Identify key terms: heart failure, advanced heart failure, Ventricular assist devices, Implantable cardioverter-defibrillators.
The key terms used during the search were “Cardiovascular assist devices,” “heart failure,” “advanced heart failure,” and “Implantable cardioverter-defibrillators.” The key terms were combined using the Boolean operators “OR” to retrieve literature with their synonyms, while “AND” was used to combine the key search terms to retrieve more refined results. I started with a list of key terms related to advanced heart failure, VADs, and another regarding these technologies specifically. Variations on these terms included heart failure, advanced (sic) heart failure, VADs and ICDS. The search string for VADs was heart failure AND ventricular assist devices, and ICD’s advanced heart failure AND implantable cardioverter-defibrillators). Limiters such as peer-reviewed articles, publication dates 2018-2023, and Published in English were also used to refine the search.
Barriers to Setting up Search Strategy and Ways to Overcome
In the search process, one of the difficulties was balancing specificity and comprehensiveness, as most of the searches gave either too few or too many irrelevant results. To overcome this, I refined the search terms repeatedly, switching Boolean operators and substituting keywords. I also used various databases, mostly PubMed and CINAHL, to ensure the extent of literature coverage was thorough. I chose carefully structured vital terms to optimize the search strategy and used Boolean operators selectively.
Synthesis of the Literature
Article 1:Drazner’s (2022) article examines the role of left ventricular assist devices (LVAD) in advanced heart failure. It describes the HeartMate platform over 30 years and how patient outcomes have improved generation by generation. Second-generation LVAD (HeartMate II) The more compact-sized and axial-flow design dramatically increases the success rate, even though there is a propensity for thrombosis.
Article 2: Butler et al. (2022) examine the place of ICD treatment in heart failure with reduced ejection fraction. It considers the challenges of modern medical treatment and asks whether the state of ICD therapy in current cutoff indications for ejection fraction still holds. Accordingly, Butler et al. (2022) call for a reassessment of ICD indications for patients under current guideline-directed medical therapy.
Synthesis:
LVADs provide a mechanical solution for helping failing hearts, and HeartMate II can resolve some problems encountered by previous devices (Butler et al., 2022). Conversely, the ICD article stresses that with continuously developing medical treatments, it is time to reconsider what warrants IC indications. Complementing each other, in a sense, both technologies help deal with the variety of issues involved; specifically, they provide mechanical assistance (LVAD) and prevent sudden cardiac death (ICD) (Drazner, 2022). Their involvement in patient care can help ameliorate for people with advanced heart failure.
The Technology I Would Implement and Why
Left ventricular assist devices (LVADs) appear to be more of an appropriate response to the problems of advanced heart failure. Drazner’s (2020) article highlights how LVAD technology is developing. One of the most notable advances in this area has been with HeartMate II, a new iteration that boasts a slimmer and more effective axial-flow pump than its predecessor. Some predispositions to thrombosis notwithstanding, this technology has shown improved patient outcomes Butler et al. (2022). LVADs provide mechanical support to a failing heart, overcoming the shortcomings of conventional medical treatment and offering hope for patients with reduced ejection fraction (Drazner, 2020). As described in the literature, the continuing progress in LVAD design means it is an attractive candidate for integrated care of advanced heart failure.
How would the Technology Be Applied to This Problem?
Advanced heart failure entails a comprehensive approach to implementing left ventricular assist devices (LVADs) in the nursing workflow (Butler et al., 2022). Following LVAD implantation, nurses are essential in patient education, preoperative preparation, and postoperative care. The LVAD’s functions, the patient’s hemodynamic status, and possible complications should all be monitored constantly (Drazner, 2022). Nursing interventions are centered on taking care of the driveline, ensuring that anticoagulation therapy is adhered to, and teaching patients when the device alarm sounds or something goes wrong.
How Technology Addresses the Problem
As patients move from hospital care to home and outpatient care, nurses continue to be indispensable bridges linking the different levels of medical arrangements (Groenewegen et al., 2020). They educate patients about device management, help them get used to lifestyle changes, and watch for warning signs of complications. Technology and integration of communication systems denote telehealth consultations where nurses can remotely examine patients to judge whether the LVAD is working correctly (Drazner, 2022). This enables stable functioning at any stage during long-term management as well. It also promotes patient recovery and subsequent development on their timetable towards everyday life.
Conclusion
The application of left ventricular assist devices (LVADs) has increased as an important new tool to meet these formidable challenges of advanced heart failure. The literature cites that LVADs provide a solution in stages (Groenewegen et al., 2020). They have been developed over decades and are constantly improved to improve patient outcomes. This technology has considerable potential as part of the continuum from acute care to outpatient management. When the development and clinical use of LVADs are combined with a holistic approach to nursing workflow, they offer individuals with advanced heart failure an enhanced quality of life; health is improved and can be sustained for many years.
References
Butler, J., Talha, K. M., Aktas, M. K., Zareba, W., & Goldenberg, I. (2022). Role of Implantable Cardioverter Defibrillator in Heart Failure with Contemporary Medical Therapy. Circulation: Heart Failure, 15(8). https://doi.org/10.1161/circheartfailure.122.009634
Drazner, M. H. (2022). Left Ventricular Assist Devices in Advanced Heart Failure. JAMA, 328(12), 1207. https://doi.org/10.1001/jama.2022.16348
Groenewegen, A., Rutten, F. H., Mosterd, A., & Hoes, A. W. (2020). Epidemiology of heart failure. European Journal of Heart Failure, 22(8), 1342–1356. https://doi.org/10.1002/ejhf.1858
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