., Davidson, P., Roberts, A., & Dennison-Himmelfarb, C. (2019). A
quasi-experimental study examining a nurse-led education program to improve knowledge, self-care, and reduce readmission for individuals with heart failure. Contemporary Nurse, 55(1), 15–26. https://doi.org/10.1080/10376178.2019.1568198
Breathitt, K., Maffett, S., Foraker, R. E., Sturdivant, R., Moon, K., Hasan, A., Abraham,
- W. (2018).Pilot randomized controlled trial to reduce readmission for heart failure using novel tablet and nurse practitioner education. The American Journal of Medicine, 131(8) 8, 974–978. https://doi.org/10.1016/j.amjmed.2018.02.017
Clarkson, J. N., Schaffer, S., & Clarkson, J. J. (2017). The effect of an inter-professional heart
failure education program on hospital readmissions. Journal for Healthcare Quality, 39(2), 78–84. https://doi.org/10.1097/JHQ.0000000000000027
Melnyk, B. M. & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare:
A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.
Rice, H., Say, R., & Betihavas, V. (2018). The effect of nurse-led education on hospitalization,
readmission, quality of life and cost in adults with heart failure: A systematic review. Patient Education and Counseling, 101(3), 363–374. https://doi.org/10.1016/j.pec.2017.10.002.