Assessing the Problem
The high risk of readmission among heart failure patients has been noted as an issue. Care quality, patient safety, and healthcare system and individual costs will all be evaluated as a result of this analysis. My practicum patient was a 65-year-old woman called Mei Lee, she was suffering from heart failure. To supplement my research, I spoke with authorities in the field and relevant industries. I was concerned about Mei Lee’s heart failure and wanted to know whether she or her loved ones had ever been in any dangerous situations because of it. This aids in pinpointing any possible damage or negative repercussions brought on by the issue. Mei Lee said she had fallen several times at home due to her dizziness and weakness as a result of her heart failure. These safety incidents call attention to the necessity for efficient management and measures to forestall future damage.
Patient safety, quality of treatment, and healthcare expenditures are all negatively affected by the high number of readmissions, which I explained to Mei Lee during our initial appointment. Disquietude, fever, chills, unbending nature, hack, dyspnea, and chest uneasiness are some disease-related side effects patients report encountering. When the finding was considered in light of the patient’s clinical presentation and chest imaging, a blood culture or bronchoscopy examination of the lower respiratory tract was utilized to affirm the determination. The general forecast was terrible, and comorbidities contributed to this.
Lacking consideration of Mei Lee’s cardiovascular breakdown, which brings about intensifications and readmissions, is demonstrated by her continuous visits to the crisis division (ED) and her set of experiences of hospitalizations. She is currently taking different medications, like diuretics, beta-blockers, and ACE inhibitors, and the majority of them are covered by her protection. Discombobulation and fatigue are two antagonistic impacts that Mei Lee experiences intermittently, highlighting the requirement for careful observation and treatment of her condition. In addition to that, she sees her primary care physician once per month and participates in cardiac rehabilitation classes twice weekly. Because of these frequent visits and treatments, she must have continued monitoring, support, and follow-up care to manage her heart failure best. The coverage that Mei Lee has for her insurance makes it possible for her to finance necessary therapies and gives her access to them.
My Experience with the Patient
During the first two hours of my practicum, I examined the patient’s medical condition. I also conferred with authorities on the subject and the relevant industry to acquire further information. Mei Lee admitted the existence and gravity of the issue during their consultation. She was worried that her health, happiness, and healthcare bills would all suffer due to her repeated hospitalizations. She felt that reducing the high incidence of readmissions among heart failure patients was crucial to increase patient safety, boosting treatment quality, and decreasing healthcare costs. I spoke with patients and looked at evidence-based practice publications and websites to learn more about the extent of the issue. High readmission rates have been linked to higher morbidity, death, and healthcare expenditures for heart failure patients, as reported by these sources. The data showed that specific measures were needed to lower readmission rates and improve patient health outcomes.
Evidence-Based Practise Review
As part of my research, I reviewed several crucial evidence-based practices (EBP) documents and websites, such as those from the National Institutes of Health and Biomed Central, which discussed Heart Failure in healthcare facilities. These materials were beneficial because they detailed effective preventative measures, treatment protocols, and evidence-based interventions. One of the most common reasons for both first and subsequent hospital stays is heart failure (HF). Clinicians, researchers, and other stakeholders are emphasizing reducing readmissions among HF patients (Wang et al., 2022). Despite the widespread availability of evidence-based treatments for managing HF, there is room for advancement regarding the reliability of these therapies and the efficacy of newly developed techniques for preventing readmissions.
As per the research, in 2010, an estimated 1 million people were released from the hospital with HF as their primary diagnosis. In 2012, HF cost a total of $30.7 billion. Medicare reports that the median risk-standardized 30-day readmission rate for HF was 23.0% between 2009 and 2012 (Ziaeian & Fonarow, 2019). Researchers and policymakers focus on readmissions because they are seen as a preventable cause of subpar health care and wasteful expenditure. For 2015 and beyond, the Affordable Care Act mandates a financial penalty for hospitals with high rates of unnecessary readmissions; this penalty cannot exceed 3 percent of the hospital’s total Medicare revenues. Medicare’s previous approach of group payments based on diagnoses did not include a financial penalty for unnecessary hospital readmissions. At present, the Clinic Readmission Decrease Program regulated by the Communities for Government medical care and Medicaid Administrations (CMS) solely assesses risk-changed 30-day readmission rates for cardiovascular breakdown, intense myocardial areas of localized necrosis, pneumonia, constant obstructive aspiratory infection, and elective complete knee and hip arthroplasty.
Hospitals throughout the globe are concerned about the high incidence of readmission for patients with heart failure. Many intervention efforts to decrease readmission rates have centered on the value of education for patients and a structured care plan in smoothing the transition from hospital to home. Prescription reconciliation, communication, patient awareness, and monitoring are all seen to benefit from the shifting of care plans. Although a nurse-coordinated transition of care has been shown to reduce readmission rates for heart failure patients, this claim has yet to be rigorously tested. Improvements in communication are needed for creating a nurse-coordinated care transition plan for heart failure patients, as are adjustments to health policy and reimbursement mechanisms that better match incentives and performance measurements.
Influence Of Leadership, Collaboration, Communication, Change Management, And Policy
Experts in the field and the company’s line of work were interviewed to determine the problem’s relation to leadership, teamwork, communication, change management, and policy. A multidisciplinary strategy, clear lines of communication, and teamwork among healthcare providers were stressed throughout these consultations (Slyer et al., 2019). Patient safety, evidence-based practice implementation, and quality improvement programs were all cited as examples of the need for strong leadership from the panel of experts. Care quality, patient safety, and costs associated with heart failure readmissions are significantly impacted by corporate or governmental regulations and state board nursing practice guidelines.
