Introduction
This assignment seeks to create a PICOT question on a topic of interest with a specific focus on its significance and the barriers and facilitators involved in implementing the practice proposed in the PICOT. Therefore, the topic chosen revolves around elderly patients with heart failure and why most of them end up being readmitted shortly after being discharged. More specifically, the paper will strive to provide a clear comparison between those patients who adequately adhere to discharge education and those who do not follow the same.
This topic is significant since the issue of readmission 30 days after discharge is increasingly becoming high with respect to heart failure patients. According to Rizzuto et al. (2022), the mean readmission rate for patients with heart failure is 21 percent at the national level. The authors further observed that “heart failure affects about 6.2 million adults in the United States and has an estimated national cost of $ 30 billion annually” (Rizzuto et al., 2022, p. 14). In essence, this issue demands prompt action due to the significant number of deaths linked to it.
PICOT Question
Will elderly patients with heart failure (P) who adequately comply with discharge education and related interventions (I), compared to those who hardly follow their discharge education (C), experience a decreased risk of hospital readmission (O) within 30 days (T)? The specific population being addressed in this PICOT question is elderly male patients aged 65 years and living in the U.S. Heart failure in this population is considered the leading cause of mortality and hospitalization. Without evidence-based practice, this population may fail to receive the highest quality care needed for timely discharge (Melnyk et al., 2009).
The primary intervention is discharge education, which, as explicated in the study of Seferovic et al. (2019), should be provided through effective and evidence-based strategies. In essence, discharge education is critical in improving self-care in patients diagnosed with heart failure. The main alternative is a lack of discharge education, regardless of whether the patient is given medication. More specifically, the alternative here is patients with a low level of knowledge and understanding of heart failure. In this case, the outcome is a reduced likelihood of being readmitted to the hospital within 30 days for those who comply with discharge education.
Facilitators and Barriers to Implementing the Practice
It is imperative to note that the practice, as evidenced in the PICOT question, relates to discharge education. It is clear that discharge education plays an essential role in readmission. However, the two common barriers to implementing this practice are a lack of self-care knowledge and heart failure-related emotions. Regarding the former, many patients, after being discharged, often lack knowledge about the condition, its etiology, and medications because of limited health literacy (Steiner et al., 2020).
On the latter, fear is a common emotion affecting their ability to independently follow discharge education. On the other hand, the two facilitators of implementing discharge education include adequate resources and well-designed strategies. First, resources for education include printed materials, physicians, and community outreach programs. Second, well-designed strategies are tailored to suit the patient’s interests, limitations, and learning style.
Conclusion
In conclusion, heart failure is increasingly becoming common, specifically among elderly patients aged 65 years and above. As evidenced above, most patients are readmitted 30 days after discharge. The critical issue is whether discharge education could help reduce the readmission rate within 30 days after discharge. Overall, heart failure, specifically in the U.S., requires immediate solutions because of the high number of deaths associated with it.
References
Melnyk, B. M., Fineout-Overholt, E., Stillwell, S. B., & Williamson, K. M. (2009). Igniting a spirit of inquiry: An essential foundation for evidence-based practice. American Journal of Nursing, 109(11), 49-52. Web.
Rizzuto, N., Charles, G., &Knobf, M. T. (2022). Decreasing 30-day readmission rates in patients with heart failure. Critical Care Nurse, 42(4), 13-19. Web.
Seferovic, P. M., Ponikowski, P., Anker, S. D., Bauersachs, J., Chioncel, O., Cleland, J. G., & Coats, A. J. (2019). Clinical practice update on heart failure 2019: Pharmacotherapy, procedures, devices and patient management. An expert consensus meeting report of the Heart Failure Association of the European Society of Cardiology. European Journal of Heart Failure, 21(10), 1169-1186. Web.
Steiner, J. M., Dhami, A., Brown, C. E., Stout, K. K., Curtis, J. R., Engelberg, R. A., & Kirkpatrick, J. N. (2020). Barriers and facilitators of palliative care and advance care planning in adults with congenital heart disease. The American Journal of Cardiology, 135, 128-134. Web.