This article provides a solution essay to Population Health Research and PICOT Question .
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In this course, you will be complete a 2-part assignment in which you conduct research about a population of focus, develop a PICOT statement, and write a Literature Review. The PICOT statement and Literature Review you write in this course can be used for your evidence-based practice project in the next course so be sure to select an issue you want to continue working on in your next course…
Solution
Population Health Research and PICOT Question
Introduction
Heart failure management is a significant challenge facing the healthcare industry across the world. Medically HF is defined as the occurrence of heart muscle fails to pump sufficient blood as per the body requirements. Savarese & Lund (2017) report that about 5.7 million people in the US have HF with projections indicating the figure will reach 8 million by 2030. Studies also suggest that more than 80% of these emergency departments’ visits due to HF result in hospital admission even as heart as the cost of treating HF continues to rise. Furthermore, readmissions for heart failure cost the hospitals about $15000 and are more than a billion dollars in the states taking part in the Healthcare Cost Utilization Project (HCUP) Gai & Pachamanova, 2019). In 2012, the Centers for Medicare and Medicaid Services (CMS) implemented the Hospital Readmission Reduction Program (HRRP), intending to decrease unplanned hospital readmissions rates. Through the HRRP, hospitals are financially penalized for increased readmission s for HF, acute myocardial infarction (AMI) as well as pneumonia. Poor patient outcomes and increased financial costs directly connected hospital readmissions validate the significance of addressing hospital readmissions due to HF at the level of healthcare organizations. Consequently, this essay purposes for developing a PICOT statement on how to decrease HF hospital readmission rates among the adult population.
New York State Statistics on Heart Disease
The Centers for Disease Control and Prevention (2017) indicate that that heart disease was the leading cause of death with over 44 000 fatalities followed by cancer, accidents, chronic lower respiratory diseases, and stroke. Furthermore, America’s Health rankings(2020)on Heart disease ranks Utah as the healthiest state with a value of 2.4% and West Virginia at 8.3% as the least healthy state against a national average of 4.2%. New York State, whose statistics are used, was ranked at number 4. In terms of age the number of adult individuals living with heart disease in New York State expressed as a percentage of state population stood at 0.8% for (18-44), 3.9 for (45-64) and 10.5% compared to the national rates of 0.9%, 4.6% and 11.4 % respectively. Compared to women, more men die of heart disease. At the same time, African American race leads in heart disease fatalities followed by Whites, then Asian r Pacific Islanders and American Indians recording the least number of deaths attributable to heart disease.
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Based on these heart disease indicators the pertinent clinical question that uses the PICOT framework states,’ 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 distinction of Heart Failure, Heart Attack, and Cardiac Arrest
Although its onset can be acute, HF is a chronic condition that renders the heart pump inadequate blood leading to the hormone as well as the nervous system to compensate insufficient blood supply. The body may increase the blood pressure, causing the heart to beat faster and make it to retain salt and water. HF is different from a heart attack and cardiac arrest. A heart attack happens when blood flow is blocked, usually by a blood clot plaque buildup in the arteries. The causes heart muscle to begin to die, necessitating a heart surgery to address the blockage and restore normal blood flow. Likewise, a cardiac arrest occurs when the heartbeat stops and needs to be restarted. Essentially, heart failure is a chronic condition requiring long term heart attack, a blood circulation issue while a cardiac arrest is an electrical problem resulting from heart arrhythmia.
Population Demographics and Health Concerns
As Gresia, Wright & Li (2017), heart disease and stroke accounted for 24 % of all fatalities that were premature among New York City grownups. At the same time, the researchers found that 1 in every six deaths occurs among grownup s who are yet to celebrate their sixty-fifth birthday—increasing age starting at 45 years in men and 55 in women other risk factors that increase the risk of heart disease. Another HF is smoking, having diabetes, high cholesterol, and high blood pressure, being overweight, and exposure to high levels of air pollution. Living in top poverty neighborhoods also increases the risk of HF. Other risk factors include stress and non-modifiable factors like having a family history of heart disease, being of African American origin, and also gender. For example, the risk of dying prematurely of heart disease was twofold in very high neighborhoods than living in low areas. Many of these risk factors are, however, modifiable, which is why the PHFEP intervention is appropriate.
