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Epidemmology
Epidemmology
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Extraneous Variables
There are two types of extraneous variables: Intrinsic variables and external factors. Intrinsic variables are factors intrinsic to the subjects, such as, age, gender, and diagnosis. External factors arise from the research itself. Multiple comorbidities, such as, renal insufficiency and diabetes would be intrinsic variables that could influence the study. Patients with these conditions may be more likely to be admitted into the hospital for these conditions within thirty days of being discharged from the hospital with a primary diagnosis of congestive heart failure. This could be controlled by creating sub-groups of each population and further comparing them to each other. For example, data analysis could take the population with a primary diagnosis of congestive heart failure and a secondary diagnosis of diabetes that were provided the teach-back intervention and comparing this group with the control group with the same primary and secondary diagnosis to determine if there was a difference in 30 day readmission rates. A second extraneous variable would be age, as younger individuals might be able to retain new knowledge, and have the means of applying self-management behaviors more consistently. Randomization is the best way to control intrinsic variables. Consistent data collection and communication is an external factor that needs to be controlled. Using the same instrument, and entering data electronically will standardize data collection. While following the same teach-back format will be utilized to standardized communication.
Instrument
The Dutch Heart Failure Knowledge Scale is the tool that will be utilized to assess knowledge retention. It is a 15-item questionnaire that can be self-administered. T...
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...of each, describe signs and symptoms of worsening symptoms and what to do, and describe a low salt diet. Each item will be taught, assessed, retaught, and reassessed until clarity is established. The intervention will be conducted by a specific individual that has met proficiency in the teach-back method.
Data Collection Procedure
In this case the printed questionnaire will be given to every patient enrolled in the study prior to an education intervention. The questionnaire will be sent to the patient three days post discharge from the hospital. Since this tool can differentiate high or low knowledge, data will be entered electronically according to responses. Additionally, demographic material such as age, gender, primary and secondary diagnosis will be attached to each questionnaire. The demographic material and questionnaire will be coded for ease of data entry.
were put into groups and were guided by a member of the FSC centre. We
1. Outline the causes, incidence and risk factors of the identified disease and how it can impact on the patient and family (450 words)
The NHS Outcomes Framework has five standard domains which is set out to improve the quality and outcome of care and services that is being delivered to the patients and service users (National Quality Board, 2011). As such, this project plan is focused on domain 2 as it has been mentioned before, is based on improving the quality of people with long term conditions. Nurses will give cardiac discharge advice to patients on self care, thus identifying how to improve and manage their condition so that they can continue with their normal lifestyle. Furthermore patients will be advised on how to overcome stress and depression which will help them in maintaining the activities of living (DoH, 2013).
Takeda, Taylor, Khan, Krum, & Underwood. (2012) states ‘(1) case management interventions (intense monitoring of patients following discharge often involving telephone follow up and home visits); (2) clinic interventions (follow up in a CHF clinic) and (3) multidisciplinary interventions (holistic approach bridging the gap between hospital admission and discharge home delivered by a team). The components, intensity and duration of the interventions varied, as did the ‘usual care’ comparator provided in different trials’. (P. 2).
Regulate the clinical data by enforcing stringent data management practices and mitigate the deviation in data collection and recording. The study protocol will define the source of data collection with Case Report Forms (CRFs), method of storage paper/ electronic and information retained for data archiving. Each subject will be identified with unique ID and Subject Identification Log will be maintained separately from trail analysis documents. The DMS prevents unblinding of specific documents, which protect the privacy and confidentiality of the subject, unless required by the study protocol. Identifiable documents and records will be maintained in accordance with the data retention period as specified in the protocol and the requirement of the regulations and IRB. Any update or changes implemented will be recorded in the revision history of the respective documents. The clinical trial team will be trained on clinical documentation and
...y hired nurses on the heart failure floor since discharge education remains one of the responsibilities. I believe knowledge is an important factor to empower the patients about heart failure care and nurses spend nearly 24 hours a day with hospitalized patients; therefore, nurses can be patient advocates by reinforcing teaching. Most importantly, I believe that catering to the patient’s individual needs and establishing a good nurse-patient relationship enhances trust and learning which in the long run, is very beneficial to both nursing practice and the quality of life of the patient. Overall, what I discovered about heart failure is that there is no simple solution in preventing heart failure hospital readmission. Even with the recommended evidence-based practice suggestions, hospital readmission rates for HF still seem to remain high throughout the country.
