Introduction
Heart disease is a general term used for various heart conditions. Specific heart conditions are characterized by different symptoms, diagnoses, and treatment methods (CDC, 2022). Further, heart conditions are usually named according to the specific area of the heart they affect. Currently, heart disease is the leading cause of death in the United States. In 2020, heart disease was directly linked to the death of 697,000 people, which reflects one in every five deaths (CDC, 2022). Coronary Artery Disease (CAD) is the world’s most common type of heart disease. In 2020, CAD accounted for the death of 382,820 people, which is more than half the total number of death caused by heart disease (CDC, 2022). According to the CDC, 7.2% (more than 20 million) of adults above twenty years have CAD. CAD is usually caused by the narrowing of the arteries, which inhibits blood flow to the heart (CDC, 2022). These statistics speak to the gravity of the health condition, which is slowly becoming a pandemic in the United States. Additionally, the government spent more than $ 229 billion in the financial year 2017/2018 to deal with heart disease (CDC, 2022). The other common types of heart disease include; congenital heart failure (CHF), arrhythmias, cardiomyopathy, and heart valve disease (Tsao et al., 2022).
According to research, there are various major risk factors for CAD and heart disease in general. These include alcohol consumption, smoking, obesity, hypertension, physical inactivity, and genetics. Alcohol drinking weakens the heart muscle, making it difficult for the heart to pump blood, leading to various heart conditions. Excessive alcohol consumption has also been linked to high blood pressure, a significant risk factor for heart disease. Smoking, on the other hand, causes heart disease in various ways. First, nicotine narrows the airways causing multiple heart conditions. Heart disease is incurable, and there primary and secondary prevention is the main focus of the prevention and treatment of heart disease. This study will focus on the intervention in addressing the healthcare issue.
Leadership and Change Management
Secondary prevention of heart disease requires various changes in the patient’s lifestyle. To institute these changes and accomplish optimal care for the patient, the nurses should implement multiple leadership strategies. Transformational leadership is characterized by inspiration, motivation, and self-drive. In this regard, the leader motivates and inspires the group to work towards the set goal and vision. Transformational leadership is anchored on four basic principles: idealized influence, intellectual stimulation, inspirational motivation, and individualized consideration. Intellectual stimulation is characterized by innovation, while idealized influence is characterized by trust, passion, and leading by example. This leadership style has been widely used in all sectors of the economy, including nursing.
According to Collins et al. (2020), transformational leadership has many advantages, including enhancing patient outcomes. The article argues that transformational leadership is essential for improving the quality of care as it reduces hospital stay re-hospitalization and enhances the patient experience of care. On the other hand, Boamah et al. (2018) analyzed the influence of the leadership strategy on patient safety and job satisfaction. According to the study, transformational leadership creates an enabling friend that is good for both the patient and the nurses and hospital staff. This leadership style will be essential in setting and accomplishing smart goals. These goals include healthy eating, physical activity, and medication adherence.
Change management is also essential in changing the lifestyle of the patient in primary and secondary prevention of the disease. Change management is defined as the aspect of managing change in an organization. In this regard, there are various aspects of change management that had an influence on this intervention. These aspects of change management include having an opportunity to influence the change, being prepared for the change, and valuing the change. (Nilsen et al., 2020). These aspects of change management enable the patient to participate fully in the change and understand its influence on his lifestyle and its benefit on his health.
Additionally, Lewins three-stage model will be used to effect the change. The model has three major stages termed unfreezing, change, and refreezing. The model was developed by Kurt Lewin in 1940,s and has been used by many organizations to implement change over the past (Hussain et al., 2018). The first step unfreezing, is characterized by analyzing the different ways that actualize the change and help people let go of the old habit. The second phase, change, is characterized by the actual implementation of the change (Hussain et al., 2018). The implementation of change encompasses a change in thoughts, behavior, and feelings. The last phase is characterized by the full adoption of the change as the new normal (Hussain et al., 2018).
