Capella FPX 4025 Assessment 4

Presenting Your PICO(T) Process Findings to Your Professional Peers

Acute Heart Failure (AHF) is the unexpected start of heart failure signs. It is a significant cause of unplanned admissions among patients aged over 64. Despite advances in medicine, AHF remains associated with unfavorable clinical outcomes, and rates of readmission within 90 days and death within one year vary from 10.1% to 30.2% (Arrigo et al., 2020). Providing timely treatment for AHF is essential to decreasing admissions and positive consequences. This paper addresses the problem of rehospitalization among AHF patients and assesses evidence-based, nurse-led educational programs and self-management strategies.

Diagnosis: Prognosis, Potential Risks, and Associated Complications

AHF is a serious medical condition where the heart is unable to drive sufficient blood to supply the body with the oxygen it needs. It results in fluid accumulation. Systemic congestion describes this condition due to increased biventricular filling pressures that lead to fluid overload (Arrigo et al., 2020). One of the most concerning outcomes of AHF is the frequent cycle of hospital readmissions caused by fluid retention and incomplete recovery. AHF continues to represent a healthcare challenge, with 90-day rehospitalization and one-year mortality rates ranging from 10.2% to 30.3% (Arrigo et al., 2020). It burdens healthcare systems economically, with annual readmission costs per patient reaching around $16,000 (Mauro et al., 2023).

Comorbid conditions impact patients with AHF. Common comorbidities such as hypertension (70.2%), diabetes (40.3%), and renal failure (ranging from 20.2% to 30.4%) elevate the risk of AHF, among older adults. The typical age range for AHF diagnosis is between 69 and 72 years, with around 50% of affected individuals being male. A significant portion of these patients (65.2% to 75.3%) have a prior history of heart failure (Mauro et al., 2023). Risk factors like ischemic heart disease contribute to 30.6% to 40.3% of AHF-related hospitalizations in South America. Psychosocial factors like depression, stress, and loss of cognitive functioning increase the risk of unintended readmissions or death among AHF patients (Arrigo et al., 2020).

These chronic complications involve repeat episodes of heart failure, deteriorating cardiac function, and thromboembolic complications. For instance, an AHF patient is unable to control symptoms of breathlessness or edema. Without proper education and support for self-management, these conditions get aggravated. It resulted in repeated hospital readmissions and poor health. Educational programs led by nurses and self-care measures, such as symptom tracking, medication compliance, and lifestyle changes, are essential for enabling patients to control their condition. These interventions are crucial to minimizing readmission rates. It enhances symptom management and patient health outcomes (Bernard et al., 2023). 

Formulating the Research Question

To address the challenges in AHF management, the following PICO(T) inquiry was formulated: “In adults hospitalized with AHF (P), how does nurse-led patient education and self-care support (I), compared to standard discharge instructions alone (C), affect hospital readmission rates and symptom management (O) over 12 weeks (T)?”. This inquiry seeks to enhance patient outcomes by evaluating structured educational interventions and self-care strategies to improve symptom control and reduce hospital readmissions.

This question reflects each component of the PICO(T) process. Population (P) includes adults hospitalized with AHF, a group at high risk for readmissions due to challenges such as inadequate self-management and poor symptom control. Intervention (I) involves nurse-led patient education and self-care support. It includes tailored discharge planning, medication adherence guidance, and personalized symptom monitoring (Bernard et al., 2023). This method empowers adults to manage their condition after discharge better.

Comparison (C) is standard discharge instructions offering minimal personalized education and follow-up support. Outcome (O) focuses on reducing hospital readmission rates and improving symptom management. These are the critical factors for enhancing patient outcomes and engagement in managing AHF. Time (T) is 12 weeks, providing enough time to assess the impact of the intervention on readmission rates. This inquiry allows for focused research on the efficiency of instruction and healthcare support in decreasing admissions and improving symptom management in AHF patients.

Summary of Evidence from Peer-Reviewed Sources

A comprehensive review of scholarly articles discovered the influence of teaching and self-care support on adults hospitalized with AHF. The information exploration was methodically directed using reputable electronic databases such as PubMed, CINAHL, the Cochrane Library, and Google Scholar. All selected sources were critically appraised using the CRAAP criteria: Currency, Relevance, Authority, Accuracy, and Purpose to guarantee the validity and credibility of the findings (Kalidas, 2021). Four high-quality articles were selected to evaluate the efficiency of educational interventions in AHF care.

Using a current evidence approach, Wu et al. (2024), emphasized that heart failure hospitals offer services like medicine titration, teaching, mental provision, and follow-up care. It led to positive clinical outcomes, reducing readmission rates. Published in the peer-reviewed International Journal of Nursing Sciences, this article provides evidence supporting the role of nursing interventions in enhancing long-term outcomes for AHF patients through patient empowerment and continuity of care.

Capella FPX 4025 Assessment 4

A key study by Kaseb et al. (2024) emphasized the efficiency of collaborative educational approaches, the teach-back method, in improving patient understanding and knowledge retention. This technique engaged patients in their care, improving symptom recognition and medication adherence. According to the World Health Organization (WHO), AHF is internationally the leading source of demise. It accounts for more than 18 million deaths annually. Studies indicate that approximately 26% of adults who are discharged with heart failure are readmitted within 30 days because of cardiovascular complications. The European Society of Cardiology recommends individualized patient education as a class 1 recommendation in managing heart failure.

