Reducing Polypharmacy and ACB Scores - A Multi-Faceted Approach for Improved Patient Outcomes.pdf
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The AHSN Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications. Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely. To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Mind over bladder - Prevent harm associated with excessive or inappropriate anticholinergic burden, can be viewed here. For more information about the polypharmacy programme, please visit https://www.ahsnnetwork.com/programmes/medicines/polypharmacy/
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Reducing Problematic Polypharmacy in Haringey Care Homes.pdf
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Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Reducing Problematic Polypharmacy in Haringey Care Homes, can be viewed here.
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Professor Judith H. Hibbard, Professor of Health Policy, University of Oregon talks about increasing patient activation to improve outcomes and reduce costs at The King's Fund Annual Conference.
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To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Reducing Problematic Polypharmacy in Haringey Care Homes, can be viewed here.
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Evidence-Based Practices & NursingIntroduction Normally,.docx
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Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
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By: Michael Blank1122020 A mindfulness-based intervention to increase resilie
1/12/2020 A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomi…
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813792/?report=printable 1/21
Lancet Public Health. 2018 Feb; 3(2): e72–e81.
Published online 2017 Dec 19.
doi: 10.1016/S2468-2667(17)30231-1: 10.1016/S2468-2667(17)30231-1
PMCID: PMC5813792
EMSID: EMS75520
PMID: 29422189
A mindfulness-based intervention to increase resilience to stress in
university students (the Mindful Student Study): a pragmatic
randomised controlled trial
Julieta Galante, PhD, Géraldine Dufour, MA, Maris Vainre, MA, Adam P Wagner, PhD, Jan Stochl,
PhD, Alice Benton, MSc, Neal Lathia, PhD, Emma Howarth, PhD, and Peter B Jones, Prof, PhD
Department of Psychiatry, University of Cambridge, Cambridge, UK
University Counselling Service, University of Cambridge, Cambridge, UK
Educational and Student Policy, Academic Division, University of Cambridge, Cambridge, UK
National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of
England, Cambridge, UK
British Association for Counselling and Psychotherapy: Universities and Colleges Division, Leicestershire, UK
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
Department of Computer Science, University College London, London, UK
Julieta Galante: [email protected]
Correspondence to: Dr Julieta Galante, Department of Psychiatry, University of Cambridge, Douglas House,
Cambridge CB2 8AH, UKCorrespondence to: Dr Julieta Galante, Department of PsychiatryUniversity of
CambridgeDouglas HouseCambridgeCB2 8AHUK [email protected]
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0
license
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Summary
Background
The rising number of young people going to university has led to concerns about an increasing demand for
student mental health services. We aimed to assess whether provision of mindfulness courses to university
students would improve their resilience to stress.
Methods
We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18
years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via
remote survey software using computer-generated random numbers, to receive either an 8 week
mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental
health support as usual, or mental health support as usual alone. Participants and the study management
team were aware of group allocation, but allocation was concealed from the researchers, outcome
assessors, and study statistician. The primary outcome was self-reported psychological distress during the
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...
1122020 A mindfulness-based intervention to increase resilie
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813792/?report=printable 1/21
Lancet Public Health. 2018 Feb; 3(2): e72–e81.
Published online 2017 Dec 19.
doi: 10.1016/S2468-2667(17)30231-1: 10.1016/S2468-2667(17)30231-1
PMCID: PMC5813792
EMSID: EMS75520
PMID: 29422189
A mindfulness-based intervention to increase resilience to stress in
university students (the Mindful Student Study): a pragmatic
randomised controlled trial
Julieta Galante, PhD, Géraldine Dufour, MA, Maris Vainre, MA, Adam P Wagner, PhD, Jan Stochl,
PhD, Alice Benton, MSc, Neal Lathia, PhD, Emma Howarth, PhD, and Peter B Jones, Prof, PhD
Department of Psychiatry, University of Cambridge, Cambridge, UK
University Counselling Service, University of Cambridge, Cambridge, UK
Educational and Student Policy, Academic Division, University of Cambridge, Cambridge, UK
National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of
England, Cambridge, UK
British Association for Counselling and Psychotherapy: Universities and Colleges Division, Leicestershire, UK
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
Department of Computer Science, University College London, London, UK
Julieta Galante: [email protected]
Correspondence to: Dr Julieta Galante, Department of Psychiatry, University of Cambridge, Douglas House,
Cambridge CB2 8AH, UKCorrespondence to: Dr Julieta Galante, Department of PsychiatryUniversity of
CambridgeDouglas HouseCambridgeCB2 8AHUK [email protected]
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0
license
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Summary
Background
The rising number of young people going to university has led to concerns about an increasing demand for
student mental health services. We aimed to assess whether provision of mindfulness courses to university
students would improve their resilience to stress.
