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• W137382768 abstract "Steps to Reducing Heart Failure Hospital Readmissions Through Improvement in Outpatient Care by Patricia Dunn MSN, ARNP, University of Central Florida, 1999 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2015 Abstract The outpatient care of the heart failure (HF) patient is fragmented due to lack of evidence-based practice guidelines use. The primary goal of this project was to improve the care of the HF patient in the outpatient arena through use of clinical pathways using the logic model as the project framework. The intervention was carried out over a 4-week period on a convenience, random sample of patients (n = 80) attending a cardiology practice. The patients were recruited from 2 physicians’ patient populations and selected based on an adult diagnosis of HF, reduced ejection fraction of <40% at some point in time, and a New York Heart Association (NYHA) functional class II-V. Comparisons were made in the documentation of care between patients on or off the pathway. The intervention included documentation of patient education, care follow-up, medications, NYHA class, and symptom exacerbation, documented in the electronic medical record. The quality of care data were evaluated based on 3 of the Joint Commission core measures for outpatient care of the HF patient. Additional data were collected regarding use of the clinical pathway based on provider and week of implementation. Data were analyzed via a Chi-square test of independence comparing pathway use by provider and use of pathway as study progressed. The comparative results show statistically significant differences in use of the pathway by provider and a statistically significant increase in use during the project. The quality of care results varied in statistical significance. The pathway utilization increased over time and provided a method for standardizing documentation of care for the HF patient in this outpatient clinic, a benefit for HF patients and providers in this cardiology practice and beyond.The outpatient care of the heart failure (HF) patient is fragmented due to lack of evidence-based practice guidelines use. The primary goal of this project was to improve the care of the HF patient in the outpatient arena through use of clinical pathways using the logic model as the project framework. The intervention was carried out over a 4-week period on a convenience, random sample of patients (n = 80) attending a cardiology practice. The patients were recruited from 2 physicians’ patient populations and selected based on an adult diagnosis of HF, reduced ejection fraction of <40% at some point in time, and a New York Heart Association (NYHA) functional class II-V. Comparisons were made in the documentation of care between patients on or off the pathway. The intervention included documentation of patient education, care follow-up, medications, NYHA class, and symptom exacerbation, documented in the electronic medical record. The quality of care data were evaluated based on 3 of the Joint Commission core measures for outpatient care of the HF patient. Additional data were collected regarding use of the clinical pathway based on provider and week of implementation. Data were analyzed via a Chi-square test of independence comparing pathway use by provider and use of pathway as study progressed. The comparative results show statistically significant differences in use of the pathway by provider and a statistically significant increase in use during the project. The quality of care results varied in statistical significance. The pathway utilization increased over time and provided a method for standardizing documentation of care for the HF patient in this outpatient clinic, a benefit for HF patients and providers in this cardiology practice and beyond. Steps to Reducing Heart Failure Hospital Readmissions Through Improvement in Outpatient Care by Patricia Dunn MSN, ARNP, University of Central Florida, 1999 Project Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Nursing Practice Walden University February 2015 Acknowledgments I would like to thank the faculty at the Walden University School of Nursing for providing the opportunity for an excellent educational growth experience. I would especially thank Dr. Catherine Harris, PhD for her exceptional patience, mentoring, and responsiveness throughout this project. I would also extend my appreciation to Dr. Robert McWhirt, DNP for his positive encouragement and to the university research reviewer, Dr. Oscar Lee for his assistance in this process. I am extremely grateful to Dr. Nancy Johnson, MD, FACC, FAHA for her clinical mentorship and support, which was so valuable to me throughout this program and project. Lastly, I thank my loving husband Keith and daughter Kelsie for their patience, tolerance, and sacrifice in order to help me pursue this goal. Without their continued support and encouragement, completion of this endeavor may not have been possible." @default.
• W137382768 created "2016-06-24" @default.
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• W137382768 date "2015-01-01" @default.
• W137382768 modified "2023-09-27" @default.
• W137382768 title "Steps to Reducing Heart Failure Hospital Readmissions Through Improvement in Outpatient Care" @default.
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