There are many reasons I have used health care services at different times in my lifetime from birth to the present time. I have utilized pregnancy healthcare services. I have used health care services for preventive care such as a yearly Pap smear or health physicals. My friends, family and my co-workers may use health care services for the same reasons as mine, especially if they are of the same gender.
The peer-reviewed article that I chose was about heart disease. Heart disease needs particular attention from health care administrators, since “Chronic heart failure (CHF) is a progressive syndrome that results in a poor quality of life for the patient and places an economic burden on the health care system”. (Ramani, Uber, & Mehra, 2010). There is no one test to diagnose heart failure.
Hypertension increases the risk of heart failure 2 to 3 fold. (He, et al, 2001) The American College of Cardiology (ACC) has identified 4 stages of heart failure. (Hunt, Abraham, Chin et al, 2009). Screening patients for heart failure is sometimes controversial. Health care administrators...
Cardiomyopathy, by definition, means the weakening of the heart muscle. The heart is operated by a striated muscle that relies on the autonomic nervous system to function. Cardiomyopathy is diagnosed in four different ways based on what caused the illness and exactly what part of the heart is weakened. The four main types of cardiomyopathy are dilated cardiomyopathy, hypertrophic cardiomyopathy, restrictive cardiomyopathy, and arrhythmogenic right ventricular dysplasia. One other category of cardiomyopathy that is diagnosed is “unclassified cardiomyopathy.” Unclassified cardiomyopathy is the weakening of the heart that does not fit into the main four categories.
It was to this respect that, the search could detect ‘’hypertension’’ as the leading risk factor for heart disease. And this preceded three quarters of heart failures cases as compared to coronary artery disease, which led to most heart failures in less than 40% of the cases. Also, an increase in left ventricular end-diastolic diameter became a mirror to the Framingham study as incident heart diseases in the individuals who are free from myocardial infarction. Although studies have shown that, the manifestation of heart failures can be present without the left ventricular systolic dysfunction, other risk factors could lead to that. Also, they (Framingham study) were able to detect ‘’too much of cholesterol’’ as a link to cardiovascular diseases. Moreover, research believed that has elevated among certain heart diseases such as coronary heart often leads to stroke, too high blood pressure among numerous patients. Having said that, the search discovered ‘’obesity’’ also as a concomitantly with hypertension which elevates lipids and diabetes versus questions on smoking behavior. Having said that, these risk factors are believed to have attributed to heart diseases. Therefore, it became a national concern to the general US population and that of the fourth director of Framingham heart study, William Castelli
Takeda A, Taylor SJC, Taylor RS, Khan F, Krum H, Underwood M. (2012). Clinical service organisation for heart failure (Review). Cochrane Database of Systematic Reviews. Issue 9. Art. No.: CD002752. DOI: 10.1002/14651858.CD002752.pub3.
My clinical rotation for NURN 236 is unique in that all patients I care for at Union Memorial Hospital in Baltimore, Maryland have a diagnosis of heart failure (HF). HF occurs when the heart is unable to pump adequate blood supply, resulting in insufficient oxygen and nutrients to the tissues of the body (Smeltzer, Bare, Hinkle, and Cheever, 2012). Approximately 670,000 Americans are diagnosed with HF each year and is the most common hospital discharge diagnosis among the elderly (Simpson, 2014). Moreover, according to the Centers for Medicare and Medicaid Services (CMS), HF is the leading cause of 30-day hospital readmission followed by acute myocardial infarction (AMI) and pneumonia (medicare.gov|Hospital Compare, 2013). This information along with my weekly HF patient cohort prompted my curiosity regarding impacts of HF readmissions, factors of HF readmission, and to compare suggested evidence based practice with policies utilized at Union Memorial for reducing the 30-day readmission rate for HF.
Stage A people are at a high risk for developing heart failure. This includes people with high blood pressure, diabetes, coronary artery disease and metabolic syndrome. Stage A also includes people with a history of alcohol abuse, cardiotoxic drug therapy, rheumatic fever, and family history of cardiomyopathy.
High blood pressure is called the “silent killer” because it often has no warning signs or symptoms, and many people don’t know they have it. For most patients, high blood pressure is found when they visit their health care provider or have it checked elsewhere. Because there are no symptoms, people can develop heart disease and kidney problems without knowing they have high blood pressure. Some people may experience: bad headache, mild dizziness, and blurry vision. Traditionally, diagnosis of high blood pressure (BP) has relied on consecutive checks of clinic BP over a 2 to 3 month period, with hypertension confirmed if BP remains persistently raised over 140/90 mmHg. This method of diagnosis has significant limitations because the BP measured for an individual patient in a clinic setting may not reflect their BP in day-to-day life. The main concern is that as a result of the “white coat syndrome”, hypertension may be over-diagnosed when checked in the clinic setting; resulting ...
