scholarly journals Nurses' Knowledge Related to Heart Failure Essentials

2014 ◽  
Author(s):  
Ann Garris
Keyword(s):  
Heart Failure ◽  
Acute Care ◽  
Care Setting ◽  
Hospital Admissions ◽  
Educational Interventions ◽  
The United States ◽  
Experimental Program ◽  
Acute Care Setting ◽  
Post Test ◽  
Nurses Knowledge

<p>Heart Failure is a complex syndrome which continues to be a major health issue in the United States and worldwide. Strategies and educational interventions implemented by hospitals to reduce hospital admissions and readmissions for this costly chronic disease have not been consistently successful. Patient education is an important strategy for the management of HF to improve quality of life, optimize patient outcomes, and reduce the use of healthcare resources by reducing readmissions. The purpose of this program development was to increase nurses’ knowledge regarding HF education to be provided to HF patients prior to discharge from the acute care setting. A quasi-experimental program design with a pre and post-test intervention was performed on a 38 bed medical telemetry unit at RI Hospital a Level 1 trauma center in Providence, RI. Registered nurses were asked to complete a pre and post-test survey, <em>Nurse Knowledge of Heart Failure </em>by Albert et al (2002). Nine RNs out of thirty two (28.8%) agreed to participate and completed the pre-test, attended one of the HF education classes followed by completion of the post-test. Pre-tests scores ranged from 60-90 out of possible 100, with a mean score of 73.3%. Post-test scores ranged from 70-95 out of possible 100, with a mean score of 86.1%, an increase of almost 13%. These findings suggest that providing HF education can be successful in increasing nurses’ knowledge regarding HF education provided to HF patients prior to discharge from the acute care setting.</p>

scholarly journals Disparity in the Setting of Incident Heart Failure Diagnosis

2021 ◽  
Author(s):  
Alexander T. Sandhu ◽  
Rebecca L. Tisdale ◽  
Fatima Rodriguez ◽  
Randall S. Stafford ◽  
David J. Maron ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Care ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Care Setting ◽  
Patient Characteristics ◽  
Outpatient Setting ◽  
Acute Care Setting ◽  
Diagnostic Codes ◽  
Black Patients

Background: Early heart failure (HF) recognition can reduce morbidity, yet HF is often initially diagnosed only after a patient clinically worsens. We sought to identify characteristics that predict diagnosis in the acute care setting versus the outpatient setting. Methods: We estimated the proportion of incident HF diagnosed in the acute care setting (inpatient hospital or emergency department) versus outpatient setting based on diagnostic codes from a claims database covering commercial insurance and Medicare Advantage between 2003 and 2019. After excluding new-onset HF potentially caused by a concurrent acute cause (eg, acute myocardial infarction), we identified demographic, clinical, and socioeconomic predictors of diagnosis setting. Patients were linked to their primary care clinicians to evaluate diagnosis setting variation across clinicians. Results: Of 959 438 patients with new HF, 38% were diagnosed in acute care. Of these, 46% had potential HF symptoms in the prior 6 months. Over time, the relative odds of acute care diagnosis increased by 3.2% annually after adjustment for patient characteristics (95% CI, 3.1%–3.3%). Acute care diagnosis setting was more likely for women compared with men (adjusted odds ratio, 1.11 [95% CI, 1.10–1.12]) and for Black patients compared with White patients (adjusted odds ratio, 1.18 [95% CI, 1.16–1.19]). The proportion of acute care diagnosis varied substantially (interquartile range: 24%–39%) among clinicians after adjusting for patient-level risk factors. Conclusions: A large proportion of first HF diagnoses occur in the acute care setting, particularly among women and Black patients, yet many had potential HF symptoms in the months before acute care visits. These results raise concerns that many HF diagnoses are missed in the outpatient setting. Earlier diagnosis could allow for timelier high-value interventions, addressing disparities and reducing the progression of HF.

scholarly journals Nurses' Knowledge of Hypoglycemia and Treatment in the Adult Hospitalized Patiend with Diabetes: A Quality Improvement Project

2017 ◽  
Author(s):  
Brittney O'Neale
Keyword(s):  
Quality Improvement ◽  
Test Scores ◽  
Educational Program ◽  
Care Setting ◽  
Diabetic Patients ◽  
Acute Care Setting ◽  
Improvement Project ◽  
Post Test ◽  
Hospital Protocols ◽  
Nurses Knowledge

