Question

Case Study: You are working as a clinician in a clinic that serves the indigent population. Many of the patients are 50 years old and older,  and have chronic congestive heart failure ( CHF). Your manager asked you for evidence-based resources to identify strategies to reduce frequent hospital readmissions. Answer each of the following:  1. Find an evidence-based article that focuses on strategies to reduce frequent hospital readmissions among patients 50 years and older, with chronic congestive heart failure. Reference your article at the end of your initial post. On time post.  .2.  From your article, what is your PICO ( PICOT,PICOTT) question? Identify your P-I-C-O-T.

At least 250-300 words

Answer 1

Evidence-based article that focuses on strategies to reduce frequent hospital readmissions among patients 50 years and older, with chronic congestive heart failure include- patient education, discharge planning, medication reconciliation, scheduling follow-up before discharge, communication with outpatient providers, and follow-up telephone calls. It is proven that combination of intevention is effective in reducing the hospital risk and not a single intervention alone is effective.Higher quality discharge summaries and timely transmission are associated with a lower risk of readmission for HF patients. Moreover,an early trial of a nurse-directed multidisciplinary intervention providing comprehensive education to the patient and family, medication review, and intensive follow-up reduced readmissions by 56.2% and also improved quality of life A meta-analysis of interventions for older HF patients found that comprehensive discharge planning with post-discharge support reduces HF readmissions and improved outcomes without increasing costs.

Studies shows that hospitals with higher nurse staffing ratios have a 41% decrease in  receiving Medicare penalties for excessive readmissions while controlling for case-mix and hospital characteritiscs.Hospitals with a greater proportion of patients receiving follow-up care within 7 days of discharge have a lower risk of 30-day mortality and readmission controlling for patient and hospital factors.

Boback Ziaeian^a,b and Gregg C. Fonarow^c,*The Prevention of Hospital Readmissions in Heart Failure oct21,2015

The PICOT question formt is used for  developing answerable, researchable questions.

• P: Population/patient - age, gender, ethnicity, individuals with a certain disorder

• I: Intervention/indicator (Variable of Interest) - exposure to a disease, risk behavior, prognostic factor

• C: Comparison/control - could be a placebo as in no disease, absence of risk factor, Prognostic factor B

• O: Outcome - risk of disease, accuracy of a diagnosis, rate of occurrence of adverse outcome

• T: Time - the time it takes for the intervention to achieve an outcome or how long participants are observed.

• Preventive PICOT question

• what are the different strategies to reduce frequent hospital readmissions among patients 50 years and older, with chronic congestive heart failure.

• Here P [ population ] - 50 year old patient with chronic congestive heart failure ( CHF)

• an evidence-based article that focuses on strategies to reduce frequent hospital readmissions - outcome