Role of Nursing Science, Health Determinants, and Epidemiologic, Genomic, and Genetic Data in Positively Influencing Population Health Management
Nursing science significantly impacts on the HF management among the 45 years and above adults, because it would address health disparities defined as variations in healthcare quality that are not caused by access-related factors or clinical needs, the suitability of the intervention or patient preferences(Graham, 2015). Furthermore, data on health determinants and epidemiological data would help to alleviate social determinants of health like poverty levels, decrease stress and promote physical exercises which go a long way in reducing and preventing complications from HF. Tayal, Prasad & Cook(2017) posit that advances in the genetics of dilated cardiomyopathy and genomics of heart failure have helped to discover common and rare variants of alleles that point to individual susceptibility to HF. Armed with this knowledge, healthcare professionals and patients to have insights on the pathogenesis of HF and act appropriately.
Overview of the Potential Solution
The author of this paper proposes the post-discharge HF education program (PHFEP) s the intervention approach that would if successfully implemented, lead to a decrease in the one-month hospital readmission rate among HF adults aged 45 years or more within New York State. The PHFEP will be led by nurses working in the outpatient department of an acute care clinical facility. The EBP program has recognized best practices embracing patient education as well as their families as a way to improve patient quality of life and decrease one-month hospital readmissions. The program will use Dorothea Orem’s self- care behaviors for adult HF patients. The PHFEP works on the assumption that there is a knowledge gap due to misinformation which acts as a barrier to effective management of HF. The patients’ will be recruited during their inpatient visit and upon discharge referred to the HF outpatient clinic. The patient education intervention will help get answers to the PICOT question stating ‘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)?’
How PHFEP Incorporates Health Policies and Goals That Support Health Care Equity for Adults Aged 45 Years and Above Living With HF
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In-hospital management of HF has key parameters for patient evaluation, which include the early phase, intermediate phase, and late phase management (Bakosis, Christofilis & Karavidas, 2017). A post-discharge follow-up plan for HF should consist of an education plan on self-assessment of monitoring of congestion, weight monitoring, dietary recommendations, and red flags, which should prompt a visit to the physician. Other components of the PHFEP include follow up appointments as well as recommended laboratory and additional assessments at regular intervals. These health policies are distilled in the four measures of HF. Namely, discharge instructions, left ventricular function assessment, a test of left ventricular systolic dysfunction (either angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEI) and cessation of smoking counseling.
Conclusion
In conclusion, this essay has identified heart disease mortality and morbidity indicator for the state of New York to identify heart failure as the clinical problem I wish to explore concerning the adult population aged 45 or more. The paper has also described how nursing science and health determinants, among other factors, may positively influence the management of population health of adults living with HF. It has also formulated a PICOT question and proposed PHFEP as the solution to reduce one-month hospital readmission rates.
References
Bakosis, G., Christofilis, I., & Karavidas, A. (2017). Treatment goals and discharge criteria for hospitalized patients with acute heart failure. Continuing Cardiology Education, 3(3), 100-106.
Centers for Disease Prevention and Control (2017) Stats of the State of New York, URL https://www.cdc.gov/nchs/pressroom/states/newyork/newyork.htm Accessed 05/12/2020.
Gai, Y., & Pachamanova, D. (2019). Impact of the Medicare hospital readmissions reduction program on vulnerable populations. BMC health services research, 19(1), 837.
Graham, G. (2015). Disparities in cardiovascular disease risk in the United States. Current cardiology reviews, 11(3), 238-245.
Gresia, V., Wright, M., & Li, W. (2017). Premature heart disease and stroke deaths among adults in New York City. New York City Department of Health and Mental Hygiene Epi Data Brief, 95.
Savarese, G., & Lund, L. H. (2017). The global public health burden of heart failure. Cardiac failure review, 3(1), 7.
Tayal, U., Prasad, S., & Cook, S. A. (2017). Genetics and genomics of dilated cardiomyopathy and systolic heart failure. Genome medicine, 9(1), 20.
Question/Paper Details
In this course, you will be complete a 2-part assignment in which you conduct research about a population of focus, develop a PICOT statement, and write a Literature Review. The PICOT statement and Literature Review you write in this course can be used for your evidence-based practice project in the next course so be sure to select an issue you want to continue working on in your next course.
PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting the population of focus. Additionally, the information derived from a good PICOT makes it easier to perform a literature search in order to find translational research sources that can be used to address the clinical problem.
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Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT and conduct research on the population.
Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen. Describe the population\’s demographics and health concerns, and explain how nursing science, health determinants, and epidemiologic, genomic, and genetic data may impact population health management for the selected population. Provide an overview of a potential solution for solving the health issue related to your population and the intended PICOT statement. Describe how the solution incorporates health policies and goals that support health care equity for the population of focus.
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.
