Translating Evidence Into Practice Essay Assignment Paper
Translating Evidence Into Practice Essay Assignment Paper
PICOT Question and Essence to Nursing Practice
PICOT question: Among Medicare patients discharged with a diagnosis of CHF (P) how does discharge planning (I) compared to follow-up via telephone calls(C) prevent readmission within 30days (O) post discharge?
Translating Evidence Into Practice Essay Assignment Paper
In clinical practice, patients who have been diagnosed and admitted of heart failure are at high risk of readmission on the 3rd day after discharge. Researchers and clinicians have associated readmissions with poor quality of care which predisposes the same patients to a high risk of mortalities, morbidities and additional medical costs which could otherwise be prevented. Readmissions are also a major contributing factor to a patient’s deteriorating health status which results in poor health outcomes (Masri et al., 2018). Some of the currently available interventions to address this issue such as adequate staffing to improve nurses’ work environment have yielded fewer results. In the patient’s best interest, nurses are encouraged to actively take part in evidence-based research in identifying evidence-based solutions to address this issue since they directly interact with these patients at the point of care (Shan et al., 2014). Previous studies have proven that the most ideal interventions are those which increase the support given to patients at the point of care during admission, at the time of discharge and promote communication afterward. Only then can the lives and health outcomes of these patients improve.
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Summary of Article Findings
The articles cited different factors as the major contributors to hospital readmissions among patients with heart failure such as in-hospital treatment complications, inadequate care coordination, poor quality of care coordination, patients not being adequately educated and insufficient follow-up. Among all the strategies that were outlined, the one that seemed to be the most beneficial was discharge planning and coordinated care. Coordinated care among nurses, members of healthcare teams and patient-centric approaches proved to be more successful when compared to single nurse approaches that centered on the management of the condition (Wan et. al., 2017). Discharge planning was also identified as a comprehensive intervention approach that is associated with significantly reducing readmission rates and all-cause mortalities in patients with heart failure. The purpose of discharge planning is to improve how services are coordinated from the hospital to the outpatient setting and at home based on a patient’s needs (Ziaeian & Fonarow 2016). Discharge planning involves; regular follow-up visits, patient education on medications and diet, social and emotional support and coordination among healthcare providers. Translating Evidence Into Practice Essay
Similarly, Chamberlain et al., (2018) in their study noted that most readmissions among patients with congestive heart failure 30 days after hospitalization were congestive heart failure, renal complications, and other comorbidities. They highlight that to prevent heart failure readmissions, interventions which promote the continuum of care from hospital to the outpatient clinic, and at home are the most effective. This requires highly coordinated care among healthcare providers and home caregivers. Chamberlain et al., (2018) emphasized on the need to enhance risk stratification measures prior which will increase safety in discharges done at the emergency department or when transitioning patients whose risk is not yet advanced to alternate treatment pathways to prevent readmissions, which will also conserve resources (Chamberlain et al., 2018). A perfect example of a risk stratification model that can be used is the RAHF scale. Nurses in hospital settings can use this scale to approximate the unique risk of an individual to be readmitted within 30 days after discharge. Risk stratification measures need to be combined with social work, support from community health partners and pharmacy (Chamberlain et al., 2018).
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How the Identified Evidence-Based Practice Contributes To Better Outcomes
Discharge planning increases the time nurses take to directly interact with patients before being released to go home. Nurses use this time to increase their connection with patients and specifically use it for the patient’s benefit to: discuss the drugs prescribed, frequency and dosing, to talk about dietary modifications, physical activity, linkage with primary care providers and making schedules for outpatient follow-up(Ziaeian & Fonarow 2016). Therefore, the discharge summaries will be comprehensive enough to include all this information which can serve as the patient’s reminder when out of the hospital. Through clinical decision making and coordinated care, discharge planning helps to prevent premature discharges which may otherwise result in early readmissions in patients with heart failure (Ziaeian & Fonarow 2016). Translating Evidence Into Practice Essay
It should also be noted that the RAHF scale helps nurses to improve clinical decision making on the management of patients and to prevent any premature discharges among patients whose risk of readmission is high by accurately determining an individual’s readmission risk (Chamberlain et al., 2018). Therefore, nurses can use the RAHF scale to identify patients with heart failure who are at a high risk of readmission based on clinical and demographic factors such as age, race and underlying comorbidities. Based on the identified risks, nurses can thereafter implement personalized preventive and precautionary care strategies with the aim of reducing the rates of hospital readmissions (Chamberlain et al., 2018).
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