It focuses on patient activation and self-monitoring. The ESC guidelines are reliable and used extensively in clinical decision-making in cardiovascular care (ESC, 2021). A review by Bulto and Hendriks (2023) emphasized the value of patient empowerment through organized education programs. It investigated the impact of interventions such as medication education and nutritional counseling, finding that they improve patient compliance and minimize the risk of hospital readmissions. The validity of this review rests in its systematic approach and publication within the European Journal of Cardiovascular Nursing, a well-established journal within the discipline. These results highlight the importance of nursing positions in supporting sustained improvement in patient outcomes after AHF hospitalization.

Evidence-Based Response to the PICO(T) Question

Evidence reaffirms the PICO(T) question by illustrating nurse-implemented patient education and self-care support being more effective than traditional discharge instruction in enhancing outcomes for adults hospitalized with AHF. Inadequate recognition of symptoms and poor self-management are the leading causes of readmission and deterioration of health status for AHF patients. Organized education and support interventions, such as the teach-back method and counseling on medicines, have improved patient understanding, encouraged compliance with treatment plans, and enhanced symptom tracking (Kaseb et al., 2024).

Bulto and Hendriks (2023) emphasized that empowering patients through education lowers readmission risks and improves quality of life. These conclusions rest on several assumptions. It includes that patients are motivated to engage in self-care, that nurses have the training and time to deliver individualized education, and that healthcare systems support continuity of care. Health literacy, socioeconomic barriers, and access to follow-up care impact efficacy. Future research explores educational methods to address patient needs and reduce disparities in AHF management.

Essential Care Steps Guided by Evidence-Based Recommendations

Research-based strategies are vital to improving outcomes in adults hospitalized with AHF by executing effective nurse-led education and self-care support. The first critical step involves providing individualized patient education before discharge. It focuses on symptom recognition, medicine obedience, obesity check, and water limit. Early education enables patients to understand their condition and detect signs of decompensation. It reduces the risk of readmission. The second step includes using interactive strategies like the teach-back method and structured self-care plans.

These enhance understanding and retention (Kaseb et al., 2024). These approaches ensure that patients can apply what they learn daily. It promotes adherence and reduces the probability of problems. Studies show that such education methods lower admission frequencies and recover the standard of health among AHF adults (Bulto & Hendriks, 2023). The final step is follow-up and support through nurse-led interventions. It includes scheduled phone calls or clinic visits. This safeguards continuity of care, reinforces education, and addresses emerging concerns. These steps are suitable because they authorize persons to address their disorder. It led to better symptom control, reduced readmissions and improved clinical outcomes.

Conclusion

Implementing teaching and healthcare advocacy has decreased admission frequencies in adults with AHF. Evidence from peer-reviewed studies highlights the efficiency of individualized teaching strategies. It includes the teach-back technique, promoting adherence, improving empathy, and engaging in care. These interventions empower patients and improve clinical outcomes.

References

Arrigo, M., Jessup, M., Mullens, W., Reza, N., Shah, A. M., Sliwa, K., & Mebazaa, A. (2020). Acute heart failure. Nature Reviews Disease Primers, 6(1). https://doi.org/10.1038/s41572-020-0151-7

Bernard, T. L., Hetland, B., Schmaderer, M., Zolty, R., & Pozehl, B. (2023). Nurse-led heart failure educational interventions for patient and informal caregiver dyads: An integrative review. Heart & Lung, 59, 44–51. https://doi.org/10.1016/j.hrtlng.2023.01.014

Capella FPX 4025 Assessment 4

Bulto, L., & Hendriks, J. (2023). The role of nurse-led intervention to empower patients in cardiovascular disease care. European Journal of Cardiovascular Nursing, 23(2). https://doi.org/10.1093/eurjcn/zvad095

ESC. (2021, August 25). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Escardio.org. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Acute-and-Chronic-Heart-Failure

Kalidas, E. A. J. (2021). The effectiveness of CRAAP test in evaluating credibility of sources. International Journal of TESOL & Education, 1(2), 1-14. https://www.i-jte.org/index.php/journal/article/view/25

Kaseb, A., Zeydi, A. E., Dovvombaygi, H., & Nazari, A. M. (2024). Effects of education based on teach-back methods on self-care and quality of life of the patients with heart failure: A systematic review. BioMed Central Cardiovascular Disorders, 24(1). https://doi.org/10.1186/s12872-024-04264-5

Mauro, C., Chianese, S., Cocchia, R., Arcopinto, M., Auciello, S., Capone, V., Carafa, M., Carbone, A., Galzerano, D., Maffei, V., & Marra, A. M. (2023). Acute heart failure: Diagnostic–therapeutic pathways and preventive strategies. A real-world clinician’s guide. Journal of Clinical Medicine, 12(3), 846. https://doi.org/10.3390/jcm12030846

Capella FPX 4025 Assessment 4

Wu, X., Li, Z., Tian, Q., Ji, S., & Zhang, C. (2024). Effectiveness of nurse-led heart failure clinic: A systematic review. International Journal of Nursing Sciences, 11(3), 315–329. https://doi.org/10.1016/j.ijnss.2024.04.001