<p>There are currently more than 29 million people in the United States with diabetes. With increasing numbers of diabetic patients across the nation, it is imperative that health care professionals receive the knowledge and skills required to manage them in the acute care setting. Hypoglycemia is the most common side effect of diabetes treatment (Borzi et al., 2016) and is defined by the American Diabetes Association (ADA) as a condition that occurs when one's blood glucose is lower than normal, usually less than 70 mg/dl. Nurses’ knowledge of hypoglycemia and their adherence to hospital protocols are essential to achieving positive patient outcomes. Research demonstrates that nurses in the acute care setting are not receiving consistent formal training on the care of adult diabetic patients and sometimes fail treat the patient according to evidence based hospital protocols. The purpose of this quality improvement project was to increase nurses’ knowledge of hypoglycemia and treatment in the adult hospitalized patient with diabetes. The project design was a pre-test, educational program and post-test on two medical-surgical units in a small community hospital in Rhode Island. Seventeen nurses completed the pre-test component (N=17, 22%) and eighteen nurses (N=18, 23%) attended the educational program and completed the post-test. Pre-test scores ranged from 11 to 94 out of a possible 100, with a mean score of 59.8%. Post-test scores ranged from 27 to 100, with a mean score of 76.5%. The average of post-test scores increased by about 16.7%. These findings suggest that providing hypoglycemia education can be successful in increasing nurses’ knowledge of hypoglycemia treatment and management in the adult hospitalized patient with diabetes.</p>

Introduction to Complementary, Alternative, and Traditional Therapies

2014 ◽  
Vol 34 (6) ◽  
pp. 50-56 ◽  
Author(s):  
Debra Kramlich
Keyword(s):  
United States ◽  
Critical Care ◽  
Acute Care ◽  
Care Setting ◽  
The United States ◽  
Critical Care Nurses ◽  
Acute Care Setting ◽  
Traditional Therapies

The use of complementary, alternative, and traditional therapies is increasing in the United States, and patients and their families are bringing these practices into the acute care setting. Acute and critical care nurses are in a unique and trusted position to advocate for their patients and to promote safe incorporation of complementary, alternative, and traditional therapies into the plan of care.

scholarly journals The diagnostic accuracy of the natriuretic peptides in heart failure: systematic review and diagnostic meta-analysis in the acute care setting

BMJ ◽  
2015 ◽  
Vol 350 (mar04 22) ◽  
pp. h910-h910 ◽  
Author(s):  
E. Roberts ◽  
A. J. Ludman ◽  
K. Dworzynski ◽  
A. Al-Mohammad ◽  
M. R. Cowie ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Acute Care ◽  
Natriuretic Peptides ◽  
Care Setting ◽  
Meta Analysis ◽  
Acute Care Setting

scholarly journals Evaluation of Unit Equivalency of Insulin Glargine to Insulin Detemir in an Acute Care Setting

2018 ◽  
Vol 34 (6) ◽  
pp. 239-243
Author(s):  
Elizabeth A. Cook ◽  
Taylor Gill ◽  
Scott Taylor
Keyword(s):  
Blood Glucose ◽  
Insulin Glargine ◽  
Acute Care ◽  
Insulin Detemir ◽  
Care Setting ◽  
Fasting Blood Glucose ◽  
The United States ◽  
Acute Care Setting ◽  
Glucose Lowering ◽  
Significant Difference

Background: Insulin glargine and insulin detemir are the most commonly prescribed basal insulins in the United States. While these analogs chemically differ, clinical trials have established no significant difference in efficacy. However, controversy remains as to whether the 2 agents are comparable with regard to unit equivalency. Objectives: To determine the ratio of glucose lowering between insulin detemir and insulin glargine. Methods: This institutional review board-approved, single-center, retrospective, case-crossover study was conducted in patients with diabetes mellitus with inpatient admissions between June 30, 2014, to July 1, 2015. Patients must have received both insulin detemir and insulin glargine on either the same or separate hospital visits. A blood glucose–lowering ratio for both insulin glargine and insulin detemir was calculated for each patient based off of up to 5 days of fasting blood glucose values and the total number of units of insulin administered. Results: Fifty-two patients were included in this study. No significant difference was found in the blood glucose–lowering ratio between insulin glargine (0.23 mg/dL/unit) as compared with insulin detemir (0.16 mg/dL/unit; P = .08). Conclusion: No difference was found in the blood glucose–lowering ratio between insulin glargine and insulin detemir. The results of this study suggest that conversion between insulin glargine and insulin detemir using a 1:1 ratio in an acute care setting may be appropriate.

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