Section B: Proposal/Problem Statement and Literature Review Nursing Paper

The Proposal/Problem Statement and Literature Review Nursing Paper provides a summary of the research conducted to support the PICOT, including subjects, methods, key findings, and limitations.

Proposal/Problem Statement and Literature Review Nursing Paper

Part Two: Proposal/Problem Statement and Literature Review

This EBP project is proposed to lower HF the one-month heart failure readmission rates in the acute care hospital setting by implementing a change initiative that would increase patient knowledge of HF self-care activities. The current EBP proposes to focus on measures that would decrease hospital readmissions that can be prevented by integrating the best practices in connection to HF self-care activities. This is because educating the patient together with their families on how to manage effectively and early treatment would potentially lower the one-month hospital readmission rates and yield improved outcomes. As such the refined PICOT question which was “Amongst adults aged over 45 years diagnosed with heart failure (Population-P), would post-discharge HF education program hereafter abbreviated as (PHFEP) (Intervention- I) compared to conventional heart disease education (Comparison-C) decrease the rate of one-month hospital readmissions and improved quality of life for the patient (Outcome- O) within 90 days (Time –T)?’

The proposed problem state, therefore, states The EBP project is proposed to initiate measures whose successful implementation would lower the one-month hospital readmission rates for adult patients diagnosed with HF.

Read Section A: Organizational Culture and Readiness Assessment

Summary of the Literature Review Articles – Problem Statement and Literature Review

      The proposed PICOT question helped guide a comprehensive literature search that helped to identify, analyze, and synthesize the relevant literature that supports the PHFEP initiative. The articles’ subjects, methods, key findings were then synthesized. The search from healthcare-based databases like PubMed, Medline, and CINAHL yielded over 270 articles. Search terms from the PICOT question and problem statements like self-care, education, and HF were used in the search process. The articles meeting the inclusion criteria of being published in English and within not older than five years were synthesized. The subjects of the selected articles included Ba et al.’s (2020) integrative review, which sought to highlight transitional care interventions to Ziaenian& Fonarow (2016), which focused on strategies for preventing HF hospital readmission.

From another perspective, Su et al. (2019) explored the socioeconomic predictors and their impact on HF readmissions. The methods used in the review articles also varied from Diez et al. (2019) use of randomized control trial and qualitative methodology, which was utilized by Glogowska et al. (2015) while Qaddoura et al. (2015) used systematic reviews and meta-analysis approach. At the same, these studies also emphasized the role of patient education and the need to adhere to the HF self-care practices as a way of effective management of HF (Souza et al., 2019; Toukhasati et al., 2019). The articles also had notable limitations, like the small number of participants in the RCTs makes the findings of the study less generalizable (Dies et al., 2019).

Another study limitation was the inclusion of only those articles publishing English and failing to explore the gray literature databases like dissertations and non-peer-reviewed articles. The general trend in all the findings of the articles selected underpinned the fact that HF hospital readmissions were largely preventable events (Ba et al., 2020). The overall effect of these limitations is that not all research that is relevant was included in the literature review.

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Section b: proposal/problem statement and literature review nursing paper
Section B: Proposal/Problem Statement and Literature Review Nursing Paper

ConclusionProblem Statement and Literature Review

In conclusion, the need for nurse-led face-to-face patient education sessions is bound to improve HF disease management. As the articles reviewed indicate, patients with HF knowledge scores are less likely to be readmitted in hospitals compared to patients with low HF scores indicating the efficacy of the proposed education intervention. The increase in HF knowledge improves the patients’ self-care confidence and practices. All these findings support the need for comprehensive post-discharge HF patient education applying the best practices, which would ultimately lead to reduced HF readmission rates.

References – Problem Statement and Literature Review

Diez, N. P., Campos, R. C., Roiz, S., Salaverria, I., Subijana, E., González, M. J. E., & Sobradillo, P. (2019). Effectiveness of self-care program for hospital readmissions prevention in patients with potentially avoidable hospitalizations 🙁 AUTOCUID) randomized clinical trial. International Journal of Integrated Care (IJIC)19.

Glogowska, M., Simmonds, R., McLachlan, S., Cramer, H., Sanders, T., Johnson, R., & Purdy, S. (2015). Managing patients with heart failure: a qualitative study of multidisciplinary teams with specialist heart failure nurses. The Annals of Family Medicine13(5), 466-471.

Jones, G. S., & Baldwin, D. R. (2018). Recent advances in the management of lung cancer. Clinical Medicine, 18(Suppl 2), s41.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334032/

Linn, A. C., Azollin, K., & de Souza, E. N. (2016). Association between self-care and hospital readmissions of patients with heart failure/Associação entre autocuidado e reinternação hospitalar de pacientes com insufi ciência cardíaca/Asociación entre la auto-atención y reingresos hospitalarios de pacientes con insufi ciencia cardíaca. Revista Brasileira de Enfermagem69(3), 469.

Mai Ba, H., Son, Y. J., Lee, K., & Kim, B. H. (2020). Transitional Care Interventions for Patients with Heart Failure: An Integrative Review. International Journal of Environmental Research and Public Health17(8), 2925.

Qaddoura, A., Yazdan-Ashoori, P., Kabali, C., Thabane, L., Haynes, R. B., Connolly, S. J., & Van Spall, H. G. C. (2015). Efficacy of hospital at home in patients with heart failure: a systematic review and meta-analysis. PloS one10(6).

Sousa, J. P., Neves, H., Lobão, C., Gonçalves, R., & Santos, M. (2019). The effectiveness of education on symptoms recognition in heart failure patients to manage self-care: a systematic review protocol-L’efficacia dell’istruzione sul riconoscimento di sintomi in pazienti affetti da insufficienza cardiaca ai fini Del self-care: UN protocollo di revisione sistematica. Professional infermieristiche, 72(1)

Su, A., Al’Aref, S. J., Beecy, A. N., Min, J. K., & Karas, M. G. (2019, July). Clinical and socioeconomic predictors of heart failure readmissions: A review of contemporary literature. In Mayo Clinic Proceedings (Vol. 94, No. 7, pp. 1304-1320). Elsevier.

Toukhsati, S. R., Jaarsma, T., Babu, A. S., Driscoll, A., & Hare, D. L. (2019). Self-Care Interventions That Reduce Hospital Readmissions in Patients with Heart Failure; Towards the Identification of Change Agents. Clinical Medicine Insights: Cardiology13, 1179546819856855.

Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness, and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6932768/

Ziaeian, B., & Fonarow, G. C. (2016). The prevention of hospital readmissions in heart failure. Progress in cardiovascular diseases58(4), 379-385.

Section B: Proposal/Problem Statement and Literature Review

In NUR-550, you developed a PICOT statement and literature review for a population quality initiative. In 500-750 words, include the following:

  1. Refine your PICOT into a proposal or problem statement.
  2. Provide a summary of the research you conducted to support your PICOT, including subjects, methods, key findings, and limitations.

General Guidelines:

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Note: After submitting the assignment, you will receive feedback from the instructor. Use this feedback to make revisions for your final paper submission. This will be a continuous process throughout the course for each section.

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