Lesle, S. J., Hartswood, M., Meurig, C., McKee, S. P., & Slack, R. (2006). Clinical Decision Support Software for management of chronic heart failure: Development and Evaluation. Computers in Biology and Medicine vol. 36, 495-506.
“At its core evidence based ‘anything’ is concerned with using valid and relevant information in decision making” “high quality research is the most important source of valid information”. Psychological Association (2006, p. 273) defines EBP as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. " When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most recent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement of the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.... ... middle of paper ...
... J. (2009). Heart disease and stroke statistics--2010 updated: a report from the American Heart Association. Journal of the American Heart Association. doi:10.1161/CIRCULATIONAHA.109.192667
230) in EBP. Clinical opinion, together with the best relevant research evidence, provides the framework to for the best patient outcome. The nurse’s clinical opinion is acquired through knowledge and skills developed from undergraduate, graduate, or continuing education, clinical experience, and clinical practice (Melnyk & Fineout-Overholt, 2010). Clinical opinion also includes internal evidence, which is generated within a clinical setting from quality improvement outcomes, management initiatives or EBP implementation projects (Melnyk & Fineout-Overholt, 2010). Nurses use their clinical opinion when they identify each patient’s condition, individual risks, personal values and expectations, benefits of possible interventions, and gather evidence for EBP. When searching for the best available evidence, there is a hierarchy in the strength of evidence. The highest level of evidence usually comes from a systematic review or an evidence-based clinical practice guideline based on a systematic review. Systematic reviews provide the strongest evidence through a summary combining the results from many relevant, unbiased studies, to answer a particular clinical question. Nurses critically assess the individual studies, to gather the best evidence available for patient care. Systematic
Coronary heart disease or coronary artery disease affects 16.8 million people in the United States and causes more than 607,000 deaths annually (Lemone, chap.30). It is caused by atherosclerosis which is the accumulation of fatty deposits in the arteries causing impaired blood flow to the myocardium. CAD or coronary artery syndrome is usually without symptoms but may induce heart attack, angina and acute coronary syndrome if not properly treated. There are many risk factors associated with CAD like obesity, high cholesterol diet, hereditary, physical inactivity, just to name a few. Patients with CAD may be unable to identify and manage their risks factors. It is imperative for nurses to educate the patient about CAD and measures to enhance their health.
Just as breast cancer is killing our African American women, heart disease is also one of the major diseases killing our women. Heart disease is one of the nation’s leading causes of death in both woman and men. About 600,000 people die of heart disease in the United States (Americas heart disease burden, 2013). Some facts about heart disease are every year about 935,000 Americans have a heart attack. Of these, 610,000 are a first heart attack victim. 325,000 happen in people who have already had a heart attack. Also coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and loss of productivity. Deaths of heart disease in the United States back in 2008 killed about 24.5% of African Americans.
There are many causes in America that leads to mortality. Cardiovascular disease is the number one cause of death in America. Coronary heart disease, heart attacks, and other diseases can lead to heart failure. Coronary heart disease cost an estimate of $108.9 billion for the United States in 2010. The total costs include medications, decrease in productivity, and medical services.
O'Brien, D. (2009). Randomized controlled trials (RCTs). In R. Mullner (Ed.), Encyclopedia of health services research. (pp. 1017-1021). Thousand Oaks, CA: SAGE Publications, Inc. doi: http://dx.doi.org.proxy1.ncu.edu/10.4135/9781412971942
Heart failure is most probably to happen as we age. However, anyone can develop heart failure, which is actually a severe long term chronic illness. Nevertheless, one can live a full and active life with the appropriate medical treatment and attention one pays to their lifestyle. Numerous of individuals who develop heart failure have had other heart conditions previously. The most prevalent condition that amounts to heart failure is coronary artery disease, blood pressure as well as prior heart attack. (American Heart Association, Causes and risks of heart failure, 2018; Retrieved from http://www.heart.org/HEARTORG/Conditions/HeartFailure/CausesAndRisksForHeartFailure/Causes-and-Risks-for-Heart-Failure_UCM_002046_Article.jsp#mainContent