Communication and Collaboration Strategies
For this assignment, I will be working with 50-year-old male suffering from CAD. The fifty-year-old male will be named DD (not his real name) to enhance patient privacy under the HIPAA privacy law. DD was diagnosed with CAD six years ago. The primary risk factors for my patient are healthy eating and physical inactivity.
Taking care of patients with CAD requires the collaboration of all the involved stakeholders, including patients, their primary caregivers, doctors, social workers, and nurses. The entire continuum of care rests on the patient as a major shareholder and therefore requires his or her involvement throughout the care period. According to the laws of the land, the patient has the power to accept or decline various medications or medication procedures based on his belief and interests. Patient-centered care rests on the principle that the patient has innate knowledge about their health acquired through experience throughout his or her life (Kusnanto, 2018). There are many advantages of gaining patients’ insights, including getting insights into any allergies or extreme reactions the patient might have to various medications (Kusnanto, 2018). Further, gathering patient information enhances secondary prevention as the practitioners learn the specific risk factors affecting the patient in question. In this regard, I learned that DD doesn’t struggle with smoking, alcohol consumption, medication adherence, obesity, diabetes, or hypertension. However, DD struggles with healthy eating and physical inactivity.
To enhance interdisciplinary collaboration and coordination among all involved stakeholders, there is a need for effective communication. Effective communication ensures that the right information is transferred to the right party at the right time and for the right purpose. To gain information on the patient, the nurse or medical practitioner must practice active listening. Active listening, in this case, is characterized by a few factors, including creating an enabling environment, showing empathy, focusing on the patient’s thoughts and feelings, asking questions, and not judging the patient. Regarding collaboration among the other stakeholders, there is a need for the development of a system that ensures that the right information is delivered to the right person at the right time and for the right purpose. Such a system, electronic medical records (EMR), is already in place in the hospital.
Healthcare Policies
Every government is mandated to enact policies that improve the livelihood of its constituents. Various health policies affect the coordination of care. They include the HIPPA act and the affordable care act, and the Illinois Board of Nursing. The Illinois Board of Nursing ensures patient safety and the enhancement of quality of care by issuing standards of operation to all nurses. Further, the board ensures that all the nurses practicing in the state have achieved the educational and experience threshold to do so.
The HIPPA act was ratified in 1965. The Act protects patient data from exposure and manipulation by healthcare organizations and other covered entities. Essentially, the Act prohibits the disclosure of patient information by covered entities (CDC, 2018). According to the Act, covered entities include healthcare clearinghouses, hospitals, and healthcare providers like nursing homes, health insurance companies, and business institutions (CDC, 2018). The information protected under this Act includes medical health records and identifiable health information (CDC, 2018). The Act also outlines various conditions under which the information may be disclosed without the patient’s authorization.
The affordable care act was signed into law in 2010. The Act contains various provisions that address three major healthcare issues; healthcare costs, expanding the Medicaid program, and access to health insurance. Regarding access to health insurance, the Act articulates that insurance companies must not deny patients with existing conditions coverage or charge them high premiums. Further, the insurance companies must have a minimum number of preventive services without cost-sharing. The Act also expanded the Medicaid program by expanding coverage to adults whose income is 138% below the federal poverty level. Regarding the reduction of costs, the Act streamlined services, reduced fraud, strengthened the healthcare workforce, and incorporated health information technology. (Crowley et al., 2019).
PART TWO: Intervention
The focus of this intervention will be secondary prevention of CAD, which leads to healthy living and reduces the probability of escalation of the disease which may have dire consequences including heart failure and heart attack. The intervention therefore will focus on educating DD on the various risk factors of CAD and their implication on his health. For instance, the intervention will focus on how smoking, alcohol consumption, obesity, physical inactivity, unhealthy eating causes heart disease. The intervention will be in the form of a brochure.
Further, regarding the personal risk factors for DD, the intervention will focus on healthy eating and physical inactivity. In this regard, the intervention will not only focus on how unhealthy eating and physical inactivity causes heart disease but also on the types of foods DD should include in his diet and the types of foods he should avoid. Further, the intervention will also focus on the amount of optimal physical activity required per day or per week and the types of exercises to undertake. Regarding healthy eating, the patient will be advices will include vegetables, nuts, fruits, sea foods and poultry in his daily meals while avoiding junk foods, red meat, bacon, and foods rich in saturated fats. Regarding physical activity, the patient will be advised to do at least 150–300 minutes of moderate-intensity aerobic physical activity or 75-150 minutes of vigorous intensity aerobic physical activity.