Methods
We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18
years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via
remote survey software using computer-generated random numbers, to receive either an 8 week
mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental
health support as usual, or mental health support as usual alone. Participants and the study management
team were aware of group allocation, but allocation was concealed from the researchers, outcome
assessors, and study statistician. The primary outcome was self-reported psychological distress during the
S � � � �� � � � D � � � � � � � � �� �
T�� L�����. P�����
H�����
...
Effects of Community-Based Health WorkerInterventions to Imp.docx
Effects of Community-Based Health Worker
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Populations: A Systematic Review
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Frank R. Lin, MD, PhD, Laura N. Gitlin, PhD, and Hae-Ra Han, RN, PhD
Background. Community-based health workers (CBHWs) are frontline
public health workers who are trusted members of the community they
serve. Recently, considerable attention has been drawn to CBHWs in pro-
moting healthy behaviors and health outcomes among vulnerable pop-
ulations who often face health inequities.
Objectives. We performed a systematic review to synthesize evidence
concerning the types of CBHW interventions, the qualification and
characteristics of CBHWs, and patient outcomes and cost-effectiveness
of such interventions in vulnerable populations with chronic, non-
communicable conditions.
Search methods. We undertook 4 electronic database searches—PubMed,
EMBASE, Cumulative Index to Nursing and Allied Health Literature, and
Cochrane—and hand searched reference collections to identify randomized
controlled trials published in English before August 2014.
Selection. We screened a total of 934 unique citations initially for titles
and abstracts. Two reviewers then independently evaluated 166 full-
text articles that were passed onto review processes. Sixty-one studies
and 6 companion articles (e.g., cost-effectiveness analysis) met eligi-
bility criteria for inclusion.
Data collection and analysis. Four trained research assistants extracted
data by using a standardized data extraction form developed by the
authors. Subsequently, an independent research assistant reviewed
extracted data to check accuracy. Discrepancies were resolved through
discussions among the study team members. Each study was evaluated
for its quality by 2 research assistants who extracted relevant study
information. Interrater agreement rates ranged from 61% to 91% (av-
erage 86%). Any discrepancies in terms of quality rating were resolved
through team discussions.
Main results. All but 4 studies were conducted in the United States.
The 2 most common areas for CBHW interventions were cancer pre-
vention (n = 30) and cardiovascular disease risk reduction (n = 26). The
roles assumed by CBHWs included health education (n = 48), counseling
(n = 36), navigation assistance (n = 21), case management (n = 4), social
services (n = 7), and social support (n = 18). Fifty-three studies provided
information regarding CBHW training, yet CBHW competency evalua-
tion (n = 9) and supervision procedures (n = 24) were largely under-
reported. The length and duration of CBHW training ranged from 4
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Running head MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO .docx
Running head: MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO 2
MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO 8
Managing Congestive Heart Failure through Motivational Education
Rosaline Hicks
Chamberlain University
Dr. Sheryl Cator
March 26, 2020
The purpose of this paper is to discuss how motivation can improve outcomes in congestive heart failure (CHF). CHF is a chronic progressive condition that affects the pumping ability of the heart muscles. This paper will cover CHF as a practice problem, the role of evidence to in regard to CHF, and the role of the DNP practice scholar in the translation of evidence.
Addressing issues related to CHF management through education program is important in the improvement of self-management. Most of the reported readmission cases, morbidity, and mortality are associated with poor self-care and self-management of the diseases. The focus of most healthcare facilities when it comes to the management of the CHF is focused on an identified medication regimen, and little to no attention is given to the importance of patient education to improve self-management of CHF.
