pico heart failure

PICO Heart Failure

To complete this week, after reading chapter two in Melnyk and reviewing the lectures you submit a 2-3 page paper that explores the background of your issue. For this paper #1 you will be defining this issue or disease using the literature. It will end with the PICOT question. The parts of your paper should include:

  • Introduction
  • Definition
  • Epidemiology
  • Clinical Presentation
  • Complications
  • Diagnosis
  • Conclusion with PICOT Question

What I have provided below is what I have written up to this point, before the professor had asked about the 7 bullet points above. I have references that are 5 years old or older which was not liked. The Danna article is a study protocol. It has not been done. Glogowska is a qualitative study. Did the Gustafsson review measure the indicated outcome variables in your targeted population? The Travis study was conducted in an urban area. The studies must align with your targeted population. All studies must be current- published within the last 5 years.

This is a research paper I has used from a previous research course. But it needs to be evidenced based project. I could provide the whole paper????? and each week let you know what is wanted???????

Heart disease affects the circulatory system and overall ability of the heart to function in its normal state. It is the number one source of demise and primary cause of disability for Floridians (Florida Department of Health, n.d.). Heart disease consists of coronary artery disease (CAD), heart failure (HF), and additional heart related diseases. It is primarily a disease associated to regimen and can be treated or stopped with teaching of risk factors and lifestyle modifications.

Background of the Problem

According to the existing Community Health Assessment Summary for Volusia County, Florida concluded in 2013, the six central causes for ambulatory care sensitive conditions (ACSC) causing in hospital inpatient releases for uninsured individuals are associated to chronic diseases that can be managed through early intervention (Community Health Assessment, 2013) . These conditions are diabetes, cardiovascular disease, cancer, obesity, access to health care and tobacco use (Community Health Assessment, 2013). These conditions accounted for 1,046 hospital admissions related to congestive heart failure and 2,655 hospital admissions related to coronary artery disease in Volusia County (Community Health Assessment, 2013).

Statement of the Problem

Heart Failure (HF) remains a repeated source of unforeseen hospital admittances and a costly condition (Glogowska et al., 2015). Studies continue to display a discontinuation and crumbling of care once heart failure patients are released from the healthcare facility (Glogowska et al., 2015).A Heart Failure Program can have a pronounced influence on decreasing the amount of repeated admittances through enabling individuals with information and care to assist with management of continuing illness and increase compliance with their treatment plan in outpatient clinics that can be coordinated and managed by the Advanced Practice Nurse (APN) (Danna, Garbee, & Kessler, 2014). It can develop patient-provider interactions; diminish unsuitable use of the emergency department with increased applicable usage of primary and specialty care, and in general enhanced well-being of the peoples (Danna et al., 2014).

Significance of the Disease

Circulatory disease integrates all diseases of the heart and blood vessels. These consist of: atherosclerosis, rheumatic heart disease, heart failure, cerebrovascular, hypertension, and ischemic heart. “Congestive heart failure is the first-listed diagnosis in 875,000 hospitalizations, and the most common diagnosis in hospital patients age 65 years and older” (Emory Healthcare, 2017). As a state, outlining these concerns through execution of guidelines in several facets of care to make certain that Floridians can attain high quality healthcare that will lead to a healthier quality of life.

The accumulative costs of supervision of this illness have caused the necessity to cultivate and place a community centered heart failure program that can be managed in an outpatient locale (Gustafsson & Arnold, 2016). Numerous individuals do not understand their disease course or abide by the given care plans (Travis, Hardin, Benton, Austin, & Norris, 2012). It stands for this purpose that there exists a necessity meant for heart failure programs that center on residents health-based care directed by an advance nurse practitioner that can work with a multidisciplinary team in order to deliver proficient services, increase wellbeing results and eventually diminish healthcare expenses (Gustafsson & Arnold, 2016).Decreasing heart failure remittance requirements must be initiated throughout in-patient hospitalizations. This can exist by expending the appropriate multidisciplinary action plans, medication administration, altering risk factors and way of life, as well as patient education focused on evidence based guidelines and procedures (Travis et al., 2012). This shows that heart failure programs in an outpatient locale ensure enhanced patient gratification, symptom management and largely quality of life expectancy (Gustafsson & Arnold, 2016).


