Reducing Heart Failure Admissions
1st
As part of the quality improvement team on the medical surgical unit floor my job is to decrease hospital admission for heart failure. A few ways that I could guide patients into preventing heart failure would be to change or improve their diet, work on healthy ways to cope with stress factors in their life, and to make sure that a form of exercise is implemented into their routine. The steps that I will take to conduct a literature review would be to firstly, provide information about a study on heart failure and discuss their conclusion, recommendations, and education. Then I would implement new interventions, protocols, or policies to improve heart failure, and lastly I would create a question that could direct the new interventions, protocols, and policies in the hospital. The theoretical frameworks that could work well with my idea’s on improving heart disease in the medical-surgical floor would be, either middle range nursing theory or situation-specific nursing theory. A middle range nursing theory “contains a limited number of concepts and are focused on a limited aspect of reality” as stated in the Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice e-book, and a situation-specific nursing theory is “more specific than middle range theories and are composed of limited number of concepts (pg 77)”. Looking at both theories side-by-side a situation-specific nursing theory would probably be the better choice because, the question is focused on decreasing hospital admission for heart failure on the medical-surgical unit floor, which is very specific as opposed to just saying “decreasing hospital admission for heart problems in the hospital” which is more broad and could entail anything from congenital heart problems to high blood pressure for anyone in the hospital.
2nd
In order to decrease hospital admission for heart failure patients, the change would have to be done as a preventative measure. There is nothing that can be done during the moment to limit the amount of admissions are related to heart failure because if they were already admitted, you cannot change it then. With that being said, my literature review would be based of preventative measures of heart failure.
Some steps I would specifically take to conduct a literature review on decreasing hospital admission for heart failure patients would be to form a group from many different areas to do this research together. I think that having a cardiac doctor, cardiologist, a nurse on the medical-surgical floor, some CNAs, and anyone else interested in the topic of decreasing hospital admission for heart failure patients would help because it would bring many different sides to the information. Each person would bring their own information to the table and research different parts of heart failure prevention, so I think it would be very informative to everyone to hear the different opinions. Once this group of people is formed, I would have a meeting and make sure everyone is on the same page about the literature review that they would be completing, then give some time for research. I would then have weekly meetings to check in on research and start developing a more condensed literature review from everyone’s information they have gained.
I think that a conceptual framework would work best for this situation of decreasing the amount of heart failure admission patients. With conceptual framework being a grand theory and consisting of the theories from “Florence Nightingale, Virginia Henderson, Martha Rogers, Dorothea Orem, and Betty Neumann,” it creates a whole perspective of the patient, health, and the environment to better care. I think when looking at preventative care, it is important to look at patients in different categories and determine risk factors based on their health prior to heart failure; however, also looking at and considering the environment the patient lives and grew up in, because all of that makes a difference. Preventative care is more of a grand theory because you have to take in information from many different aspects in order to form plans on what to do to prevent and decrease the amount of patients admitted to the hospital for heart failure.
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