A study by Bader et al (2018) revealed that an advanced heart failure program helped in the improvement of disease awareness and self-care behaviors when the patients were led by well-trained heart failure nurses. Another study by Howie-Esquivel et al (2015) used the approach of TEACH-HF intervention to manage CHF patients. The study outcome revealed a significantly lower hospital re-admission rate and decrease in the length of stay.
DNP practice scholar play a key role in the translation of evidence. The DNP practice scholar is instrumental in the initiation of projects that focus on the standardized educational process for CHF patients. The initiation is done through the development of new education tools and clinician documentation of evidence-based heart failure care (Myslenski, 2018). Practice Problem and Question
Patient education is becoming an effective process of managing CHF at home. Patient education aids in the improvement of knowledge and self-care behaviors, thereby, reducing the incidence of readmissions cases (Bader, et al., 2018).
Heart failure is a common, high-risk condition that is characterized with high reports hospitalization and sometimes death. This disease affects more than 6.5 million Americans and in 2012 the CDC reported that it cost approximately 30.7 billion dollars to care for CHF patients and wages lost due to hospitalization. Unlike other cardiovascular illnesses, CHF appears to be the most common one and nearly 1 million new cases are being reported annually internationally. This, therefore, makes it the fastest growing cardiovascular disorder (Savarese & Lund, 2017).
This study is guided by the following Picot question: Does the multidisciplinary educational approach work effectively towards the prevention of hospital re-admission for patients diagnosed with congestive heart ...
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Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely.
To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Reducing opioid prescribing, can be viewed here.
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To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Pharmacist Interventions and Medication Reviews at Care Homes - Improving Medication Safety and Patient Outcomes, can be viewed here.
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Discusses how psychosocial care for cancer patients needs to be reorganized so that a broader range of cancer patients are served. Routine screening for distress is unlikely to be an efficient means of countering tendencies of cancer care more generally becoming more organized around time efficiency and billable procedures. Psychosocial care for many cancer patients involves discussions, negotiations, and care coordination they cannot be well fit into the idea of a counseling session. The unsung heroes of providing such care are underappreciated social workers and oncology nurses.
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Evidence-Based Practices & NursingIntroduction Normally,.docx
Evidence-Based Practices & Nursing
Introduction
Normally, PICOT format is helpful in formulation of questions in an evidenced based clinical practice. PICOT generated questions generally fall under for main categories of clinical practices. These include; therapy, prevention, diagnosis, etiology as well as Prognosis. The essential elements in PICOT questions. The PICOT format is valuable in addressing research questions comprehensively. Five elements are normally addressed including; population, intervention, comparison, outcome and time as well (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Summary of Case Study
The ever increasingly high incidence of breast cancer conditions has posed serious challenges in the nursing profession. Provision of appropriate healthcare to the cancer patients has been lacking leading to adverse effects of the proliferation of cancerous cells which further worsen the conditions of the patients. As primary care, clinicians have the responsibility to stressing providing healthcare services within healthcare facilities as well as monitoring treatment in home based facilities to help manage cancer condition. Most cancer patient need clinicians who practice evidence-based clinical practices (Riva, Malik, Burnie, Endicott, & Busse, 2012).
Research Question
In cancer patients receiving chemotherapy, will they have better white blood cell count monitoring with a follow-up at home versus follow-up at a health care facility during their treatment?
PICOT Format
1) P-Population: Patients aged 18-60 years-old, breast cancer who have not received chemotherapy in the past six months are subjected to the treatment. Patients with other serious health conditions such as heart diseases were excluded in the study. 30 patients, with 15patients stationed at the healthcare facility while the other 15 patients receiving home-based care, are expected to take part in the study.
2) I -Intervention: The patients will receive dosage based on the age, sex and health general body health as well as the stage of cancer cells proliferation in the body. The patients are required take the prescribed drugs at regular intervals. The subjects will be subjected to treatment under the same during the research study.
3) C-Comparison: All the subject regardless of variations in their level of dose requirement will be subjected to the same treatment for the same duration, 3months. Standardized treatment will be given to subjects with no extreme variations in their level of dose requirement and would be used as an active control group. Using this strategy, it will be possible to minimize the non-specific effects due to a group of the patient receiving treatment within the healthcare.
