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After open heart surgery patients often develop symptoms associated with congestive heart failure (CHF), or fluid volume overload. To prevent heart failure-related symptoms in the postoperative period patients must be educated on heart failure self-care.
To decrease the percentage of postoperative open heart surgical patients with CHF-related questions and concerns from 44% to 30% by March 2020.
A cardiac surgery educational booklet and an educational electronic health record template were identified to guide a CHF educational pathway. Intensive care staff nurses provided patient education after surgery. PDSA cycles were performed in succession to roll out the quality improvement (QI) initiative.
Of patients experiencing postoperative issues, 44% of patients developed symptoms or concerns related to heart failure. Upon implementation of the CHF-focused pathway 15% of patients were exhibiting symptoms or concerns related to CHF, out of all patients with postoperative issues.
CHF, and fluid volume overload continues to be a difficult pathology requiring close management and follow up. After open heart surgery, providing concise, CHF-focused education results in reduced CHF-related patient concerns after discharge.
By providing a disease-focused patient education nurses can reduce the complications that patients develop after an inpatient hospital.
By providing a disease-focused patient education nurses can reduce the complications that patients develop after an inpatient hospital.
Heart failure (HF) is a chronic condition associated with high rates of hospital readmissions. The prevalence and costs of HF are expected to rise dramatically by 2030 (Heidenreich,et al., 2013).
A 24-month, retrospective study was conducted using electronic medical record (EMR) chart review, seeking to identify if postdischarge follow-up phone calls decreased 30-day readmissions in individuals with HF.
The study included 705 adult participants who were admitted to the hospital for HF. Some received a postdischarge call within 2 business days of discharge, and some did not.
Participants who received the postdischarge call were less likely to be readmitted (20.1%) than participants who did not receive a postdischarge call (28.8%;
= .007). Participants who received the postdischarge call were more likely to have a follow-up visit within 14 days (70.1%) than participants who did not receive a postdischarge call (30.2%;
< .001).
The findings from this study may help to drive future transitional care strategies for individuals diagnosed with HF.
Nurse-led transitional care interventions offer potential solutions to ensure safe, effective hospital discharges.
Nurse-led transitional care interventions offer potential solutions to ensure safe, effective hospital discharges.
One-third of the U.S. Phlorizin population has prediabetes, but 90% remain undiagnosed because healthcare providers are not screening for this condition.
The purpose of this quality improvement project was to monitor prediabetes screening and identification, and implement evidence-based recommendations including registered dietician referral.
This project involved using an evidence-based screening tool to measure individual risk of prediabetes. Aggregate data was collected to evaluate screening implementation, evidence-based recommendations offered by providers, and assess patient risk factors.
The percentage of patients at risk for prediabetes was 41.3% (
= 111). The most frequent risks were identified as overweight, history of hypertension, family history of type 2 diabetes mellitus (T2DM), and older age. Providers offered education on weight loss 68.5% (
= 76) and exercise 76.6% (
= 85) but referred 33.3% (
= 37) patients for nutrition education. The screening rates were 52.3% (
= 176) and 72.5% (
= 244) in clinics A and B respectively.
A gap remains in using evidence-based recommendations to decrease risk of prediabetes. Prediabetes screening identified a greater percentage of persons in this population.
There is a need for consistent practice of evidence-based recommendations. This project set the benchmark for future efforts to educate, encourage, and measure providers successes.
There is a need for consistent practice of evidence-based recommendations. This project set the benchmark for future efforts to educate, encourage, and measure providers successes.
Heart failure (HF) has become a national concern, with approximately 5.7 million adults in the United States suffering from this life-altering disease. Improved education of these patients prior to discharge helps patients manage their disease adequately and reduce symptom exacerbations.
This quality improvement initiative aimed to determine the effectiveness of an educational intervention in improving nurses' knowledge of HF discharge teaching and documentation of this education in patient charts.
This project was conducted at a Magnet-recognized acute care hospital with 39 critical care step-down beds. Twenty-nine nurses employed on the step-down unit participated in the educational intervention. Pre/post nurse knowledge and chart review data were analyzed.
There was a statistically significant increase in the percentage of patients receiving HF education from unit nurses from preintervention 77.0% (
= 81) to postintervention 96.4% (
= 138) (
< .001). There was also a statistically significant increase in the mean number of days patients were educated from 1.64 to 2.58 days (
< .001). Nurse knowledge also increased from pretest (69.7%) to posttest scores (100%) (
< .001).
Providing HF educational opportunities enhanced nurse knowledge and increased their documentation of HF education in patient charts.
Nurse educators may use the study results to improve nurse education and practices aimed at reducing HF readmissions.
Nurse educators may use the study results to improve nurse education and practices aimed at reducing HF readmissions.
Atherosclerotic cardiovascular disease (ASCVD) is a major contributor to nationwide morbidity, mortality, and healthcare costs in the United States. Over 92 million adults have at least one form of ASCVD, and annual costs for treatment are anticipated to surpass one trillion dollars within the next 15 years.
The objective of this study was to evaluate the medication therapy of a population of adults in comparison to the American College of Cardiology/American Heart Association (ACC/AHA) recommendations for statin therapy for ASCVD risk reduction.
The adult population receiving care from a group of hospital outpatient clinics was examined using a database query. Rates of ASCVD in a multicounty area were compared and provider adherence to current guidelines was assessed.
Rural counties showed higher rates of ASCVD. Rates of statin medication prescribing for patients of each ACC/AHA statin benefit group ranged from 66.2% to 74.8%.
Adherence to guidelines varied among counties and optimal adherence was not achieved.