Based on http://www.austincc.edu/adnlev1/rnsg1161online/clinical_homework_samples/Nursing_care_plan_sample.htm column one: nursing diagnosis; column two: the expected outcome and goal of what you would like to see from the patient after a specific time frame; column three: interventions; (column four: scientific rationale for each intervention)
The best way to prevent heart failure is to minimize the risks that cause it and to control existing health problems that are related to the condition such as high blood pressure and diabetes. If a person does happen to have heart failure there are many medications and treatments that can help control the disease and help the patient continue to live as normal of a life as possible. After being discharged from the hospital Mr. Carver will have to be aware of his condition at all times and take the proper measures to keep himself healthy. He will have to make many life changes and continue to keep up on any appointments made to make sure his condition is under control. With the proper understanding and management of his disease, Mr. Carver will be in a good condition to resume his life as before.
This piece of work will be based on the pre-assessment process that patients go through on arrival to an endoscopy unit in which I was placed during my second year studying Adult Diploma Nursing. I will explore one patient’s holistic needs, identifying the priorities of care that the patient requires; I will then highlight a particular priority and give a rationale behind this. During an admission I completed under the supervision of my mentor, I was pre-assessing a 37 year old lady who had arrived at the unit for an upper gastrointestinal endoscopy. During the pre-assessment it was important that a holistic assessment is performed as every patient is an individual with unique care needs as the patient outlined in this piece of work has learning disabilities it was imperative to identify any barriers to communication (Nursing standards 2006). There were a number of nursing priorities identified, the patient also has hypertension.
...rovide education. Each patient admitted to cardiac rehab has a risk factor profile on admission and reassessed throughout the program and on discharge. Education is provided based on the individual needs of each patient and to the entire group in relation to cardiovascular health and wellness. The PHN focus entails many aspects such as trend detection, collecting and analyzing data, disaster preparedness and relief, reporting of communicable diseases and many other duties for the entire community, not just a select group as I do. (Stanhope & Lancaster, 2012, Chapter 46)
The purpose of the paper is to discuss the activities involved during the evaluation of a patient. Evaluation of a patient can be seen as the process of examining a patient critically. It comprises of gathering and analyzing data about a patient and the illness (Allan, 2012). The core reason is to make judgment about the disease one is suffering from. Such judgment will guarantee proper treatment and diagnosis. Typically, gathering of information from the patient is the role of nurses while making judgment and prescription is the doctor’s role (Jacques, 1988). In any case all practitioners are required to know how to evaluate a patient.
Key words such as closed and open questions are very well explained. Differentiating when to use each type of question is described and useful for facilitating an interactive dialogue. It is important to understand how to assist the patient in relaying important details and to ensure that what the patient has expressed is understood.
care for patients. In addition, the study will determine the factor of income and the burden of
In the health care industry, gathering information in order to find the best diagnosis route or even determine patient satisfaction is necessary. This is complete by conducting a survey and collecting data. When the information is complete, we then have statistical information used to make administrative decision within the healthcare field. The collection of meaningful statistics is an important function of any hospital or clinic.
It reveals that clients are shifting from a perspective of ambivalence about proposed or potential change towards one of increased confidence and motivation. Teach back method The nurse can also employ the teach-back method, a strategy that helps patients understand and recall their instructions. After the nurse gives a patient the instructions about his or her medication, the patient then explains the instructions back to you. Depending on the patient's comprehension, affirm his or her understanding or go over the instructions again.