4) O-Outcome: The response in chemotherapy treatments will be check by examining the numbers of defective cancerous cells in the body tissues. The patients will report to the theatre in order to be examined by an oncologist. The results will be recorded i ...
Path a Manualized Program for HIV Prevention with Persons with Mental Illness...
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By: Michael Blank1122020 A mindfulness-based intervention to increase resilie
1/12/2020 A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomi…
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813792/?report=printable 1/21
Lancet Public Health. 2018 Feb; 3(2): e72–e81.
Published online 2017 Dec 19.
doi: 10.1016/S2468-2667(17)30231-1: 10.1016/S2468-2667(17)30231-1
PMCID: PMC5813792
EMSID: EMS75520
PMID: 29422189
A mindfulness-based intervention to increase resilience to stress in
university students (the Mindful Student Study): a pragmatic
randomised controlled trial
Julieta Galante, PhD, Géraldine Dufour, MA, Maris Vainre, MA, Adam P Wagner, PhD, Jan Stochl,
PhD, Alice Benton, MSc, Neal Lathia, PhD, Emma Howarth, PhD, and Peter B Jones, Prof, PhD
Department of Psychiatry, University of Cambridge, Cambridge, UK
University Counselling Service, University of Cambridge, Cambridge, UK
Educational and Student Policy, Academic Division, University of Cambridge, Cambridge, UK
National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of
England, Cambridge, UK
British Association for Counselling and Psychotherapy: Universities and Colleges Division, Leicestershire, UK
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
Department of Computer Science, University College London, London, UK
Julieta Galante: [email protected]
Correspondence to: Dr Julieta Galante, Department of Psychiatry, University of Cambridge, Douglas House,
Cambridge CB2 8AH, UKCorrespondence to: Dr Julieta Galante, Department of PsychiatryUniversity of
CambridgeDouglas HouseCambridgeCB2 8AHUK [email protected]
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0
license
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Summary
Background
The rising number of young people going to university has led to concerns about an increasing demand for
student mental health services. We aimed to assess whether provision of mindfulness courses to university
students would improve their resilience to stress.
Methods
We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18
years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via
remote survey software using computer-generated random numbers, to receive either an 8 week
mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental
health support as usual, or mental health support as usual alone. Participants and the study management
team were aware of group allocation, but allocation was concealed from the researchers, outcome
assessors, and study statistician. The primary outcome was self-reported psychological distress during the
S � � � �� � � � D � � � � � � � � �� �
T�� L�����. P�����
H�����
...
1122020 A mindfulness-based intervention to increase resilie
1/12/2020 A mindfulness-based intervention to increase resilience to stress in university students (the Mindful Student Study): a pragmatic randomi…
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5813792/?report=printable 1/21
Lancet Public Health. 2018 Feb; 3(2): e72–e81.
Published online 2017 Dec 19.
doi: 10.1016/S2468-2667(17)30231-1: 10.1016/S2468-2667(17)30231-1
PMCID: PMC5813792
EMSID: EMS75520
PMID: 29422189
A mindfulness-based intervention to increase resilience to stress in
university students (the Mindful Student Study): a pragmatic
randomised controlled trial
Julieta Galante, PhD, Géraldine Dufour, MA, Maris Vainre, MA, Adam P Wagner, PhD, Jan Stochl,
PhD, Alice Benton, MSc, Neal Lathia, PhD, Emma Howarth, PhD, and Peter B Jones, Prof, PhD
Department of Psychiatry, University of Cambridge, Cambridge, UK
University Counselling Service, University of Cambridge, Cambridge, UK
Educational and Student Policy, Academic Division, University of Cambridge, Cambridge, UK
National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care East of
England, Cambridge, UK
British Association for Counselling and Psychotherapy: Universities and Colleges Division, Leicestershire, UK
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK
Department of Computer Science, University College London, London, UK
Julieta Galante: [email protected]
Correspondence to: Dr Julieta Galante, Department of Psychiatry, University of Cambridge, Douglas House,
Cambridge CB2 8AH, UKCorrespondence to: Dr Julieta Galante, Department of PsychiatryUniversity of
CambridgeDouglas HouseCambridgeCB2 8AHUK [email protected]
Copyright © 2018 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0
license
This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Summary
Background
The rising number of young people going to university has led to concerns about an increasing demand for
student mental health services. We aimed to assess whether provision of mindfulness courses to university
students would improve their resilience to stress.