The use of evidence-based practices, care that prioritizes patients, care coordination, and clear communication are all emphasized in these guidelines and regulations. Studies have shown that adhering to these norms and guidelines leads to better patient outcomes, fewer hospital readmissions, and more efficient use of available resources. Many options exist for dealing with heart failure readmissions in a way that improves treatment quality, boosts patient safety, and cuts costs. Transitional care programs, improved medication management, better information for patients and self-management, better care coordination, and more robust community resources are all things that can be done. Studies have shown that these methods help lower readmission rates, enhance patient outcomes, and maximize resource usage (Rosen et al., 2019). Patient outcomes, including treatment adherence, contentment, and interpretation of information, are influenced by the rapport and connection nurses develop with patients. Prior research has shown that individuals with HF are less likely to be satisfied with their care when doctors fail to explain illness management clearly.
Mei Lee’s lack of knowledge about the adverse effects of hospitalizations on her wellness and medical expenses was a barrier when explaining the situation to her. Mei Lee was initially unaware of the gravity of the situation or its ramifications for her treatment, but this changed once her doctors were frank with her and gave her all the information she needed. Communication breakdowns put patients in danger on their own and as a layer underneath other types of avoidable injury. In acute care settings, communication breakdowns most often occur during transfers of care (i.e., between care areas or shift changes), which may have severe consequences for patients. They are dangerous exchanges where vital information about the patient’s condition and treatment plan might be miscommunicated, delaying or even preventing necessary care.
How The High Rate of Readmissions Among Patients with Heart Failure Impacts The Quality Of Healthcare, Patient Safety, And Cost
There are areas of strength between the pace of readmission for cardiovascular breakdown patients and the general nature of clinical consideration, patient well-being, and cost. Rehashed hospitalizations after an underlying course of treatment are warnings that something was not exactly right with the principal plan of care, proposing a potential breakdown in correspondence and coherence that could have deplorable results. Deficient patient schooling, ill-advised release arranging, and an absence of follow-up treatment all decrease medical care quality.
As well as improving the probability of inconveniences during medical procedures, clinic-obtained diseases, and medicine mistakes, high readmission rates adversely affect patient security. The pervasiveness of readmissions exacerbates the length of a patient’s visit to the medical clinic. An individual’s psychological and actual well-being might endure because of the additional pressure accompanying regular medical clinic stays. To work on persistent well-being, diminishing the regular event of readmissions is urgent.
A high readmission rate might genuinely affect one’s funds since it builds the all-out cost of medical care by requiring more clinical assets, tests, and therapies. To save and utilize assets, limiting readmissions in the event that feasible is desirable. Various methodologies may alleviate this issue, such as better coordination of care, patient schooling, self-administration, momentary consideration programs, giving preventive estimates greater need, and executing information-driven quality improvement drives (Upadhyay et al., 2019). Clinical experts might improve the nature of their care, help patient security, and decrease medical services costs by diminishing the number of readmissions experienced by patients with cardiovascular breakdowns. The outcome is better well-being for the patients.
Conclusion
The high prevalence of heart failure readmissions negatively impacts safety, quality of treatment, and financial burdens. The scope of the issue was determined via discussions with Mei Lee and other experts in the field, as well as through a study of evidence-based practice publications. State board nursing practice guidelines, rules, and legislation are essential to mitigating the problem’s effects. Evidence-based recommendations were made on enhancing care quality, patient safety, and efficiency. Continuous assessment and quality improvement may be supported by using benchmark data. A nurse’s responsibility includes educating patients. Evidence suggests it cuts down on hospital stays and readmissions. In-person nursing education has increased disease management knowledge among individuals with HF. Nurses spend far more time interacting with and caring for patients than other healthcare professionals.
References
Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2019). Teamwork in healthcare: Key Discoveries Enabling Safer, high-quality care. American Psychologist, 73(4), 433–450. NCBI. https://doi.org/10.1037/amp0000298
Slyer, J. T., Concert, C. M., Eusebio, A. M., Rogers, M. E., & Singleton, J. (2019). A systematic review of the effectiveness of nurse-coordinated transitioning of care on readmission rates for patients with heart failure. JBI Library of Systematic Reviews, 9(15), 464–490. https://doi.org/10.11124/01938924-201109150-00001
Upadhyay, S., Stephenson, A. L., & Smith, D. G. (2019). Readmission Rates and Their Impact on Hospital Financial Performance: A Study of Washington Hospitals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 56(56), 004695801986038. https://doi.org/10.1177/0046958019860386
Wang, Y., Eldridge, N., Metersky, M. L., Rodrick, D., Faniel, C., Eckenrode, S., Mathew, J., Galusha, D. H., Tasimi, A., Ho, S.-Y., Jaser, L., Peterson, A., Normand, S.-L. T., & Krumholz, H. M. (2022). Analysis of Hospital-Level Readmission Rates and Variation in Adverse Events Among Patients With Pneumonia in the United States. JAMA Network Open, 5(5), e2214586–e2214586. https://doi.org/10.1001/jamanetworkopen.2022.14586
Ziaeian, B., & Fonarow, G. C. (2019). The Prevention of Hospital Readmissions in Heart Failure. Progress in Cardiovascular Diseases, 58(4), 379–385. https://doi.org/10.1016/j.pcad.2015.09.004
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