PICO Question

Heart failure individuals have the top hospital remittance rates in the United States (Shaw et al., 2014). Teaching is very imperative for these residents, mutually inpatient and outpatient. It is vital to have a number of training modals accessible for patients to study and to be more effective in decreasing remittance rates (Shaw et al., 2014). For individuals who are 65 years old and older with heart failure (P), does an outpatient heart failure program lead by a APN have decreased hospital remittance (I) by increasing patients’ empowerment and gaining control over the disease process (C) thus enhancing patient satisfaction, symptom management and overall quality of life (O)?

It is vital that individuals identify initial indications of worsening heart failure (Siabani et al., 2013). Timely follow up by registering individuals in a heart failure program can avert deteriorating results and allow patients to manage their personal health care with the support of an APN and a multidisciplinary team that can address a number of aspects of the disease process (Danna et al., 2014).

Prescription compliance, dietary management, ADL’s and weight monitoring are part of the discharge treatment plan. All heart failure patients are to be registered in the heart failure program at discharge. The facets will be observed and measured by tracking readmission rates and trends. Readmissions and heart failure program registration will be monitored by means of medical records and current hospital databases that will record information on admittance, upon discharge, and remittance centered on the heart failure diagnosis.


Community Health Assessment (2013). Retrieved from November 18, 2017 from http://www.floridahealth.gov/provider-and-partner-…

Danna, D., Garbee, D., & Kessler, P. (2014). Effectiveness of advanced practice nurse-led heart failure clinics on all-cause mortality: A systematic review of quantitative evidence protocol. JBI Database of Systematic Reviews and Implementation Reports, 12. http://dx.doi.org/10.11124/jbisrir-2014-1753

Emory Healthcare (2017).Heart & Vascular: Conditions & Treatments.Heart Failure Statistics.Retrieved November 18, 2018 from https://www.emoryhealthcare.org/heart-vascular/wellness/heart-failure-statistics.html

Florida Department of Health (n.d.).Heart Disease.Retrieved September 18, 2017 from http://www.floridahealth.gov/diseases-and-conditions/heart-disease/index.html

Glogowska, M., Simmonds, R., McLachlan, S., Cramer, H., Sanders, T., Johnson, R., … Purdy, S. (2015). Managing patients with heart failure: A qualitative study of multidisciplinary teams with specialist heart failure nurses. Annals of Family Medicine, 13, 5. http://dx.doi.org/10.1370/afm.1845.

Gustafsson, F., & Arnold, M. (2016). Heart failure clinics and outpatient management: Review of the evidence and call for quality assurance. European Heart Journal, 25, 1596-1604. http://dx.doi.org/10.1016/j.ehj.2004.08.004

Shaw, R., McDuffle, J., Hendrix, C., Edie, A., Lindsey-Davis, L., Nagi, A., … Williams, J. (2014). Effects of nurse-managed protocols in the outpatient management of adults with chronic conditions. Annals of Internal Medicine, 113-121. http://dx.doi.org/10.7326/M13-2567

Siabani, S., Leeder, S., & Davidson, P. (2013). Barriers and facilitators to self-care in chronic heart failure: A meta-synthesis of qualitative studies. SpringerOpen Journal, , 320. Retrieved from http://springerplus.com/content/2/1/320

Travis, L., Hardin, S., Benton, Z., Austin, L., & Norris, L. (2012). A nurse-managed population based heart failure clinic: Sustaining quality of life. Journal of Nursing Education and Practice, 2. http://dx.doi.org/10.5430/jnep.v2n4p1

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