Methods
We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18
years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via
remote survey software using computer-generated random numbers, to receive either an 8 week
mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental
health support as usual, or mental health support as usual alone. Participants and the study management
team were aware of group allocation, but allocation was concealed from the researchers, outcome
assessors, and study statistician. The primary outcome was self-reported psychological distress during the
S � � � �� � � � D � � � � � � � � �� �
T�� L�����. P�����
H�����
...
Effects of Community-Based Health WorkerInterventions to Imp.docx
Effects of Community-Based Health Worker
Interventions to Improve Chronic Disease
Management and Care Among Vulnerable
Populations: A Systematic Review
Kyounghae Kim, RN, MSN, Janet S. Choi, MPH, Eunsuk Choi, RN, PhD, MPH, Carrie L. Nieman, MD, MPH, Jin Hui Joo, MD, MA,
Frank R. Lin, MD, PhD, Laura N. Gitlin, PhD, and Hae-Ra Han, RN, PhD
Background. Community-based health workers (CBHWs) are frontline
public health workers who are trusted members of the community they
serve. Recently, considerable attention has been drawn to CBHWs in pro-
moting healthy behaviors and health outcomes among vulnerable pop-
ulations who often face health inequities.
Objectives. We performed a systematic review to synthesize evidence
concerning the types of CBHW interventions, the qualification and
characteristics of CBHWs, and patient outcomes and cost-effectiveness
of such interventions in vulnerable populations with chronic, non-
communicable conditions.
Search methods. We undertook 4 electronic database searches—PubMed,
EMBASE, Cumulative Index to Nursing and Allied Health Literature, and
Cochrane—and hand searched reference collections to identify randomized
controlled trials published in English before August 2014.
Selection. We screened a total of 934 unique citations initially for titles
and abstracts. Two reviewers then independently evaluated 166 full-
text articles that were passed onto review processes. Sixty-one studies
and 6 companion articles (e.g., cost-effectiveness analysis) met eligi-
bility criteria for inclusion.
Data collection and analysis. Four trained research assistants extracted
data by using a standardized data extraction form developed by the
authors. Subsequently, an independent research assistant reviewed
extracted data to check accuracy. Discrepancies were resolved through
discussions among the study team members. Each study was evaluated
for its quality by 2 research assistants who extracted relevant study
information. Interrater agreement rates ranged from 61% to 91% (av-
erage 86%). Any discrepancies in terms of quality rating were resolved
through team discussions.
Main results. All but 4 studies were conducted in the United States.
The 2 most common areas for CBHW interventions were cancer pre-
vention (n = 30) and cardiovascular disease risk reduction (n = 26). The
roles assumed by CBHWs included health education (n = 48), counseling
(n = 36), navigation assistance (n = 21), case management (n = 4), social
services (n = 7), and social support (n = 18). Fifty-three studies provided
information regarding CBHW training, yet CBHW competency evalua-
tion (n = 9) and supervision procedures (n = 24) were largely under-
reported. The length and duration of CBHW training ranged from 4
hours to 240 hours with an average of 41.3 hours (median: 16.5 hours) in
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Running head MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO .docx
Running head: MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO 2
MANAGEMENT OF CONGESTIVE HEART FAILURE THROUGH MO 8
Managing Congestive Heart Failure through Motivational Education
Rosaline Hicks
Chamberlain University
Dr. Sheryl Cator
March 26, 2020
The purpose of this paper is to discuss how motivation can improve outcomes in congestive heart failure (CHF). CHF is a chronic progressive condition that affects the pumping ability of the heart muscles. This paper will cover CHF as a practice problem, the role of evidence to in regard to CHF, and the role of the DNP practice scholar in the translation of evidence.
Addressing issues related to CHF management through education program is important in the improvement of self-management. Most of the reported readmission cases, morbidity, and mortality are associated with poor self-care and self-management of the diseases. The focus of most healthcare facilities when it comes to the management of the CHF is focused on an identified medication regimen, and little to no attention is given to the importance of patient education to improve self-management of CHF.