Technology, Care Coordination, and Community Resources
The advancement of mankind has led to various advancements in technology. Overtime, these advancements in technology have leveraged to enhance the quality of care. For instance, telehealth is one of the technologies that have revolutionized the healthcare system. Telehealth can be defined as the provision of healthcare remotely through telecommunication means (Turan et al., 2020).
This technology has already proved to be instrumental in the management of CAD. According to research, telehealth reduces the morbidity and mortality rates of CAD, enhances medication adherence and reduces waist circumference and triglyceride (Turan et al., 2020). Further telehealth also enhances physical activity (Turan et al., 2020). This technology will be essential for DD since he can consult the doctors, nurses and other medical practitioners remotely which reduces the cost of care and enhances time management. Further, in the current world, mobile phones, and laptops have become parts of lives and can also be leveraged for the betterment of healthcare. In this regard, DD will be advised to use medication adherence applications like Medisafe Pill Reminder and physical activity applications which count the number of steps and the amount of calories burnt in a day.
Care coordination involves coordinating and collaborating with all stakeholders in patient care by sharing information and organizing activities to improve patient care. Effective care coordination relies on effective communication to improve the quality of care. In this regard, the right information should be transmitted to the right person at the right time. This aspect will ensure that all patient needs and preferences are met at the right time and in the right way (Williams et al., 2019).
There are various community resources that can help enhance secondary prevention and the quality of care. Various websites are available for free to the community members and contain reliable information regarding healthy eating and the secondary prevention of heart disease. They include Centre for Disease Control (CDC), The American Heart Association, and Healthy Hearts. Further, the community has parks, bike lanes, and gyms that enhance physical activity.
Conclusion
Heart disease is a general term used for various heart conditions. Currently, heart disease is the leading cause of death in the United States, accounting for one in every five death. (CAD) is the world’s most common type of heart. Secondary prevention and medication adherence are the leading measures in the management of the health condition.
References
Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180-189.
CDC (June 14, 2022). Heart Disease. Centers for Disease Control and Prevention. Retrieved from: https://www.cdc.gov/heartdisease/index.htm
Centers for Disease Control and Prevention. (February 7, 2022). Heart Disease Facts CDC.gov. https://www.cdc.gov/heartdisease/facts.htm
Collins, E., Owen, P., Digan, J., & Dunn, F. (2020). Applying transformational leadership in nursing practice. Nurs Stand, 35(5), 59-66.
Crowley, R. A., Bornstein, S. S., & Health and Public Policy Committee of the American College of Physicians (2019). Improving the patient protection and affordable care act’s insurance coverage provisions: A position paper from the American College of Physicians. Annals of Internal Medicine, 170(9), 651-653.
Kusnanto, H. (2018). Patient-centered care. Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer), 1(2), 51-52.
Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses, and assistant nurses. BMC health services research, 20(1), 1-8.
The Centers for Disease Control and Prevention. (September 14, 2018) Health Insurance Portability and Accountability Act of 1996 (HIPAA). Retrieved from: https://www.cdc.gov/phlp/publications/topic/hipaa.html
Tsao, C. W., Aday, A. W., Almarzooq, Z. I., Alonso, A., Beaton, A. Z., Bittencourt, M. S., … & American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. (2022). Heart disease and stroke statistics—2022 update: a report from the American Heart Association. Circulation, 145(8), e153-e639.
Turan Kavradim, S., Özer, Z., & Boz, I. (2020). Effectiveness of telehealth interventions as a part of secondary prevention in coronary artery disease: A systematic review and meta‐analysis. Scandinavian Journal of Caring Sciences, 34(3), 585-603.
Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Finney Rutten, L. J., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives. BMC health services research, 19(1), 1-10.
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