A study by Bader et al (2018) revealed that an advanced heart failure program helped in the improvement of disease awareness and self-care behaviors when the patients were led by well-trained heart failure nurses. Another study by Howie-Esquivel et al (2015) used the approach of TEACH-HF intervention to manage CHF patients. The study outcome revealed a significantly lower hospital re-admission rate and decrease in the length of stay.
DNP practice scholar play a key role in the translation of evidence. The DNP practice scholar is instrumental in the initiation of projects that focus on the standardized educational process for CHF patients. The initiation is done through the development of new education tools and clinician documentation of evidence-based heart failure care (Myslenski, 2018). Practice Problem and Question
Patient education is becoming an effective process of managing CHF at home. Patient education aids in the improvement of knowledge and self-care behaviors, thereby, reducing the incidence of readmissions cases (Bader, et al., 2018).
Heart failure is a common, high-risk condition that is characterized with high reports hospitalization and sometimes death. This disease affects more than 6.5 million Americans and in 2012 the CDC reported that it cost approximately 30.7 billion dollars to care for CHF patients and wages lost due to hospitalization. Unlike other cardiovascular illnesses, CHF appears to be the most common one and nearly 1 million new cases are being reported annually internationally. This, therefore, makes it the fastest growing cardiovascular disorder (Savarese & Lund, 2017).
This study is guided by the following Picot question: Does the multidisciplinary educational approach work effectively towards the prevention of hospital re-admission for patients diagnosed with congestive heart ...
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- 1. Reducing Polypharmacy and ACB Scores: A Multi-Faceted Approach for Improved Patient Outcomes Maria Gilbert • References: 1. Salahudeen, M. S., Duffull, S. B., & Nishtala, P. S. (2015). Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC geriatrics, 15, 31. 2. Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is polypharmacy? A systematic review of definitions. BMC geriatrics, 17(1), 230. 3. Dhalwani, N. N., Fahami, R., Sathanapally, H., Seidu, S., Davies, M. J., & Khunti, K. (2017). Association between polypharmacy and falls in older adults: a longitudinal study from England. BMJ Open, 7(10), e016358 What Went Well: 1.Data-Driven Approach: The utilisation of SystmOne to identify high-risk patients was effective. 2.Proactive Communication: The process of reaching out to patients via SMS or letter for scheduling SMRs seems to have worked well, leading to successful completion of numerous SMRs. 3.Educational Initiatives: Increasing clinician awareness about the risks of ACB medications likely contributed to safer prescribing practices. 4.Positive Initial Results: 15 patients saw their ACB scores decrease significantly. The absence of new high-risk patients in the recent monthly searches. What Could Have Gone Better: 1.Patient Reachability: Some patients did not have mobile numbers, indicating a possible gap in communication channels. 2.Ongoing Monitoring: Maintaining momentum is critical. It would be beneficial to develop strategies for ongoing patient engagement and continuous clinician education to ensure sustained improvements. Results: 1.Our initial search identified 50 patients Of these, 25 had not had an SMR in the preceding 12 months. 2.Contact was established with all 25 patients. 3.24 SMRs were conducted. 4.15 patients saw their ACB scores decrease from >5 to below 3. 5.Clinician awareness regarding ACB risks improved, evidenced by no new high-risk patients identified in the monthly searches over the last two months. Conclusions: We demonstrated that a systematic, multi-faceted approach to managing polypharmacy and high ACB scores can yield significant improvements in both patient safety and clinician awareness. Regular monitoring, proactive patient communication, and clinician education have proven to be effective strategies. This process ensured a proactive and comprehensive approach towards tackling polypharmacy and high ACB scores in our patient population. As we moved through the steps, we kept patient health outcomes and clinician awareness at the forefront of our efforts. Background & Actions Tackling Polypharmacy & High ACB Scores: In the face of escalating polypharmacy and high Anticholinergic Cognitive Burden (ACB) scores among patients1,2,3, we launched a quality improvement initiative designed to mitigate these risks. Through these targeted strategies, we are making strides in addressing polypharmacy and high ACB scores, aiming for safer patient outcomes and more informed prescribing practices. 0 10 20 30 40 50 60 Initial Patients Without SMR in last 12/12 Contact Established SMRs Conducted ACB Score Decreased Number of Patients